Road Pricing Health Impact Assessment (HIA)

How Could Road Pricing Impact on Our Health?

In San Francisco, the ways people travel – by car, bus, foot, or bike – affect the city's environment and residents' health in ways that are both positive and negative. The transportation system affects physical activity, air pollution and asthma, injury collisions, and even stress and heart disease. Analyzing the health impacts of proposed changes to transportation can help to make more informed decisions, save lives, and prevent disease.

The San Francisco Department of Public Health's Program on Health, Equity and Sustainability received funding from the Robert Wood Johnson Foundation's Active Living Research program to conduct a health impact assessment (HIA) of a congestion pricing policy under study in San Francisco, California. Specifically, the San Francisco County Transportation Authority (SFCTA) is studying a potential program that would charge $3 during AM/PM rush hours to travel into or out of the congested northeast quadrant of San Francisco (see map, below). This scenario was found to be the best performing among dozens analyzed in the SFCTA's Mobility, Access and Pricing feasibility study. This road-pricing fee would fund public transit, road maintenance, and bicycle and pedestrian street improvements.

Congestion Pricing Boundaries for the Northeast Cordon Scenario

Road Pricing Boundaries

SFDPH completed the HIA in Summer 2011 and found that today's transportation system puts a heavy burden on health – though San Franciscans also received notable benefits from walking and biking for transportation. In the future – without new policies or funding to manage transportation as the population increases – San Franciscans are estimated to experience increased negative traffic-related health impacts, particularly in the northeast quadrant of San Francisco. However, there will be some health benefits as residents increase levels of walking and biking. With the potential future implementation of road pricing, San Franciscans could see significant health-related improvements relative to a future without road pricing – including fewer deaths due to air pollution, more cycling and walking and associated health benefits, and fewer pedestrian and cyclist injuries. In some cases these benefits are an improvement over current conditions in the city. The HIA did not find evidence of inequitable health effects on low-income, elderly, or young populations.

Pathways through which Road Pricing Policies Potentially Effect Health

Road Pricing Frameworksml

The HIA also estimated that the health-related economic costs of today's transportation system are very high – as much as $1.12 billion a year. Road pricing could generate significant economic value by reducing transportation-related adverse health effects and increasing walking and biking. The HIA also made recommendations that specifically target enhancing health benefits of the policy, including increasing congestion pricing fees where they can reduce health risks (e.g., on spare the air days) and investing in targeted infrastructure to reduce pedestrian and cyclist injury and increase walking and biking for transportation. For more information regarding the HIA findings and recommendations, please see the Document Library.

Related Resources

The American Public Health Association recently published a new fact sheet on HIA on Transportation Systems and Policy.

A detailed summary of the Regional and Local Health Impacts of Driving was published by PHES in 2009.


If you have questions regarding the Road Pricing HIA, contact Megan Wier MPH, Epidemiologist at This email address is being protected from spambots. You need JavaScript enabled to view it. .