Cost-effectiveness of neighbourhood slow zones in New York City

Inj Prev. 2019 Apr;25(2):98-103. doi: 10.1136/injuryprev-2017-042499. Epub 2017 Sep 27.


Background: Neighbourhood slow zones (NSZs) are areas that attempt to slow traffic via speed limits coupled with other measures (eg, speed humps). They appear to reduce traffic crashes and encourage active transportation. We evaluate the cost-effectiveness of NSZs in New York City (NYC), which implemented them in 2011.

Methods: We examined the effectiveness of NSZs in NYC using data from the city's Department of Transportation in an interrupted time series analysis. We then conducted a cost-effectiveness analysis using a Markov model. One-way sensitivity analyses and Monte Carlo analyses were conducted to test error in the model.

Results: After 2011, road casualties in NYC fell by 8.74% (95% CI 1.02% to 16.47%) in the NSZs but increased by 0.31% (95% CI -3.64% to 4.27%) in the control neighbourhoods. Because injury costs outweigh intervention costs, NSZs resulted in a net savings of US$15 (95% credible interval: US$2 to US$43) and a gain of 0.002 of a quality-adjusted life year (QALY, 95% credible interval: 0.001 to 0.006) over the lifetime of the average NSZ resident relative to no intervention. Based on the results of Monte Carlo analyses, there was a 97.7% chance that the NSZs fall under US$50 000 per QALY gained.

Conclusion: While additional causal models are needed, NSZs appeared to be an effective and cost-effective means of reducing road casualties. Our models also suggest that NSZs may save more money than they cost.

Keywords: New York City; cost-effectiveness; neighbourhood slow zones; traffic injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Traffic / economics*
  • Accidents, Traffic / prevention & control*
  • Accidents, Traffic / statistics & numerical data
  • Cost-Benefit Analysis
  • Environment Design / economics*
  • Humans
  • Interrupted Time Series Analysis
  • Markov Chains
  • New York City / epidemiology
  • Public Health / economics*
  • Public Health / statistics & numerical data*
  • Wounds and Injuries / economics
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / prevention & control*