Objectives. To measure cost-effectiveness of an intervention to increase retrofitting of rollover protective structures (ROPS) on tractors.

Methods. Tractor overturns are the leading cause of farm fatalities. ROPS prevent these deaths. This study updates a 2011 cost-effectiveness assessment of a New York State intervention to increase use of ROPS. We subtracted intervention cost from the cost of injuries averted, then divided this figure by the number of averted injuries. We used related probabilities and costs of fatalities and injuries from published literature to calculate the program’s cost-effectiveness.

Results. The total cost of the injuries averted from 2007 to 2017 was $6 018 742 versus a total program cost of $1 776 608. The one-time retrofit costs will continue to prevent injuries as long as the tractors are used, generating additional (projected) future savings of $12 136 512, $15 781 027, and $18 924 818 if retrofitted tractors remain in operation 15, 20, or 25 years after their retrofit.

Conclusions. Social marketing was cost-effective for reducing injuries from tractor overturns.

Public Health Implications. These results indicate that the intervention model is effective from both a public health and economic standpoint and should be expanded into other states.