Comment

. 2020 Nov;128(11):115001.

doi: 10.1289/EHP6745. Epub 2020 Nov 10.

Guidelines for Modeling and Reporting Health Effects of Climate Change Mitigation Actions

Jeremy J Hess¹, Nikhil Ranadive², Chris Boyer¹, Lukasz Aleksandrowicz³, Susan C Anenberg⁴, Kristin Aunan⁵, Kristine Belesova^{6

7}, Michelle L Bell⁸, Sam Bickersteth⁹, Kathryn Bowen¹⁰, Marci Burden¹, Diarmid Campbell-Lendrum¹¹, Elizabeth Carlton¹², Guéladio Cissé^{13

14}, Francois Cohen¹⁵, Hancheng Dai^{16

17}, Alan David Dangour⁷, Purnamita Dasgupta¹⁸, Howard Frumkin³, Peng Gong¹⁹, Robert J Gould²⁰, Andy Haines⁷, Simon Hales²¹, Ian Hamilton²², Tomoko Hasegawa²³, Masahiro Hashizume^{24

25}, Yasushi Honda²⁶, Daniel E Horton²⁷, Alexandra Karambelas²⁸, Ho Kim²⁹, Satbyul Estella Kim³⁰, Patrick L Kinney³¹, Inza Kone^{32

33}, Kim Knowlton³⁴, Jos Lelieveld³⁵, Vijay S Limaye³⁴, Qiyong Liu³⁶, Lina Madaniyazi^{25

37}, Micaela Elvira Martinez^{38

39}, Denise L Mauzerall⁴⁰, James Milner⁶, Tara Neville⁴¹, Mark Nieuwenhuijsen^{42

43

44}, Shonali Pachauri⁴⁵, Frederica Perera³⁸, Helen Pineo⁴⁶, Justin V Remais⁴⁷, Rebecca K Saari⁴⁸, Jon Sampedro⁴⁹, Pauline Scheelbeek^{7

50}, Joel Schwartz⁵¹, Drew Shindell⁵², Priya Shyamsundar⁵³, Timothy J Taylor⁵⁴, Cathryn Tonne^{42

43

44}, Detlef Van Vuuren⁵⁵, Can Wang⁵⁶, Nicholas Watts⁵⁷, J Jason West⁵⁸, Paul Wilkinson⁶, Stephen A Wood^{8

59}, James Woodcock⁶⁰, Alistair Woodward⁶¹, Yang Xie^{62

63}, Ying Zhang⁶⁴, Kristie L Ebi¹

Affiliations

¹ Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA.
² Emory University School of Medicine, Atlanta, Georgia, USA.
³ Our Planet, Our Health, Wellcome Trust, London, UK.
⁴ Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
⁵ CICERO Center for International Climate Research, Oslo, Norway.
⁶ Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK.
⁷ Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.
⁸ School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA.
⁹ Rockefeller Foundation Economic Council on Planetary Health, Oxford, UK.
¹⁰ Ritsumeikan University, Kusatsu, Japan.
¹¹ Department of Environment Climate Change and Health, World Health Organization, Geneva, Switzerland.
¹² Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA.
¹³ Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
¹⁴ University of Basel, Basel, Switzerland.
¹⁵ Smith School for Enterprise and the Environment and Institute for New Economic Thinking at the Oxford Martin School, University of Oxford, Oxford, UK.
¹⁶ Laboratory of Energy & Environmental Economics and Policy (LEEEP), College of Environmental Sciences and Engineering, Peking University, Beijing, China.
¹⁷ College of Environmental Sciences and Engineering, Peking University, Beijing, China.
¹⁸ Environmental and Resource Economics Unit, Institute of Economic Growth, Delhi, India.
¹⁹ Department of Earth System Science, Tsinghua University, Beijing, China.
²⁰ Center for Climate Change Communication, George Mason University, Fairfax, Virginia, USA.
²¹ Department of Public Health, University of Otago, Wellington, New Zealand.
²² UCL Energy Institute, University College London, London, UK.
²³ National Institute for Environmental Studies, Tsukuba, Japan.
²⁴ Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
²⁵ School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
²⁶ Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
²⁷ Department of Earth and Planetary Sciences, Northwestern University, Evanston, Illinois, USA.
²⁸ Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York USA.
²⁹ Department of Epidemiology and Biostatistics, School of Public Health, Seoul National University, Seoul, South Korea.
³⁰ Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan.
³¹ Department of Environmental Health, Boston University School of Public Health, Boston, USA.
³² Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
³³ Université Félix Houphouet-Boigny, Abidjan, Côte d'Ivoire.
³⁴ Natural Resources Defense Council, New York, New York, USA.
³⁵ Max Planck Institute for Chemistry, Dept. of Atmospheric Chemistry, Mainz, Germany.
³⁶ National Institute for Communicable Disease Control and Prevention, Beijing, China.
³⁷ Department of Paediatric Diseases, Institute of Tropical Medicine, Nagasaki, Japan.
³⁸ Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA.
³⁹ Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
⁴⁰ Woodrow Wilson School of Public and International Affairs and the Department of Civil and Environmental Engineering, Princeton University, Princeton, New Jersey, USA.
⁴¹ World Health Organization, Geneva, Switzerland.
⁴² ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
⁴³ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
⁴⁴ CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain.
⁴⁵ IIASA, Laxenburg, Austria.
⁴⁶ Bartlett Faculty of the Built Environment, University College London, London, UK.
⁴⁷ Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, California, USA.
⁴⁸ Civil and Environmental Engineering, University of Waterloo, Ontario, Canada.
⁴⁹ Basque Centre for Climate Change (BC3), Leioa, Spain.
⁵⁰ Department of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK.
⁵¹ Department of Environmental Health, Harvard T.H. Chan School of Public Heath, Boston, Massachusetts, USA.
⁵² Nicholas School of the Environment, Duke University, Durham, North Carolina, USA.
⁵³ The Nature Conservancy, Arlington, Virginia USA.
⁵⁴ European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK.
⁵⁵ PBL Netherlands Environmental Assessment Agency, The Hague, Netherlands.
⁵⁶ School of Environment, Tsinghua University, Beijing, China.
⁵⁷ Institute for Global Health, University College London, London, UK.
⁵⁸ Environmental Sciences & Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁵⁹ The Nature Conservancy, New Haven, Connecticut, USA.
⁶⁰ MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
⁶¹ Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand.
⁶² School of Economics and Management, Beihang University, Beijing, China.
⁶³ Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Beihang University, Beijing, China.
⁶⁴ School of Public Health, University of Sydney, New South Wales, Australia.

PMID: 33170741
PMCID: PMC7654632
DOI: 10.1289/EHP6745

Comment

Guidelines for Modeling and Reporting Health Effects of Climate Change Mitigation Actions

Jeremy J Hess et al. Environ Health Perspect. 2020 Nov.

. 2020 Nov;128(11):115001.

doi: 10.1289/EHP6745. Epub 2020 Nov 10.

Authors

Affiliations

¹ Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA.
² Emory University School of Medicine, Atlanta, Georgia, USA.
³ Our Planet, Our Health, Wellcome Trust, London, UK.
⁴ Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
⁵ CICERO Center for International Climate Research, Oslo, Norway.
⁶ Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK.
⁷ Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.
⁸ School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA.
⁹ Rockefeller Foundation Economic Council on Planetary Health, Oxford, UK.
¹⁰ Ritsumeikan University, Kusatsu, Japan.
¹¹ Department of Environment Climate Change and Health, World Health Organization, Geneva, Switzerland.
¹² Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA.
¹³ Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
¹⁴ University of Basel, Basel, Switzerland.
¹⁵ Smith School for Enterprise and the Environment and Institute for New Economic Thinking at the Oxford Martin School, University of Oxford, Oxford, UK.
¹⁶ Laboratory of Energy & Environmental Economics and Policy (LEEEP), College of Environmental Sciences and Engineering, Peking University, Beijing, China.
¹⁷ College of Environmental Sciences and Engineering, Peking University, Beijing, China.
¹⁸ Environmental and Resource Economics Unit, Institute of Economic Growth, Delhi, India.
¹⁹ Department of Earth System Science, Tsinghua University, Beijing, China.
²⁰ Center for Climate Change Communication, George Mason University, Fairfax, Virginia, USA.
²¹ Department of Public Health, University of Otago, Wellington, New Zealand.
²² UCL Energy Institute, University College London, London, UK.
²³ National Institute for Environmental Studies, Tsukuba, Japan.
²⁴ Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
²⁵ School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
²⁶ Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
²⁷ Department of Earth and Planetary Sciences, Northwestern University, Evanston, Illinois, USA.
²⁸ Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York USA.
²⁹ Department of Epidemiology and Biostatistics, School of Public Health, Seoul National University, Seoul, South Korea.
³⁰ Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan.
³¹ Department of Environmental Health, Boston University School of Public Health, Boston, USA.
³² Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
³³ Université Félix Houphouet-Boigny, Abidjan, Côte d'Ivoire.
³⁴ Natural Resources Defense Council, New York, New York, USA.
³⁵ Max Planck Institute for Chemistry, Dept. of Atmospheric Chemistry, Mainz, Germany.
³⁶ National Institute for Communicable Disease Control and Prevention, Beijing, China.
³⁷ Department of Paediatric Diseases, Institute of Tropical Medicine, Nagasaki, Japan.
³⁸ Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA.
³⁹ Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
⁴⁰ Woodrow Wilson School of Public and International Affairs and the Department of Civil and Environmental Engineering, Princeton University, Princeton, New Jersey, USA.
⁴¹ World Health Organization, Geneva, Switzerland.
⁴² ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
⁴³ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
⁴⁴ CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain.
⁴⁵ IIASA, Laxenburg, Austria.
⁴⁶ Bartlett Faculty of the Built Environment, University College London, London, UK.
⁴⁷ Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, California, USA.
⁴⁸ Civil and Environmental Engineering, University of Waterloo, Ontario, Canada.
⁴⁹ Basque Centre for Climate Change (BC3), Leioa, Spain.
⁵⁰ Department of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK.
⁵¹ Department of Environmental Health, Harvard T.H. Chan School of Public Heath, Boston, Massachusetts, USA.
⁵² Nicholas School of the Environment, Duke University, Durham, North Carolina, USA.
⁵³ The Nature Conservancy, Arlington, Virginia USA.
⁵⁴ European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK.
⁵⁵ PBL Netherlands Environmental Assessment Agency, The Hague, Netherlands.
⁵⁶ School of Environment, Tsinghua University, Beijing, China.
⁵⁷ Institute for Global Health, University College London, London, UK.
⁵⁸ Environmental Sciences & Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁵⁹ The Nature Conservancy, New Haven, Connecticut, USA.
⁶⁰ MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
⁶¹ Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand.
⁶² School of Economics and Management, Beihang University, Beijing, China.
⁶³ Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Beihang University, Beijing, China.
⁶⁴ School of Public Health, University of Sydney, New South Wales, Australia.

PMID: 33170741
PMCID: PMC7654632
DOI: 10.1289/EHP6745

Abstract

Background: Modeling suggests that climate change mitigation actions can have substantial human health benefits that accrue quickly and locally. Documenting the benefits can help drive more ambitious and health-protective climate change mitigation actions; however, documenting the adverse health effects can help to avoid them. Estimating the health effects of mitigation (HEM) actions can help policy makers prioritize investments based not only on mitigation potential but also on expected health benefits. To date, however, the wide range of incompatible approaches taken to developing and reporting HEM estimates has limited their comparability and usefulness to policymakers.

Objective: The objective of this effort was to generate guidance for modeling studies on scoping, estimating, and reporting population health effects from climate change mitigation actions.

Methods: An expert panel of HEM researchers was recruited to participate in developing guidance for conducting HEM studies. The primary literature and a synthesis of HEM studies were provided to the panel. Panel members then participated in a modified Delphi exercise to identify areas of consensus regarding HEM estimation. Finally, the panel met to review and discuss consensus findings, resolve remaining differences, and generate guidance regarding conducting HEM studies.

Results: The panel generated a checklist of recommendations regarding stakeholder engagement: HEM modeling, including model structure, scope and scale, demographics, time horizons, counterfactuals, health response functions, and metrics; parameterization and reporting; approaches to uncertainty and sensitivity analysis; accounting for policy uptake; and discounting.

Discussion: This checklist provides guidance for conducting and reporting HEM estimates to make them more comparable and useful for policymakers. Harmonization of HEM estimates has the potential to lead to advances in and improved synthesis of policy-relevant research that can inform evidence-based decision making and practice. https://doi.org/10.1289/EHP6745.

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Figures

Figure 1 is a flow chart, having three steps, namely, sector of mitigation policy scenario, health exposures, and health effects. Sector of mitigation policy scenario includes the following steps: Step 1: Energy production (for example transition to renewable sources). Step 2: Transportation (for example transition from cars to biking). Step 3: Food Systems (for example regenerative soil management, reduced meat consumption and livestock production). Step 4: Built environment (for example energy efficient or green buildings, urban green spaces). Health exposures includes the following steps: Energy production (for example transition to renewable sources) leads to Air co-pollutants (for example particulate matter begin subscript 2.5 end subscript, nitrogen oxide, sulfur oxide, Ozone. Transportation (for example transition from cars to biking) leads to Air co-pollutants (for example particulate matter begin subscript 2.5 end subscript, nitrogen oxide, sulfur oxide, and ozone which leads to Transportation accidents (for example motor vehicle accidents), and Increased physical activity (for example increased Metabolic Equivalent of Task hours per week). Food Systems (for example regenerative soil management, reduced meat consumption and livestock production) leads to Air co-pollutants (for example particulate matter begin subscript 2.5 end subscript, nitrogen oxide, sulfur oxide, and Ozone) and Healthier diets and improved nutrition (for example decreased meat consumption). Built environment (for example energy efficient or green buildings, urban green spaces) leads to Air co-pollutants (for example particulate matter begin subscript 2.5 end subscript, nitrogen oxide, sulfur oxide, and ozone) Transportation accidents (for example motor vehicle accidents), and Increased physical activity (for example increased Metabolic Equivalent of Task hours per week). Health effects includes the following steps: Air co-pollutants (for example, particulate matter begin subscript 2.5 end subscript, nitrogen oxide, sulfur oxide, and ozone) leads to Effects on pulmonary disease (lung cancer; chronic obstructive pulmonary disease; and asthma exacerbation) and Effects on cardiovascular disease. Transportation accidents (for example motor vehicle accidents) leads to Effects on unintentional injury. Healthier diets and improved nutrition (for example decreased meat consumption) leads to Effects on cardiovascular Disease and Effects on metabolic syndrome. Increased physical activity (for example increased Metabolic Equivalent of Task hours per week) leads to Effects on cardiovascular Disease and Effects on metabolic syndrome. — **Figure 1.**
A conceptual framework that provides sector-specific examples of the multiple mechanisms and pathways through which climate change mitigation policies can affect human health. This figure is not intended to be comprehensive.

Figure 2 is a flow chart, having four steps. Step 1: Literature review between November 2014 and March 2019. Step 2: Literature review leads to Delphi R1, Delphi R2, Delphi R3 between December 2018 and March 2019. Step 3: Delphi R1, Delphi R2, Delphi R3 leads to Climate change mitigation health co-benefits workshop in March 2019. Step 4: Climate change mitigation health co-benefits workshop leads to Literature review between November 2014 and March 2019 and Post workshop processing between March 2019 and August 2019. — **Figure 2.**
Timeline and process for developing guidance document. R1, R2, and R3 were successive rounds.

Figure 3 is a flow chart, having four steps. Step 1: Scoping or baseline: Identify mitigation strategies and quantify associations with drivers of health impacts, Determine population of interest and time scale of analysis, and Obtain or estimate future trends in demographics, health status and exposures or levels of health drivers (often “business as usual” case). Step 2: Impact assessment: Estimate changes in health drivers associated with mitigation strategies and Estimate changes in health status resulting from changes in health drivers. Step 3: Valuation: Estimate economic value of changes in health status and as appropriate, estimate costs of mitigation strategies for comparison Purposes. Step 4: Sensitivity or uncertainty analyses: Conduct appropriate sensitivity and uncertainty analyses, refining valuation and impact assessment parameters through further, targeted research leads to Impact assessment: Estimate changes in health drivers associated with mitigation strategies and Estimate changes in health status resulting from changes in health drivers and Valuation: Estimate economic value of changes in health status and As appropriate, estimate costs of mitigation strategies for comparison Purposes. — **Figure 3.**
Engagement, modeling, parameterization, reporting, and synthesis considerations for health effects of mitigation policies (HEM) studies, building on figures originally published by Remais et al. (2014) and Gao et al. (2018).

See this image and copyright information in PMC

Comment in

Toward Better Estimates of the Cost of Climate Change Mitigation: Guidelines for Studying Potential Health Benefits.
Nicole W. Nicole W. Environ Health Perspect. 2020 Dec;128(12):124003. doi: 10.1289/EHP8671. Epub 2020 Dec 29. Environ Health Perspect. 2020. PMID: 33372821 Free PMC article.

Comment on

Methodological Considerations for Epidemiological Studies of Air Pollution and the SARS and COVID-19 Coronavirus Outbreaks.
Villeneuve PJ, Goldberg MS. Villeneuve PJ, et al. Environ Health Perspect. 2020 Sep;128(9):95001. doi: 10.1289/EHP7411. Epub 2020 Sep 9. Environ Health Perspect. 2020. PMID: 32902328 Free PMC article. Review.

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Guidelines for Modeling and Reporting Health Effects of Climate Change Mitigation Actions

Affiliations

Guidelines for Modeling and Reporting Health Effects of Climate Change Mitigation Actions

Authors

Affiliations

Abstract

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