Obesity-related health impacts of active transport policies in Australia - a policy review and health impact modelling study

To review Australian policies on active transport, defined as walking and cycling for utilitarian purposes. To estimate the potential health impact of achieving four active transport policy scenarios.A policy review was undertaken, using key words to search government websites. Potential health benefits were quantified using a cohort simulation Markov model to estimate obesity and transport injury-related health effects of an increase in active transport. Health adjusted life years (HALYs) gained and healthcare cost savings from diseases averted were estimated. Budget thresholds to achieve cost-effectiveness were estimated for each scenario.There is broad recognition of the health-related benefits of active transport from all levels of Australian government. Modelling results suggest significant health-related benefits of achieving increased prevalence of active transport. Total HALYs saved assuming a one-year effect ranged from 565 (95%UI 173-985) to 12,105 (95%UI 4,970-19,707), with total healthcare costs averted ranging from $6.6M (95$1.9M-11.3M) to $141.2M (95$53.8M-227.8M).Effective interventions that improve rates of active transport may result in substantial healthcare-related cost savings through a decrease in conditions related to obesity. Implications for public health: Significant potential exists for effective and cost-effective interventions that result in more walking and cycling

Economies of scale and local government expenditure: evidence from Australia

Controversy surrounds structural reform in local government, especially efforts aimed at involuntarily reducing the number of local authorities to secure scale economies. We examined whether scale economies exist in local government outlays by analyzing the expenditure of 152 New South Wales councils. Initially, council expenditure is characterized by scale economies. However, given the correlation between population and population density, it is important to determine whether the influence of population on expenditure is due to variations in population density. When areas are decomposed into subgroups on the basis of density, the evidence of scale economies largely disappears