2026/03 – Grayways as a public health intervention

Image via theroadswerenotbuiltforcars.com

Chat GPT Query: Use the “The cost-effectiveness of bike lanes in New York City,” Gu, Mohit, Muennig, Mailman School of Public Health, 8/10/2016, to model the cost effectiveness of the Grayways proposal as a public health intervention.

Chat GPT Response: Below is a model of the cost-effectiveness of the Grayways proposal as a public health intervention, using the 2016 Mailman study.

Baseline Study

The Study evaluated 45.5 miles of NYC bike lanes costing $8.1 million [$178K per mile] and found:

  • 9.32% increase in cycling probability
  • 2.2 QALYs gained per 1,000 residents over a lifetime
  • ≈ 0.0022 QALYs per resident
  • NYC population ≈ 8.8 million
  • ≈ $1,297 per QALY (very cost-effective).

Results: Grayways cost per QALY

  • Low-cost case ($5M): 5,000,000/21,300 $235 per QALY
  • High-cost case ($20M): 20,000,000/21,300 $940 per QALY

Grayways Proposal

The Grayways proposal designates approximately 500 miles of weekend recreational cycling routes across New York City using existing low-stress streets, signage, and limited upgrades rather than full capital construction.

Because Grayways:

  • Operates weekends only
  • Is recreational rather than commute-substitution oriented
  • Relies mostly on designation rather than protected lanes

We assume it achieves 10% of the per-mile behavioral effect estimated in the 2016 protected lane study.

📌 Step 1: Scaling Health Impact

From the 2016 study: 45.5 miles → 0.0022 QALYs per resident

Linear scaling to 500 miles: 500/45.5=10.99

Full linear effect (theoretical max): 0.0022×10.990.0242 QALYs per resident

Applying the conservative 10% impact assumption:

0.0242×0.10=0.00242 QALYs per resident

Total citywide QALYs: 0.00242×8,800,00021,300 QALYs

So under conservative assumptions, Grayways would generate approximately:

≈ 21,000 lifetime QALYs

📌 Step 2: Cost Assumptions

Estimated total implementation cost range:

  • Low case: $5 million
  • High case: $20 million

Per-mile costs:

Total Cost Cost per Mile
$5M $10,000/mile
$20M $40,000/mile

These costs reflect signage, wayfinding, traffic calming, and limited safety upgrades — not full protected lane construction reflected in the $178K per mile in the Mailman Study.

📌 Step 3: Cost per QALY

  • Low-cost case ($5M): 5,000,000/21,300 $235 per QALY
  • High-cost case ($20M): 20,000,000/21,300 $940 per QALY

📌 Interpretation

For context:

  • Original 2016 protected lanes: ~$1,300/QALY
  • Common public health cost-effectiveness thresholds: $50,000–$150,000/QALY

Even under heavily discounted behavioral impact assumptions, Grayways appears to be:

  • Extremely cost-effective
  • An order of magnitude more efficient than many public health interventions
  • Comparable to or better than the original protected lane investment

📌 Important Caveats

This remains a modeled projection based on:

  • Linear mileage scaling
  • Assumed population exposure
  • A 10% behavioral impact discount
  • No adjustment for diminishing marginal returns
  • No explicit modeling of crash risk changes

A full Markov simulation (as in the 2016 study) would refine these estimates further.

📌 Bottom Line

If Grayways achieves even a modest fraction of the per-mile behavioral effect of protected bike lanes, it likely delivers health benefits at a cost of hundreds—not thousands—of dollars per QALY, making it a highly cost-effective public health investment under standard economic evaluation frameworks.