One Size Does Not Fit All: Financial Incentives Needed to Change Physical Exercise Levels for Different Groups.

This study estimated the distribution of willingness to accept (WTA) for a physical activity behavior change intervention entailing the completion of 10,000 steps/day to shed light on which levels of incentives trigger a change in behavior for different proportions of the population and for more at-risk subgroups. An online contingent valuation (CV) survey was administered to 1130 respondents in the Basque Autonomous Community, Spain. The survey queried respondents about their physical activity levels and intention to engage in physical activity before presenting the WTA questions. Nonparametric WTA values were estimated for the whole sample and for subsamples of active, inactive, and overweight and obese people. One-quarter of respondents would engage with the hypothetical program even without payment, but if a monetary incentive was offered them, they would take it. The median WTA for committing to complete 10,000 steps/day is €0.23 for the full sample, €0.21 for active, €0.25 for inactive, and €0.23 for overweight and obese people. The WTA at 75th percentile is €4 for the full sample, €1.70 for active, €10.80 for inactive, and €5 for overweight and obese respondents. WTA is positively affected by a person's lack of disposable time to increase their physical activity and, for inactive people, by their poor intention to become physically active.

Costs and benefits of soil protection and sustainable land management practices in selected European countries: Towards multidisciplinary insights.

Soil protection and sustainable land management practices for croplands are usually considered to be cost-effective. However, to date little economic information has emerged about these techniques and there is no comprehensive economic appraisal to effectively help guide investment decisions. This review proposes a new multidisciplinary approach for an economic assessment of soil protection practices at the farm level at selected European sites. It draws together and integrates economic data on a selection of measures based on information related to climate change, soil degradation and biodiversity research that are rarely investigated jointly. Out of the studies reviewed, quantitative and qualitative data from 26 scientific papers and technical reports were gathered into a database. For the quantitative data analysis, 14 of those studies were used. The main results show that most practices may not pass the cost/benefit test and that their benefits are not, as is often assumed, systematically higher than their costs. Specific quantitative results are not definitive but we find that estimation methods may have unintended consequences. They may well lead to ineffective investment decisions unless more holistic and multidisciplinary approaches to soil protection are taken.

Health co-benefits and mitigation costs as per the Paris Agreement under different technological pathways for energy supply.

This study assesses the reductions in air pollution emissions and subsequent beneficial health effects from different global mitigation pathways consistent with the 2 °C stabilization objective of the Paris Agreement. We use an integrated modelling framework, demonstrating the need for models with an appropriate level of technology detail for an accurate co-benefit assessment. The framework combines an integrated assessment model (GCAM) with an air quality model (TM5-FASST) to obtain estimates of premature mortality and then assesses their economic cost. The results show that significant co-benefits can be found for a range of technological options, such as introducing a limitation on bioenergy, carbon capture and storage (CCS) or nuclear power. Cumulative premature mortality may be reduced by 17-23% by 2020-2050 compared to the baseline, depending on the scenarios. However, the ratio of health co-benefits to mitigation costs varies substantially, ranging from 1.45 when a bioenergy limitation is set to 2.19 when all technologies are available. As for regional disaggregation, some regions, such as India and China, obtain far greater co-benefits than others.

The socioeconomic future of deltas in a changing environment.

Deltas are especially vulnerable to climate change given their low-lying location and exposure to storm surges, coastal and fluvial flooding, sea level rise and subsidence. Increases in such events and other circumstances are contributing to the change in the environmental conditions in the deltas, which translates into changes in the productivity of ecosystems and, ultimately, into impacts on livelihoods and human well-being. Accordingly, climate change will affect not only the biophysical conditions of deltaic environments but also their economic circumstances. Furthermore, these economic implications will spill over to other regions through goods and services supply chains and via migration. In this paper we take a wider view about some of the specific studies within this Special Issue. We analyse the extent to which the biophysical context of the deltas contributes to the sustainability of the different economic activities, in the deltas and in other regions. We construct a set of environmental-extended multiregional input-output databases and Social Accounting Matrices that are used to trace the flow of provisioning ecosystem services across the supply chains, providing a view of the links between the biophysical environment and the economic activities. We also integrate this information into a Computable General Equilibrium model to assess how the changes in the provision of natural resources due to climate change can potentially affect the economies of the deltas and linked regions, and how this in turn affects economic vulnerability and sustainability in these regions.

Health co-benefits from air pollution and mitigation costs of the Paris Agreement: a modelling study.

BACKGROUND: Although the co-benefits from addressing problems related to both climate change and air pollution have been recognised, there is not much evidence comparing the mitigation costs and economic benefits of air pollution reduction for alternative approaches to meeting greenhouse gas targets. We analysed the extent to which health co-benefits would compensate the mitigation cost of achieving the targets of the Paris climate agreement (2°C and 1·5°C) under different scenarios in which the emissions abatement effort is shared between countries in accordance with three established equity criteria. METHODS: Our study had three stages. First, we used an integrated assessment model, the Global Change Assessment Model (GCAM), to investigate the emission (greenhouse gases and air pollutants) pathways and abatement costs of a set of scenarios with varying temperature objectives (nationally determined contributions, 2°C, or 1·5°C) and approaches to the distribution of climate change methods (capability, constant emission ratios, and equal per capita). The resulting emissions pathways were transferred to an air quality model (TM5-FASST) to estimate the concentrations of particulate matter and ozone in the atmosphere and the resulting associated premature deaths and morbidity. We then applied a monetary value to these health impacts by use of a term called the value of statistical life and compared these values with those of the mitigation costs calculated from GCAM, both globally and regionally. Our analysis looked forward to 2050 in accordance with the socioeconomic narrative Shared Socioeconomic Pathways 2. FINDINGS: The health co-benefits substantially outweighed the policy cost of achieving the target for all of the scenarios that we analysed. In some of the mitigation strategies, the median co-benefits were double the median costs at a global level. The ratio of health co-benefit to mitigation cost ranged from 1·4 to 2·45, depending on the scenario. At the regional level, the costs of reducing greenhouse gas emissions could be compensated with the health co-benefits alone for China and India, whereas the proportion the co-benefits covered varied but could be substantial in the European Union (7-84%) and USA (10-41%), respectively. Finally, we found that the extra effort of trying to pursue the 1·5°C target instead of the 2°C target would generate a substantial net benefit in India (US$3·28-8·4 trillion) and China ($0·27-2·31 trillion), although this positive result was not seen in the other regions. INTERPRETATION: Substantial health gains can be achieved from taking action to prevent climate change, independent of any future reductions in damages due to climate change. Some countries, such as China and India, could justify stringent mitigation efforts just by including health co-benefits in the analysis. Our results also suggest that the statement in the Paris Agreement to pursue efforts to limit temperature increase to 1·5°C could make economic sense in some scenarios and countries if health co-benefits are taken into account. FUNDING: European Union's Horizon 2020 research and innovation programme.

Health effects of adopting low greenhouse gas emission diets in the UK.

OBJECTIVE: Dietary changes which improve health are also likely to be beneficial for the environment by reducing emissions of greenhouse gases (GHG). However, previous analyses have not accounted for the potential acceptability of low GHG diets to the general public. This study attempted to quantify the health effects associated with adopting low GHG emission diets in the UK. DESIGN: Epidemiological modelling study. SETTING: UK. PARTICIPANTS: UK population. INTERVENTION: Adoption of diets optimised to achieve the WHO nutritional recommendations and reduce GHG emissions while remaining as close as possible to existing dietary patterns. MAIN OUTCOME: Changes in years of life lost due to coronary heart disease, stroke, several cancers and type II diabetes, quantified using life tables. RESULTS: If the average UK dietary intake were optimised to comply with the WHO recommendations, we estimate an incidental reduction of 17% in GHG emissions. Such a dietary pattern would be broadly similar to the current UK average. Our model suggests that it would save almost 7 million years of life lost prematurely in the UK over the next 30 years and increase average life expectancy by over 8 months. Diets that result in additional GHG emission reductions could achieve further net health benefits. For emission reductions greater than 40%, improvements in some health outcomes may decrease and acceptability will diminish. CONCLUSIONS: There are large potential benefits to health from adopting diets with lower associated GHG emissions in the UK. Most of these benefits can be achieved without drastic changes to existing dietary patterns. However, to reduce emissions by more than 40%, major dietary changes that limit both acceptability and the benefits to health are required.

Estimating the health effects of greenhouse gas mitigation strategies: addressing parametric, model, and valuation challenges.

BACKGROUND: Policy decisions regarding climate change mitigation are increasingly incorporating the beneficial and adverse health impacts of greenhouse gas emission reduction strategies. Studies of such co-benefits and co-harms involve modeling approaches requiring a range of analytic decisions that affect the model output. OBJECTIVE: Our objective was to assess analytic decisions regarding model framework, structure, choice of parameters, and handling of uncertainty when modeling health co-benefits, and to make recommendations for improvements that could increase policy uptake. METHODS: We describe the assumptions and analytic decisions underlying models of mitigation co-benefits, examining their effects on modeling outputs, and consider tools for quantifying uncertainty. DISCUSSION: There is considerable variation in approaches to valuation metrics, discounting methods, uncertainty characterization and propagation, and assessment of low-probability/high-impact events. There is also variable inclusion of adverse impacts of mitigation policies, and limited extension of modeling domains to include implementation considerations. Going forward, co-benefits modeling efforts should be carried out in collaboration with policy makers; these efforts should include the full range of positive and negative impacts and critical uncertainties, as well as a range of discount rates, and should explicitly characterize uncertainty. We make recommendations to improve the rigor and consistency of modeling of health co-benefits. CONCLUSION: Modeling health co-benefits requires systematic consideration of the suitability of model assumptions, of what should be included and excluded from the model framework, and how uncertainty should be treated. Increased attention to these and other analytic decisions has the potential to increase the policy relevance and application of co-benefits modeling studies, potentially helping policy makers to maximize mitigation potential while simultaneously improving health.

The health effects of climate change: a survey of recent quantitative research.

In recent years there has been a large scientific and public debate on climate change and its direct as well as indirect effects on human health. In particular, a large amount of research on the effects of climate changes on human health has addressed two fundamental questions. First, can historical data be of some help in revealing how short-run or long-run climate variations affect the occurrence of infectious diseases? Second, is it possible to build more accurate quantitative models which are capable of predicting the future effects of different climate conditions on the transmissibility of particularly dangerous infectious diseases? The primary goal of this paper is to review the most relevant contributions which have directly tackled those questions, both with respect to the effects of climate changes on the diffusion of non-infectious and infectious diseases, with malaria as a case study. Specific attention will be drawn on the methodological aspects of each study, which will be classified according to the type of quantitative model considered, namely time series models, panel data and spatial models, and non-statistical approaches. Since many different disciplines and approaches are involved, a broader view is necessary in order to provide a better understanding of the interactions between climate and health. In this respect, our paper also presents a critical summary of the recent literature related to more general aspects of the impacts of climate changes on human health, such as: the economics of climate change; how to manage the health effects of climate change; the establishment of Early Warning Systems for infectious diseases.

The costs of climate change: a study of cholera in Tanzania.

Increased temperatures and changes in rainfall patterns as a result of climate change are widely recognized to entail potentially serious consequences for human health, including an increased risk of diarrheal diseases. This study integrates historical data on temperature and rainfall with the burden of disease from cholera in Tanzania and uses socioeconomic data to control for the impacts of general development on the risk of cholera. The results show a significant relationship between temperature and the incidence of cholera. For a 1 degree Celsius temperature increase the initial relative risk of cholera increases by 15 to 29 percent. Based on the modeling results, we project the number and costs of additional cases of cholera that can be attributed to climate change by 2030 in Tanzania for a 1 and 2 degree increase in temperatures, respectively. The total costs of cholera attributable to climate change are shown to be in the range of 0.32 to 1.4 percent of GDP in Tanzania 2030. The results provide useful insights into national-level estimates of the implications of climate change on the health sector and offer information which can feed into both national and international debates on financing and planning adaptation.

Public health benefits of strategies to reduce greenhouse-gas emissions: overview and implications for policy makers.

This Series has examined the health implications of policies aimed at tackling climate change. Assessments of mitigation strategies in four domains-household energy, transport, food and agriculture, and electricity generation-suggest an important message: that actions to reduce greenhouse-gas emissions often, although not always, entail net benefits for health. In some cases, the potential benefits seem to be substantial. This evidence provides an additional and immediate rationale for reductions in greenhouse-gas emissions beyond that of climate change mitigation alone. Climate change is an increasing and evolving threat to the health of populations worldwide. At the same time, major public health burdens remain in many regions. Climate change therefore adds further urgency to the task of addressing international health priorities, such as the UN Millennium Development Goals. Recognition that mitigation strategies can have substantial benefits for both health and climate protection offers the possibility of policy choices that are potentially both more cost effective and socially attractive than are those that address these priorities independently.

Public health benefits of strategies to reduce greenhouse-gas emissions: low-carbon electricity generation.

In this report, the third in this Series on health and climate change, we assess the changes in particle air pollution emissions and consequent effects on health that are likely to result from greenhouse-gas mitigation measures in the electricity generation sector in the European Union (EU), China, and India. We model the effect in 2030 of policies that aim to reduce total carbon dioxide (CO(2)) emissions by 50% by 2050 globally compared with the effect of emissions in 1990. We use three models: the POLES model, which identifies the distribution of production modes that give the desired CO(2) reductions and associated costs; the GAINS model, which estimates fine particulate matter with aerodynamic diameter 2.5 microm or less (PM(2.5)) concentrations; and a model to estimate the effect of PM(2.5) on mortality on the basis of the WHO's Comparative Risk Assessment methods. Changes in modes of production of electricity to reduce CO(2) emissions would, in all regions, reduce PM(2.5) and deaths caused by it, with the greatest effect in India and the smallest in the EU. Health benefits greatly offset costs of greenhouse-gas mitigation, especially in India where pollution is high and costs of mitigation are low. Our estimates are approximations but suggest clear health gains (co-benefits) through decarbonising electricity production, and provide additional information about the extent of such gains.

Valuing climate change impacts on human health: empirical evidence from the literature.

There is a broad consensus that climate change will increase the costs arising from diseases such as malaria and diarrhea and, furthermore, that the largest increases will be in developing countries. One of the problems is the lack of studies measuring these costs systematically and in detail. This paper critically reviews a number of studies about the costs of planned adaptation in the health context, and compares current health expenditures with MDGs which are felt to be inadequate when considering climate change impacts. The analysis serves also as a critical investigation of the methodologies used and aims at identifying research weaknesses and gaps.

Electricity generation and health.

The provision of electricity has been a great benefit to society, particularly in health terms, but it also carries health costs. Comparison of different forms of commercial power generation by use of the fuel cycle methods developed in European studies shows the health burdens to be greatest for power stations that most pollute outdoor air (those based on lignite, coal, and oil). The health burdens are appreciably smaller for generation from natural gas, and lower still for nuclear power. This same ranking also applies in terms of greenhouse-gas emissions and thus, potentially, to long-term health, social, and economic effects arising from climate change. Nuclear power remains controversial, however, because of public concern about storage of nuclear waste, the potential for catastrophic accident or terrorist attack, and the diversion of fissionable material for weapons production. Health risks are smaller for nuclear fusion, but commercial exploitation will not be achieved in time to help the crucial near-term reduction in greenhouse-gas emissions. The negative effects on health of electricity generation from renewable sources have not been assessed as fully as those from conventional sources, but for solar, wind, and wave power, such effects seem to be small; those of biofuels depend on the type of fuel and the mode of combustion. Carbon dioxide (CO2) capture and storage is increasingly being considered for reduction of CO2 emissions from fossil fuel plants, but the health effects associated with this technology are largely unquantified and probably mixed: efficiency losses mean greater consumption of the primary fuel and accompanying increases in some waste products. This paper reviews the state of knowledge regarding the health effects of different methods of generating electricity.