The Health Economic Assessment Tool (HEAT) for walking and cycling - experiences from 10 years of application of a health impact assessment tool in policy and practice

Sonja Kahlmeier, Nick Cavill, Meelan Thondoo, Harry Rutter, Thiago Herick de Sa, Francesca Racioppi, Thomas Gotschi

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IntroductionIn recent years, walking and cycling have moved into the focus as promising approaches to achieve public health, sustainable transport, climate goals and better urban resilience. However, they are only realistic transport and activity options for a large proportion of the population when they are safe, inclusive and convenient. One way to increase their recognition in transport policy is the inclusion of health impacts of walking and cycling into transport economic appraisals.MethodsThe Health Economic Assessment Tool (HEAT) for walking and cycling calculates: if x people walk or cycle a distance of y on most days, what is the economic value of impacts on premature mortality, taking into account effects of physical activity, air pollution and road fatalities, as well as effects on carbon emissions. Different data sources were collated to examine how the HEAT in more than 10 years of existence, and to identify lessons learned and challenges.ResultsSince its launch in 2009, the HEAT has gained wide recognition as a user friendly, yet robust, evidence-based tool usable by academics, policymakers, and practitioners. Originally designed for use in Europe, it has since been expanded for global use.DiscussionChallenges for a wider uptake of health-impact assessment (HIA) tools including active transport such as HEAT are the promotion and dissemination to local practitioners and policy makers also outside European and English-speaking regions and in low- and middle-income contexts, further increasing usability, and more generally the advancement of systematic data collection and impact quantification related to walking and cycling.
Original languageEnglish
Article number1146761
Number of pages9
JournalFrontiers in Sports and Active Living
Publication statusPublished - 26 May 2023

Bibliographical note

The HEAT user survey was co-funded under a LIFE + grant to
the European Cyclists’ Federation from DG Environment,
European Commission

Data availability statement
The raw data supporting the conclusions of this article will be
made available by the authors, without undue reservation.


  • cycling
  • economic assessment
  • health impact assessment
  • walking, policy

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Anthropology
  • Physiology
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Tourism, Leisure and Hospitality Management
  • Orthopedics and Sports Medicine


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