Imprudent Infrastructure Policy as Grounds for Concern for Public Health: Evidence from OECD Countries
/Background
When making infrastructure policies, decision makers insufficiently consider negative consequences for the environment or health. This imprudent policymaking triggers poor public health outcomes. Illustrating this issue for transportation infrastructure policy, this interdisciplinary work adds to the literature by presenting evidence for the association of infrastructure policy with the incidence of non-communicable diseases in a worldwide setting.
Methods
This paper explores this association by using road infrastructure investment (as infrastructure policy) and deaths due to three different health outcomes: transport accidents, chronic obstructive pulmonary diseases (COPD), and pneumonia. The Environmental Policy Stringency (EPS) Index proxies the costs imposed on environmentally harmful externalities of policies, and thus awareness of negative consequences of policies. Descriptive statistics and fixed-effects (FE) panel-data estimation models that included the interaction of the policy variable with the EPS were conducted, using data from the OECD for 27 countries over 18 years (1995–2012).
Findings
We show that countries which never achieved a score of 3 or higher for the EPS index had higher levels of standardized death rates. This is supported by Pearson’s correlation coefficients and by t-tests for deaths due to transport accidents and COPD. Following the FE analysis, we find that in a country at median EPS, an increase in road infrastructure investment of 1% of GDP is associated, on average, with about three additional deaths per 100,000 population due to transport accidents and about 15 fewer deaths per 100,000 population due to COPD. The level of awareness required for positive public health outcomes differs from health outcome to another.
Interpretation
Low environmental awareness, and hence imprudent policy, is associated with higher death rates due to transport accidents and respiratory diseases. Infrastructure policy should be designed and implemented with public health in mind.