Policy approaches to decarbonising the transport sector in Aotearoa New Zealand: modelling equity, population health, and health-system effects

The Lancet Planetary Health

1 Sep 2024

Shaw et al.

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.

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.

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Key issues

HEALTH SERVICES AND SYSTEMS

Covering developments in the provision, funding and organisation of health care services.

EQUITY

Exploring the impacts of the health system on minorities within the population, notably including Māori, Pacifica, Asians and LGBTQI.

DRUGS, DEVICE AND DIAGNOSTICS

Covering prescription medicines and medical devices.

PUBLIC HEALTH

Focusing on efforts to promote health and prevent disease through social and economic interventions.

DIGITAL HEALTH

Exploring the potential digital transformation to provide a more connected and accessible health system.

TE TIRITI

Monitoring how the health reforms and the performance of the health sector uphold Te Tiriti obligations.