Abstract
The Sustainable Development Goals (SDGs) recognise the critical need to improve population health and environmental sustainability. This paper describes the development of a microsimulation model, MicroEnv, aimed at quantifying the impact of environmental exposures on health as an aid to selecting policies likely to have greatest benefit. Its methods allow the integration of morbidity and mortality outcomes and the generation of results at high spatial resolution. We illustrate its application to the assessment of the impact of air pollution on health in London. Simulations are performed at Lower Layer Super Output Area (LSOA), the smallest geographic unit (population of around 1500 inhabitants) for which detailed socio-demographic data are routinely available in the UK. The health of each individual in these LSOAs is simulated year-by-year using a health-state-transition model, where transition probabilities from one state to another are based on published statistics modified by relative risks that reflect the effect of environmental exposures. This is done through linkage of the simulated population in each LSOA with 1 × 1 km annual average PM2.5 concentrations and area-based deprivation indices. Air pollution is a leading cause of mortality and morbidity globally, and improving air quality is critical to the SDGs for Health (Goal 3) and Cities (Goal 11). The evidence of MicroEnv is aimed at providing better understanding of the benefits for population health and health inequalities of policy actions that affect exposure such as air quality, and thus to help shape policy decisions. Future work will extend the model to integrate other environmental determinants of health.
Highlights
IntroductionReducing the adverse consequences of poor environmental conditions is an important objective of several of the Sustainable Development Goals (United Nations, 2017), including, but not limited to, Goal 7 (affordable, clean energy), Goal 11 (sustainable cities and communities), and Goal 13 (climate action)
Reducing the adverse consequences of poor environmental conditions is an important objective of several of the Sustainable Development Goals (United Nations, 2017), including, but not limited to, Goal 7, Goal 11, and Goal 13
Air pollution can be used as a marker of sustainable development, as measures taken to achieve a low-carbon economy, such as reductions in transport or industry impact on atmospheric emissions, and effect a reduction in air pollution, including climate modifying pollutants
Summary
Reducing the adverse consequences of poor environmental conditions is an important objective of several of the Sustainable Development Goals (United Nations, 2017), including, but not limited to, Goal 7 (affordable, clean energy), Goal 11 (sustainable cities and communities), and Goal 13 (climate action). Policies aimed at improving environmental conditions have benefits to health, either through direct effects or as co-benefits (such as increasing physical activity). Quantifying the potential impact on health of policies aimed at achieving these SDGs, or of reducing environmental exposures in general, is of increasing interest to policymakers in order to track progress and evaluate effectiveness of policies and their respective impacts on health. Such policies include those aimed at the transition to a low carbon economy, many of which have potential impacts that are often, but not always, beneficial for health. Among the prominent issues of concern are those of outdoor air pollution and population health
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