Evaluating Health Impacts of NYC Congestion Pricing

New York City (NYC) is the first jurisdiction in the United States (US) to implement a cordon-based congestion charge, with the goals of alleviating traffic and increasing revenue to improve NYC’s transit system. The objective of this proposal to use a quasi-experimental approach to evaluate the health impacts of the NYC congestion pricing policy. Early predictions using simulation models suggest that the NYC congestion pricing policy will improve air quality in the congestion zone and surrounding areas because of a reduction in traffic- related air pollutant emissions due to lower vehicle-miles travelled and time spent idling in traffic. Our overall hypothesis is that a policy that influences traffic and reduces emissions can improve air quality and health outcomes related to air pollution. However, traffic diversions into communities outside of the congestion zone might translate in differential impacts of the policy on communities in the region in short-term. The premise underlying this proposal is provided by studies that show: 1) road traffic influences health through emitted air pollutants and the effect is present at levels below current standards, 2) cordon-based policies can reduce emission and improve air quality, and 3) differential impacts of cordon-based policies in subgroup residents of affected areas is largely unknown. Specific Aims are: 1) Identify the impact of congestion pricing policy on rates of asthma acute care events and cardiovascular events, by comparing trends in the congestion zone 7 years before and 1, 2, and 3 years after policy enactment with comparison areas; 2) Create a time-series model of air quality using local monitor data in NYC 7 years before and 1-3 years after policy enactment and compare trends in and outside the congestion zone; and 3) Evaluate the air quality and health impact of the policy on “spillover” communities outside of the congestion zone, stratifying by whether or not they are projected to experience increased or decreased traffic with policy implementation. We will leverage multiple sources of health data, i.e., Medicaid claims data from residents in the US Northeast and all-payer claims from residents of New York State. The project will also incorporate spatially refined measures of air pollution measures from the NYC Community Air Survey. Innovations include the use of a natural experiment design with synthetic control matching and the integration of data from a unique air monitoring system in NYC with high spatial resolution. This study will be the first to examine differential impacts on health in communities that might experience more congestion due to traffic conversion in the short-term. Results from this study will provide an evidence base for other urban areas considering the adoption of cordon-based road pricing policies. Project Number: 1R01ES037346-01A1 | Fiscal Year: 2026 | NIH Institute/Center: National Institute of Environmental Health Sciences (NIEHS) | Principal Investigator: Akhgar Ghassabian (+1 co-PI) | Institution: NEW YORK UNIVERSITY SCHOOL OF MEDICINE, NEW YORK, NY | Award Amount: $4,128,432 | Activity Code: R01 | Study Section: Community Influences on Health Behavior Study Section[CIHB] View on NIH RePORTER: https://reporter.nih.gov/project-details/11296246