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Tolling Points

Add Another Benefit to Tolling’s Long List: Public Health

Mitchell Beer

Guest blog by Mitchell Beer, Smarter Shift

To all the other accolades tolling agencies can lay claim to when they deliver safe, reliable mobility, it’s time to add a new one: Public health protector.

That’s the upshot of a research paper presented last month at a meeting of the American Economics Association, showing that children in Stockholm would have suffered 45% more asthma attacks if the city hadn’t introduced congestion pricing in 2006.

“When Stockholm started charging a fee for driving in the city center during rush hours, it reaped benefits far beyond uncrowded streets and speedy commutes,” the Inside Science blog reported last week, based on a study by economist Emilia Simeonova of Johns Hopkins University. “Many children who otherwise might have suffered asthma attacks were instead able to breathe easy.”

The Best-Ever Argument for Tolling

If you’ve ever had a child with asthma, this one is about as personal as it gets. If you’ve ever had to drop everything to rush your child to the emergency ward, then watched him or her struggle for breath for hours until the medication kicked in…from first-hand experience, the memory leaves you fighting back tears 20 years later.

When our then-two-year-old daughter had her first of many serious asthma attacks, we didn’t know what we were looking at. Once we realized we had a serious problem, we broke speed limits but no other traffic laws to get her to hospital, where we learned that her blood oxygen was dangerously low.

On the way to the ER, we saw our baby’s eyes rolling back in her head, her head lolling back in her car seat.

We gradually got her asthma under control. But it’s not something you ever forget. It’s the kind of problem you would do anything, pay anything, to prevent rather than having to solve.

And so, would your customers. You can bet that stories just like my Rachel’s are a sure route to public support for congestion pricing, managed lanes, or other forms of tolled capacity, with the right evidence connecting the dots between problem and solution.

Which brings us back to Stockholm, where Simeonova said congestion pricing made a vast difference, even though the city already enjoyed relatively clean air. "We are already looking at an area that has much lower (pollutant) levels than the current (U.S.) standards, and we are reducing those levels by a little bit," she said. "Yet we see these vast changes in the health status of children."

Major Health Benefits at $2.60 Per Trip

Stockholm’s congestion pricing zone uses an all-electronic tolling system to collect up to $2.60 per trip, depending on time of day. “Stockholm is the busiest and most polluted city in Sweden,” Inside Science reports. And without congestion pricing, “its air would have been five to 10% more polluted between 2006 and 2010, and young children would have suffered 45% more asthma attacks.”

Simeonova noted that the full benefit only became clear over a longer time span. During the seven-month trial period when Stockholm was testing out its congestion pricing system, the city only averted a 12% increase in childhood asthma rates. Over several years, that benefit increased to 45%.

"Changes in health take a while to take place," she explained. "If you're just looking at the short-term effects of lower levels of pollution, you will probably be missing a big piece of the picture."

While one environmental and health economist approached by Inside Science warned that other factors might have influenced Stockholm’s asthma rates, pediatrician Adam Spanier of the University of Maryland School of Medicine in Baltimore was impressed with what he’d read so far.

"They're showing a large public health benefit of this intervention that could easily be adapted in other places," he said. As for Simeonova, she’s advocating congestion pricing alongside a mix of other mobility options like transit—which also aligns well with managed lane development in many congested corridors.

Looking for the big picture on the benefits of tolling? IBTTA’s Summit on Finance, Policy, VMT, April 23-25, 2017 is the place to be. Check out the program today.


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