新西兰奥特亚罗瓦交通部门去碳化的政策方法:公平、人口健康和健康系统效应建模

IF 24.1 1区 医学 Q1 ENVIRONMENTAL SCIENCES Lancet Planetary Health Pub Date : 2024-09-01 DOI:10.1016/S2542-5196(24)00171-2
Caroline Shaw PhD , Anja Mizdrak DPhil , Ryan Gage MPH , Melissa McLeod PhD , Rhys Jones MPH , Prof Alistair Woodward PhD , Linda Cobiac PhD
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引用次数: 0

摘要

背景健康共同效益是交通脱碳政策的一个关键潜在优势。然而,健康效应将在现有交通-健康不平等的背景下产生,而去碳化政策本身也会影响不平等。本研究探讨了国家交通去碳化途径对新西兰奥特亚罗瓦地区人口健康、健康不平等和健康系统成本的影响。方法我们使用比例多州生命表模型,模拟了新西兰气候变化委员会制定的两种交通净零碳化途径对健康、健康系统和环境的影响。行为路径强调混合方法,包括减少驾驶、增加骑自行车和使用公共交通以及轻型车辆电气化,而技术路径则侧重于车辆电气化。我们使用了来自交通、环境、人口健康和医疗保健方面的数据来构建模型。我们通过体育活动、空气污染(PM2-5 和二氧化氮)和伤害等途径,模拟了 2018 年至 2050 年新西兰奥特亚罗瓦人口的健康影响变化。我们模拟了对毛利人(奥特亚罗瓦土著人)和非毛利人的影响。对于实现净零的每种途径,我们计算了毛利人和非毛利人的总体健康调整寿命年数(HALYs)、年龄标准化健康调整寿命年数(HALYs)和比率比的变化。我们还计算了健康系统成本和交通温室气体排放量的变化。与基线相比,两种途径都能改善人口健康、降低健康系统成本和减少生命周期温室气体排放,但行为途径的健康收益要大得多。例如,与基线相比,行为方案额外增加了 2100 HALYs(95% UI 1500-3100)。在两种途径中,毛利人的健康收益都比非毛利人高出 20-30%,但在行为途径中,毛利人获得了更多的 "HALYs"。对于2018年0-4岁的人群,毛利人和非毛利人在行为途径上的健康预期寿命差异在其一生中减少了0-5%。毛利人和非毛利人获得的健康预期寿命年数会有很大变化,这取决于对所实施路径的公平性的假设。与依赖低排放车辆的道路相比,增加体育锻炼的道路对人口健康的影响更大。行为途径对毛利人和非毛利人之间不平等的影响大于技术途径,但取决于支持去碳化的政策如何公平实施。
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Policy approaches to decarbonising the transport sector in Aotearoa New Zealand: modelling equity, population health, and health-system effects

Background

Health co-benefits are a key potential advantage of transport decarbonisation policy. However, health effects will occur in the context of existing transport–health inequities and decarbonisation policies will themselves affect inequities. This research examines the effects of national decarbonisation pathways for transport on population health, health inequity, and health-system costs in Aotearoa New Zealand.

Methods

We modelled the health, health-system, and environmental impacts of two pathways to net zero for transport developed by the New Zealand Climate Change Commission using a proportional multistate lifetable model. The behaviour pathway emphasises a mixed approach, including reduced driving, increased cycling and use of public transport, and light vehicle electrification, and the technology pathway focuses on vehicle electrification. We used data from transport, environmental, population health, and health-care sources to populate the model. We simulated changes in health effects through the pathways of physical activity, air pollution (PM2·5 and NO2), and injury for the Aotearoa New Zealand population from 2018 to 2050. We modelled impacts for Māori (the Indigenous People of Aotearoa) and non-Māori. For each pathway to net zero, we calculated changes in overall health-adjusted life-years (HALYs), age-standardised HALYs, and rate ratios for Māori and non-Māori. We also calculated changes in health-system costs and transport greenhouse gas emissions. 95% uncertainty intervals (95% UIs) were derived for all model outputs by use of a Monte Carlo simulation.

Findings

Both pathways show improvements in population health, reductions in health-system costs, and reduced lifecycle greenhouse gas emissions compared with baseline, although health gains were substantially larger in the behaviour pathway. For example, an extra 2100 HALYs (95% UI 1500–3100) were gained in the behaviour scenario compared with baseline. Health gains were 20–30% larger for Māori than non-Māori in both pathways, although more HALYs were gained by Māori in the behaviour pathway. For the cohort aged 0–4 years in 2018, healthy life expectancy differences between Māori and non-Māori reduced by 0·5% in the behaviour pathway over their lifetime. HALYs gained by Māori and non-Māori were altered substantially depending on assumptions about the equity of the implemented pathway.

Interpretation

Decarbonising transport might improve overall population health, save the health system money, and reduce health inequities between Māori and non-Māori. Pathways that increase physical activity have a larger effect on population health than those that rely on low-emission vehicles. The effects on inequity between Māori and non-Māori are larger in the behaviour pathway than in the technology pathway but dependent on how equitably policies supporting decarbonisation are implemented.

Funding

Health Research Council of New Zealand and University of Otago.

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来源期刊
CiteScore
28.40
自引率
2.30%
发文量
272
审稿时长
8 weeks
期刊介绍: The Lancet Planetary Health is a gold Open Access journal dedicated to investigating and addressing the multifaceted determinants of healthy human civilizations and their impact on natural systems. Positioned as a key player in sustainable development, the journal covers a broad, interdisciplinary scope, encompassing areas such as poverty, nutrition, gender equity, water and sanitation, energy, economic growth, industrialization, inequality, urbanization, human consumption and production, climate change, ocean health, land use, peace, and justice. With a commitment to publishing high-quality research, comment, and correspondence, it aims to be the leading journal for sustainable development in the face of unprecedented dangers and threats.
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