Policy approaches to decarbonising the transport sector in Aotearoa/NZ: Equity, health and health system impacts

BackgroundHealth co-benefits are a key potential advantage of transport decarbonisation policy. However, health impacts will occur in the context of existing transport-health inequities and decarbonisation policies will themselves impact inequities. MethodsWe modelled the health, health system and environmental impacts of the Behaviour and Technology pathways developed by the New Zealand Climate Change Commission. Household transport related health impacts were modelled through the pathways of physical activity, air pollution (PM2{middle dot}5 and NO2) and injury for the New Zealand population from 2018 to 2050. We modelled impacts for M[a]ori (the Indigenous Peoples of Aotearoa) and non-M[a]ori. FindingsBoth pathways show improvements in population health, reductions in health system costs and reduced lifecycle greenhouse gas emissions compared to baseline, although health gains were substantially larger in the Behaviour pathway. Health gains were 20-30% larger for M[a]ori than non-M[a]ori in both pathways, although more healthy life years were gained by M[a]ori in the Behaviour pathway. For those aged 0-4 in 2018, healthy life expectancy differences between M[a]ori and non-M[a]ori reduced by 0{middle dot}5% in the Behaviour pathway. Healthy life years gained by M[a]ori and non-M[a]ori altered substantially depending on assumptions about the equity of the implemented pathway. InterpretationDecarbonising transport may reduce health and healthy life expectancy inequities between M[a]ori and non-M[a]ori if policies supporting decarbonisation are implemented equitably. Pathways that increase physical activity will have a much larger impact on population health than those which rely on low emission vehicles. Funding: Health Research Council of New Zealand (20/151) and University of Otago.