Assessing the Environmental-Health-Economic Co-Benefits from Solar Electricity and Thermal Heating in Ulaanbaatar, Mongolia

Emission reduction strategies and health: a systematic review on the tools and methods to assess co-benefits

OBJECTIVE

The objective of this study is to review the current literature on the health co-benefits of emission reduction strategies and the methods and tools available to assess them.

DESIGN

Systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

DATA SOURCES

PubMed, Scopus, Web of Science, ScienceDirect and GreenFILE were searched from January of 2017 to March of 2023.

ELIGIBILITY CRITERIA

We included original, peer-reviewed journal articles that described emission (ambient air pollutant and greenhouse gases) reduction strategies and assessed their health co-benefits.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers employed standardised methods to search, screen and code the included studies, documenting their findings in an Excel spreadsheet.

RESULTS

From 6687 articles, 82 were included. Most studies show that emissions reduction strategies improve air quality, reducing mortality and morbidity. Health risk assessment and health impact assessment are common, though procedures may cause confusion. About 33% used established models like the integrated exposure-response and global exposure mortality model. Out of all studies, 16% of them used Environmental Benefits Mapping and Analysis Program-Community Edition. Only 17.8% carried out cost-benefit analyses, but these show economic worth in investing in emission reduction strategies.

CONCLUSIONS

Emission reduction strategies significantly enhance human health, with potential co-benefits offsetting intervention costs, which can be an incentive for action in low and middle-income countries. This review emphasises investing in cost-benefit analyses and research, particularly in regions with limited studies on emission reduction and health co-benefits. It provides decision-makers insights into selecting assessment methods and underscores the ongoing need for model and tool evaluation.

PROSPERO REGISTRATION NUMBER

CRD42022332480.

Rethinking Tuberculosis Morbidity Quantification: A Systematic Review and Critical Appraisal of TB Disability Weights in Cost-Effectiveness Analyses

BACKGROUND

The disability-adjusted life year (DALY), a key metric for health resource allocation, encompasses morbidity through disability weights. Widely used in tuberculosis cost-effectiveness analysis (CEAs), DALYs play a significant role in informing intervention adopt/reject decisions. This study reviews the values and consistency of disability weights applied in tuberculosis-related CEAs.

METHODS

We conducted a systematic review using the Tufts CEA database, updated to July 2023 with searches in Embase, Scopus and PubMed. Eligible studies needed to have included a cost-per-DALY ratio, and additionally either evaluated a tuberculosis (TB) intervention or included tuberculosis-related weights. We considered all tuberculosis health states: with/without human immunodeficiency virus (HIV) coinfection, TB treatments and treatment side effects. Data were screened and extracted independently by combinations of two authors.

FINDINGS

A total of 105 studies spanning 2002-2023 across 50 countries (mainly low- and middle-income countries) were extracted. Disability weights were sourced primarily from the Global Burden of Disease (GBD; 100/165; 61%), with 17 non-GBD studies additionally referenced, along with primary derivation. Inconsistencies in the utilisation of weights were evident: of the 100 usages of GBD-sourced weights, only in 47 instances (47%) had the weight value been explicitly specified with an appropriate up-to-date reference cited (constituting 28% of all weight usages, 47/165). Sensitivity analyses on weight values had been conducted in 30% of studies (31/105). Twelve studies did not clearly specify weights or their sources; nine further calculated DALYs without morbidity. The review suggests methodological gaps in current approaches for representing important aspects of TB, including TB-HIV coinfection, treatment, drug-resistance, extrapulmonary TB and psychological impacts. We propose a set of best practice recommendations.

INTERPRETATION

There is a need for increased rigour in the application, sensitivity testing and reporting of TB disability weights. Furthermore, there appears a desire among researchers to reflect elements of the tuberculosis experience beyond those allowed for by GBD disability weights.

Evaluation of Benefits and Health Co-Benefits of GHG Reduction for Taiwan's Industrial Sector under a Carbon Charge in 2023-2030

The purpose of this paper is to evaluate the monetary GHG reduction benefits and health co-benefits for the industrial sector under the imposition of a carbon charge in Taiwan. The evaluation proceeds from 2023-2030 for different rates of carbon charge for the GHGs by a model of "Taiwan Economic Input Output Life Cycle Assessment and Environmental Value" constructed in this study. It is innovative in the literature to simulate the benefits of GHG reductions and health co-benefits of air pollutions for the industrial sector under the imposition of a carbon charge comprehensively. The results consistently show benefits whether the charge is imposed on the scope 1 and scope 2 GHG emissions or on the scope 1 emissions only. The health co-benefits are on average about 5 times those of GHG reductions benefits in 2023-2030. The average total benefits with the summation of GHG reduction benefits and health co-benefits are 821.9 million US dollars and 975.1 US million US dollars per year, respectively. However, both the GHG reduction benefits and health co-benefits are consistently increasing at a decreasing rate in 2023-2030. The increased multiple for the rate of the carbon charge is higher than the increased multiple of the total benefits and this result shows that the increase of the carbon charge becomes less effective.