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Beyond traffic jam alleviation: evaluating the health and health equity impacts of New York City’s congestion pricing plan
  1. Akhgar Ghassabian1,
  2. Andrea R Titus2,
  3. Sarah Conderino3,
  4. Alexander Azan4,
  5. Rachel Weinberger5,
  6. Lorna E Thorpe4
  1. 1 Pediatrics, NYU Langone Health, New York, New York, USA
  2. 2 Population Health, NYU Langone Health, New York, New York, USA
  3. 3 Department of Population Health, NYU Langone Health, New York, New York, USA
  4. 4 Department of Population Health, New York University School of Medicine, New York, New York, USA
  5. 5 Regional Plan Association, New York, New York, USA
  1. Correspondence to Dr Akhgar Ghassabian, Pediatrics, NYU Langone Health, New York, NY 10016, USA; Akhgar.Ghassabian{at}


New York City (NYC) is slated to be the first jurisdiction in the USA to implement a cordon-based congestion tax, which will be levied on vehicles entering its Central Business District. Several cities around the world, for example, London and Stockholm, have had similar cordon-based pricing programmes, defined as road pricing that charges drivers a fee for entering a specified area (typically a congested urban centre). In addition to reducing congestion and creating revenue, projections suggest the NYC congestion pricing plan may yield meaningful traffic-related air quality improvements that could result in health benefits. NYC is a large city with high air pollution and substantial racial/ethnic and socioeconomic health inequities. The distinct geography and meteorological conditions of the city also suggest that the policy’s impact on air quality may extend beyond the NYC metropolitan area. As such, the potential breadth, directionality and magnitude of health impacts on communities who might be heavily affected by the nation’s first congestion pricing plan should be empirically investigated. We briefly review evaluation studies of other cordon-based congestion pricing policies and argue that implementation of this policy provides an excellent opportunity to employ a quasi-experimental study design to evaluate the policy’s impacts on air quality and health outcomes across population subgroups using a health equity lens. We discuss why real-time evaluations of the NYC congestion pricing plan can potentially help optimise benefits for communities historically negatively affected by traffic-related air pollution. Assessing intended and unintended impacts on health equity is key to achieving these goals.

  • Health inequalities

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  • Contributors Conception and design: AG, RW and LET. Manuscript drafting: AG, RW, LET and ART. Acquisition of data or analysis: ART, SC and AA. Interpretation of data and final review of the manuscript: all authors. AG and LET are responsible for the overall content of the manuscript. AG is the author acting as guarantor.

  • Funding AG and ART received funding from the Robert Wood Johnson Foundation Evidence for Action Program (grant #78922) to perform this research. The sponsor had no role in design, interpretation or submission of the report for publication. This work is also supported by P2CES033423 (to LET).

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.