If U.S. cities take aggressive but realistic action to replace car trips with bike trips by 2050, they could prevent more than 15,000 premature deaths every year, a new study finds — and not just in traffic crashes.

In the first study ever to model the comprehensive global public health impacts of driving-to-cycling mode shift, researchers at Colorado State University and a coalition of Spanish universities explored two very different transportation futures in 17 countries across the world: one in which world leaders made no substantial changes to their current biking policies by 2050, and one in which they replicate the approach of nations with the most carbon-efficient urban transport networks on Earth.

And they found that the latter scenario would save over 200,000 lives — and 15,000 in the U.S. alone.