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PreprintCC BYmedRxiv

Estimating healthcare cost savings from greenspace in Washington

  1. 1University of Washington Seattle Campus: University of Washington

Abstract

Greenspace is increasingly recognized as public-health infrastructure, yet its potential contribution to healthcare cost savings remains poorly quantified beyond a relatively small number of studies. To contribute to these investigations, we estimated potential avoided healthcare expenditures associated with residential greenness in Washington using a benefit-transfer framework. We applied decile-specific relative healthcare-cost ratios from a Northern California cohort of approximately five million Kaiser Permanente members to population-weighted distributions of satellite-derived normalized difference vegetation index across Washington census block groups. Ratios were calibrated to Washingtons 2020 statewide per-capita healthcare expenditure, allowing estimates to reflect the states own cost baseline. Estimated annual per-capita costs declined from $6,472.75 in the least-green decile to $5,939.39 in the greenest, a difference of $533.35. Simulated interventions yielded estimated annual statewide savings of $45.6 million from raising the lowest decile to the next decile, $157.7 million from lifting the four lowest deciles to Decile five, and $56.9 million from urban-core greening in Washingtons five largest cities. These estimates are modeled associations, not causal forecasts, and depend on transferability between regional populations and on normalized difference vegetation index as an incomplete proxy for meaningful nature access. Nonetheless, the findings highlight increased and equitable greening efforts as a potentially consequential component of preventive health and infrastructure policy.

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BibTeX
@misc{tao2026estimating,
  title = {{Estimating healthcare cost savings from greenspace in Washington}},
  author = {J. Tao and S. Rabotyagov and M. H. E. M. Browning and G. Bratman and S. A. Wood and J. Lawler},
  howpublished = {medRxiv},
  year = {2026},
  month = oct,
  doi = {10.64898/2026.10.21.26366190},
  url = {https://www.medrxiv.org/content/10.64898/2026.10.21.26366190v1},
  note = {CC BY},
}
RIS
TY  - UNPB
TI  - Estimating healthcare cost savings from greenspace in Washington
AU  - J. Tao
AU  - S. Rabotyagov
AU  - M. H. E. M. Browning
AU  - G. Bratman
AU  - S. A. Wood
AU  - J. Lawler
PY  - 2026
DA  - 2026/10/21
PB  - medRxiv
DO  - 10.64898/2026.10.21.26366190
UR  - https://www.medrxiv.org/content/10.64898/2026.10.21.26366190v1
AB  - Greenspace is increasingly recognized as public-health infrastructure, yet its potential contribution to healthcare cost savings remains poorly quantified beyond a relatively small number of studies. To contribute to these investigations, we estimated potential avoided healthcare expenditures associated with residential greenness in Washington using a benefit-transfer framework. We applied decile-specific relative healthcare-cost ratios from a Northern California cohort of approximately five million Kaiser Permanente members to population-weighted distributions of satellite-derived normalized difference vegetation index across Washington census block groups. Ratios were calibrated to Washingtons 2020 statewide per-capita healthcare expenditure, allowing estimates to reflect the states own cost baseline. Estimated annual per-capita costs declined from $6,472.75 in the least-green decile to $5,939.39 in the greenest, a difference of $533.35. Simulated interventions yielded estimated annual statewide savings of $45.6 million from raising the lowest decile to the next decile, $157.7 million from lifting the four lowest deciles to Decile five, and $56.9 million from urban-core greening in Washingtons five largest cities. These estimates are modeled associations, not causal forecasts, and depend on transferability between regional populations and on normalized difference vegetation index as an incomplete proxy for meaningful nature access. Nonetheless, the findings highlight increased and equitable greening efforts as a potentially consequential component of preventive health and infrastructure policy.
ER  -