The Health Monetization project investigates the relationship between the built environment and annual health care utilization costs in the Vancouver metropolitan region. The study leverages data from BC Generations Project on a cohort of 16,300 adults 35 to 69 years of age living in the Lower Mainland region of British Columbia. Although the BC GEN project is a longitudinal study, this study uses the baseline data which were collected between 2009 and 2015. This study also uses data from Population Data BC (PopData BC) which houses individual medical and billing records (e.g. prescriptions, medical services, and hospital visits). The PopData are linked to the BC Generation data to allow direct estimation of health care expenditure by individual. We use both cross-sectional and longitudinal analyses to examine the causal relationship between the built environment features, health behaviour, and health-related outcomes. Health care costs will be directly assessed from individual medical expenses provided by the PopData BC.

Recognition is growing that health costs are associated with transportation investments and land-use decisions. Because policymakers are held accountable for the monetary impacts of their decisions, it is important to evaluate the fiscal implications of the observed systematic relationship between transportation and land-use decisions, obesity, and physical activity. To date, cost-benefit models used to inform major transportation investment decisions have not accounted for the potential health impacts of these actions. Results from the proposed study will help to incorporate health into these cost-benefit models. These are the four aims of the study.

AIM 1: Are environmental features (walkability, bikeability, and regional accessibility) positively related to physical activity behaviours when controlling for sociodemographic factors?

AIM 2: Are built environment features inversely related to physical activity-related morbidities? And is the relationship mediated by physical activity and BMI?

AIM 3: Are built environment features inversely related to health care utilization costs? And is the relationship mediated by physical activity, obesity, and obesity-related chronic diseases?

AIM 4: Is there a significant change in health care utilization and costs before and after moving due to a change in built environment features when adjusting for sociodemographics and pre-existing conditions?


2014 – 2018


In progress.

Download the Project Fact Sheet below to learn more about this project: