Abstract and Figures

In the past decade, there has been growing evidence that activities to mitigate climate change can have beneficial impacts on public health as a result of changes to environmental pollutants and health-related behaviours. Urban settlements provide particular opportunities to help achieve reductions in greenhouse gas emissions and thus associated health benefits. Energy efficiency improvements in housing can help protect against the adverse health effects of low and high temperatures and outdoor air pollution; transport interventions, especially ones that entail increased walking and cycling, can help improve physical activity and the urban environment; and switching to low carbon fuels to generate electricity can reduce air pollution-related health burdens. However, interventions need to be carefully designed and implemented to maximize health benefits and minimize potential adverse health risks.
Content may be subject to copyright.
Urban
energy,
carbon
management
(low
carbon
cities)
and
co-benefits
for
human
health
James
Milner
1
,
Michael
Davies
2
and
Paul
Wilkinson
1
In
the
past
decade,
there
has
been
growing
evidence
that
activities
to
mitigate
climate
change
can
have
beneficial
impacts
on
public
health
as
a
result
of
changes
to
environmental
pollutants
and
health-related
behaviours.
Urban
settlements
provide
particular
opportunities
to
help
achieve
reductions
in
greenhouse
gas
emissions
and
thus
associated
health
benefits.
Energy
efficiency
improvements
in
housing
can
help
protect
against
the
adverse
health
effects
of
low
and
high
temperatures
and
outdoor
air
pollution;
transport
interventions,
especially
ones
that
entail
increased
walking
and
cycling,
can
help
improve
physical
activity
and
the
urban
environment;
and
switching
to
low
carbon
fuels
to
generate
electricity
can
reduce
air
pollution-related
health
burdens.
However,
interventions
need
to
be
carefully
designed
and
implemented
to
maximize
health
benefits
and
minimize
potential
adverse
health
risks.
Addresses
1
Department
of
Social
&
Environmental
Health
Research,
London
School
of
Hygiene
&
Tropical
Medicine,
15-17
Tavistock
Place,
London,
WC1H
9SH,
UK
2
Complex
Built
Environment
Systems
Group,
Bartlett
School
of
Graduate
Studies,
University
College
London,
Central
House,
14
Upper
Woburn
Place,
London,
WC1H
0NN,
UK
Corresponding
author:
Wilkinson,
Paul
(paul.wilkinson@lshtm.ac.uk)
Current
Opinion
in
Environmental
Sustainability
2012,
4:398404
This
review
comes
from
a
themed
issue
on
Human
settlements
and
industrial
systems
Edited
by
Heinz
Schandl
and
Anthony
Capon
For
a
complete
overview
see
the
Issue
and
the
Editorial
Received
18
May
2012;
Accepted
17
September
2012
Available
online
4th
October
2012
1877-3435/$
see
front
matter,
#
2012
Elsevier
B.V.
All
rights
reserved.
http://dx.doi.org/10.1016/j.cosust.2012.09.011
Introduction
This
paper
considers
the
issue
of
energy
consumption
by
urban
populations,
the
need
and
opportunities
for
decar-
bonization,
and
the
likely
implications
for
health
of
strat-
egies
aimed
at
reducing
carbon
dioxide
and
other
greenhouse
gas
(GHG)
emissions.
The
focus
on
urban
settings
is
motivated
by
the
projected
growth
of
urban
populations
both
in
absolute
terms
and
as
a
proportion
of
total
world
population,
especially
in
low
and
middle
income
countries,
coupled
with
the
potentially
large
con-
tribution
of
urban
populations
to
energy
consumption
and
GHG
emissions
to
the
atmosphere.
Although
definitions
vary
of
what
constitutes
urban
populations,
estimates
by
the
Population
Division
of
the
United
Nations
Depart-
ment
of
Economic
and
Social
Affairs
suggest
that
by
2008
half
of
the
world’s
population
lived
in
urban
areas,
and
that
this
proportion
may
rise
to
67%
by
2050
[1].
The
scale
and
pace
of
urbanization
are
especially
remarkable
in
Asia
[2].
The
context
of
climate
change
is
now
widely
appreciated.
The
necessary
trajectory
of
abatement
is
extremely
chal-
lenging
[3]:
a
rapid
reversal
of
the
current
upward
trend
in
GHG
emissions,
and
an
eventual
halving
of
global
GHG
emissions
by
midcentury,
with
(under
the
principle
of
convergence
to
an
equitable
global
per
capita
average)
much
larger
reduction
of
8090%
in
high-income
countries
[4].
This
can
only
be
achieved
by
major
changes
in
all
sectors
of
the
economy.
Until
recent
years,
arguments
for
climate
change
mitiga-
tion
were
largely
based
on
the
need
to
avoid
adverse
environmental,
social
and
economic
consequences.
How-
ever,
there
is
now
growing
realization
that
there
may
be
impacts
on
health,
and
that
these
impacts
may
not
only
lie
in
the
avoidance
of
the
largely
deferred
and
uncertain
climate
change-related
impacts,
but
also
in
more
immedi-
ate,
local
impacts
relating
to
changes
in
environmental
pollutants
and
health
behaviours
that
many
decarboniz-
ing
measures
would
entail.
It
is
these
ancillary
impacts
on
health
of
GHG
mitigation,
sometimes
referred
to
as
the
‘health
co-benefits’,
that
are
the
focus
of
this
review.
While
the
term
co-benefit
is
widely
used,
it
should
be
noted
that
the
consequences
of
decarbonization,
though
generally
beneficial
to
health,
are
not
always
so.
A
more
accurate
but
less
attractive
term
would
be
simply
‘health
impact’.
The
literature
in
this
area
is
inchoate
and
largely
confined
to
publications
of
the
last
10
years,
but
growing
rapidly.
This
paper
presents
a
summary
of
the
co-benefit
debate,
and
some
of
the
emerging
issues
for
policy.
Urban
energy
and
carbon
management
Consideration
of
the
large
environmental
footprint
of
cities
might
suggest
a
disproportionate
impact
in
terms
of
energy
use
and
GHG
emissions.
Indeed
previously
reported
figures
[5]
suggest
that
as
much
as
80%
of
global
energy
use
may
be
linked
to
cities.
However,
it
is
imposs-
ible
to
make
precise
statements
about
the
contribution
of
cities
to
global
GHG
emissions
because,
as
the
UN
Habitat
report
notes,
‘‘There
is
no
globally
accepted
definition
of
an
urban
area
or
city,
and
there
are
no
globally
Available
online
at
www.sciencedirect.com
Current
Opinion
in
Environmental
Sustainability
2012,
4:398404
www.sciencedirect.com
accepted
standards
for
recording
emissions
from
sub-
national
areas.’’[6]
Moreover,
the
calculation
depends
on
framing
with
respect
to
responsibility
for
the
pro-
duction
or
consumption
of
energy.
Accounting
for
where
emissions
are
produced
would
suggest
that
cities
account
for
3040%
of
global
anthropogenic
GHG
emissions
[2],
considerably
less
than
a
proportionate
contribution
would
suggest,
while
a
consumption-based
calculation
indicates
a
figure
of
4070%
[7].
Dodman
suggests
that
urban
per
capita
emissions
are
substantially
lower
than
the
average
per
capita
emissions
for
the
countries
in
which
they
are
located
[8
].
However,
he
also
notes
that
there
are
particu-
lar
reasons
to
address
GHG
abatement
at
the
urban
scale,
including
benefits
to
health
[8
,9].
The
opportunities
for
decarbonization
in
any
urban
environment
are
multiple
and
complex.
Substantial
reductions
will
require
the
combination
of
technological
development,
infrastructure
investments
and
behavioural
change.
The
mechanisms
for
achieving
such
change
will
require
the
full
panoply
of
economic,
legislative
and
educational
initiatives.
Though
often
cited
as
a
key
route
to
reducing
energy
use,
it
should
be
noted
that
energy
efficiency
often
leads
to
more
not
less
energy
consumption
[10]
largely
because
of
the
rebound
effect
that
operates
both
at
the
macro-economic
level
[11]
and
in
terms
of
the
decisions
made
by
individual
bodies
and
households
[12,13].
Countless
examples
might
be
cited:
the
effi-
ciency
of
the
car
engine,
air
travel,
street
lighting,
all
of
which
have
grown
exponentially
as
efficiency
(and
hence
affordability)
has
improved
[10].
It
is
true
that
richer
economies,
on
the
whole,
achieve
greater
economic
output
per
unit
of
greenhouse
gas
emissions
(lower
carbon
intensity)
[14],
but
despite
this
the
single
most
important
determinant
of
CO
2
emissions
is
wealth
[15].
This
is
true
among
individuals
and
at
country-level
(see
for
example
country-level
plots
of
CO
2
emissions
vs
per
capita
Gross
Domestic
Product
available
from
Gapminder
world:
www.bit.ly/tAXAv0).
This
relationship
emphasises
the
essential
need
to
decarbonize
energy
sources.
Beyond
meeting
the
targets
of
climate
change
mitigation,
there
are
additional
motivations
to
seek
decarbonization
and
the
diversification
of
energy
sources
away
from
dependence
on
fossil
fuels,
including
concerns
relating
to
the
consequences
of
‘peak
oil’
[1619],
and
the
need
to
ensure
energy
security
both
at
country
level
and
for
individual
households.
Recognition
of
the
potential
gains
to
health
and
of
improved
quality
of
life
is,
for
many,
a
compelling
argument
that
adds
powerful
weight
to
the
case
for
carbon
reduction.
Decarbonization
and
impact
on
public
health
Many
decarbonization
measures
are
not
specific
to
urban
environments
but
could
apply
in
any
setting.
Cities
do,
however,
offer
particular
opportunities
for
decarbo-
nization
in
such
areas
as
mass
transit,
waste-to-energy
generation
and
systems
for
co-generation
of
power
and
use
of
‘waste’
heat.
Although
primarily
used
for
climate
change
adaptation
purposes,
there
are
also
opportunities
for
mitigation
and
health
benefits
in
the
continued
de-
velopment
of
biophylic
cities
(for
instance,
via
reduced
indoor
summer
temperatures
without
the
need
for
air
conditioning
[20]).
It
is
impossible
to
provide
a
compre-
hensive
account
of
all
options
for
GHG
reduction
strat-
egies,
and
the
multiple
pathways
by
which
they
may
influence
health.
Further,
opportunities
for
decarboniza-
tion
exist
in
sectors
that
are
not
specific
to
urban
areas,
for
example
within
food
production
and
agriculture.
The
sections
below
outline
some
key
points
of
principle
in
relation
to
three
important
urban
sectors
(Figure
1).
Current
evidence
is
strongest
and
most
consistent
for
physical
rather
than
mental
health
impacts
and
the
majority
of
research
to
date
has
focused
on
high
income
settings.
As
such,
this
summary
will
focus
largely
on
these
areas.
Built
environment,
housing
In
the
built
environment,
urban
planning
and
the
per-
formance
and
use
of
buildings
are
both
relevant
to
GHG
reduction.
Urban
structure
and
land-use
also
influence
the
urban
heat
island
(UHI)
effect
the
phenomenon
by
which
metropolitan
areas
experience
higher
outdoor
tem-
peratures
than
surrounding
rural
areas
because
of
heat
retention
and
anthropogenic
heat
emissions
associated
with
urban
development
[21].
During
periods
of
summer
heat,
the
UHI
may
both
increase
energy
demand
for
cooling,
and
exacerbate
heat
risks
to
health
[2225].
In
theory,
land
use
changes
designed
to
reduce
the
UHI
effect,
such
as
increasing
green
space,
could
therefore
have
beneficial
effects
on
both,
but
there
are
obvious
practical
constraints
on
the
degree
of
achievable
land
use
change
in
most
cities.
In
addition,
the
potential
winter
benefits
of
the
UHI
for
reduced
heating
demand
and
exposure
to
cold
may
be
diminished.
From
a
health
perspective
it
may
be
more
cost-effective
to
concentrate
on
the
adaptation
of
buildings
to
reduce
exposure
to
heat
in
the
indoor
environment
[26]
even
if
this
conflicts
with
energy
goals
(for
example
through
provision
of
air
con-
ditioning).
Potentially
much
greater
impact
on
health
is
achievable
through
energy
efficiency
improvements
to
housing
[27

].
Energy
efficiency
of
dwellings
(both
new-build
and
refurbishments)
depends
on
the
thermal
transmission
characteristics
of
the
building
fabric
(the
insulation
levels
of
its
walls,
floors
and
roof),
the
control
of
ventilation,
and
the
efficiency
of
heating
and
other
energy-consuming
devices
used
within
the
home,
possibly
coupled
with
the
on-site
capture
of
energy
(solar,
wind,
ground
or
air
source
heat).
Improving
energy
efficiency
can
affect
health
directly
by
influencing
indoor
temperatures,
indoor
air
quality,
the
use
and
cost
of
energy
(with
indirect
effects
on
choices
for
low
income
families),
Climate
change
and
human
health
Milner,
Davies
and
Wilkinson
399
www.sciencedirect.com
Current
Opinion
in
Environmental
Sustainability
2012,
4:398404
and
the
emission
of
toxic
pollutants
to
the
local
environ-
ment.
One
of
the
major
benefits
in
temperate
climates
is
likely
to
be
protection
against
cold-related
morbidity
and
mortality
in
winter,
although
there
is
remarkably
little
direct
empirical
evidence
about
such
impacts.
However,
there
are
good
theoretical
reasons
and
some
indirect
epidemiological
evidence
to
suggest
that
well
insulated
homes
are
not
only
warmer
[28],
but
carry
a
lower
risk
of
adverse
health
effects
[2931]
and
improve
mental
and
psycho-social
well-being
[32,33].
They
may
also
help
to
reduce
indoor
temperatures
during
periods
of
outdoor
heat,
although
there
is
potential
to
exacerbate
the
risk
of
overheating
[34
].
Control
of
ventilation
in
an
attempt
to
reduce
energy
demand
generally
reduces
the
flow
of
air
from
the
outdoor
environment
to
the
inside,
which
has
the
advantage
of
protecting
against
exposure
to
outdoor
pollutants,
particu-
larly
fine
particulate
matter
and
ozone.
However,
reduced
air
exchange
also
has
potential
to
increase
the
concen-
trations
in
the
indoor
air
of
pollutants
derived
from
indoor
sources
(such
as
particles,
nitrogen
dioxide,
carbon
mon-
oxide,
radon,
second-hand
tobacco
smoke,
and
volatile
organic
compounds),
for
which
levels
can
already
be
greater
indoors
than
outdoors
in
some
circumstances
[35,36].
Reduced
ventilation
may
also
have
adverse
effects
on
mould
growth
though
warmer
temperatures
from
improved
energy
efficiency
will
offset
this
to
some
extent
[37].
Whether
tighter
control
of
ventilation
leads
to
net
health
benefits
depends
on
the
nature
of
the
venti-
lation
system,
the
local
outdoor
environment,
the
relative
toxicity
of
particles
of
indoor
and
outdoor
origin,
and
occupant
behaviour
[38].
A
2009
analysis
of
the
effect
of
energy
efficiency
improvements
to
the
UK
housing
stock
of
the
type
and
scale
required
to
meet
2030
climate
change
mitigation
targets
suggested
overall
benefits
to
health
[27

]
benefits
which
could
be
further
maximized
through
judicious
selection
of
intervention
measures
such
as
mechanical
ventilation
and
heat
recovery
(MVHR)
systems
with
particle
filtering.
If
however,
such
systems
are
not
installed,
operated
and
maintained
correctly
then
there
is
the
potential
for
health
disbenefits.
In
low-income
settings
where
occupants
are
often
exposed
to
extremely
high
concentrations
of
combus-
tion-related
pollutants
from
the
inefficient
and
poorly-
ventilated
burning
of
biomass,
the
potential
for
health
gain
is
large
given
growing
evidence
on
the
adverse
effects
of
such
exposure
on
a
range
of
health
outcomes,
including
chronic
obstructive
pulmonary
disease
and
ischaemic
heart
disease
in
adults
and
respiratory
illness
in
children
[27

,39,40
,41].
In
such
settings,
widespread
deployment
of
inexpensive
improved
cook
stoves
can
reduce
particle
exposures
substantially
and
help
to
achieve
major
public
health
gains
while
also
partly
redu-
cing
(mainly
short-lived)
GHG
emissions
[27

].
Improving
energy
efficiency
can
also
help
address
fuel
poverty
[42],
which
may
have
(as
yet
largely
un-quanti-
fied)
effects
on
health
not
only
because
fuel
poor
house-
holds
may
not
heat
their
homes
adequately,
but
also
because
of
impacts
on
the
budgets
of
low
income
families.
400
Human
settlements
and
industrial
systems
Figure
1
Chronic
disease
Mental
wellbeing
Physical
injury
Housing energy
efficiency Active transport Low carbon
motor vehicles
Low carbon
electricity
Indoor air
quality
Internal
temperature/
thermal
comfort
Physical
activity
Urban air
pollution Noise
Current Opinion in Environmental Sustainability
Key
pathways
to
health
of
relevance
to
climate
change
mitigation
in
urban
areas.
Current
Opinion
in
Environmental
Sustainability
2012,
4:398404
www.sciencedirect.com
What
is
more
complex
to
evaluate
is
the
effect
of
switch-
ing
to
more
renewable
sources
where
that
also
increases
energy
costs.
The
impact
depends
on
the
balance
of
household
energy
need
(reduced
by
energy
efficiency),
the
unit
cost
of
energy,
household
income
and
beha-
vioural
factors.
Transportation
The
main
strategies
for
decarbonizing
the
transport
sector
are
switching
to
renewable
fuel
sources
(electric
cars,
hydrogen
fuel
cells)
and/or
reducing
motor
vehicle
travel
by
reducing
the
need
for
journeys,
increasing
provision
of
public
transportation
or
by
encouraging
active
transport
(walking
and
cycling)
in
substitution
for
car
journeys.
Both
sets
of
strategies,
but
especially
those
that
entail
increased
physical
activity,
would
be
expected
to
have
appreciable
and
largely
positive
population
health
impacts
[43,44].
The
complex
pathways
by
which
trans-
port
strategies
may
affect
health
are
broadly
understood,
and
the
World
Health
Organization
has
developed
a
useful
assessment
tool
[45].
Fuel
switching
reduces
emissions
of
toxic
pollutants
to
the
urban
environment
and
thus
has
an
impact
on
air
quality,
with
population
wide
benefits
(to
mainly
cardio-
respiratory
health
[46]).
However,
the
source
of
the
energy
for
the
alternative
fuels
is
critically
important
since
little
climate
change
mitigation
will
be
achieved
if
these
are
based
on
combustion
of
fossil
fuels.
Measures
that
help
to
reduce
methane
(a
precursor
of
tropospheric
ozone
formation)
and
black
carbon
emissions
(notably
emitted
from
diesel
engines),
may
be
especially
effective
in
both
climate
change
mitigation
and
public
health
impact
[47
,48].
However,
fuel
switching
has
few
impacts
on
other
health
outcomes
except
perhaps
those
related
to
noise
pollution
[49

]:
electric
vehicles
are
quieter,
so
their
introduction
would
help
reduce
background
levels
of
noise
and
related
health
impacts
on,
for
example,
cardiovascular
disease
[50]
and
sleep
disturbance
[51].
The
overall
level
of
health
benefits
from
fuel
switching
may
be
substantial
where
there
is
a
high
level
of
substi-
tution
of
conventional
petroleum
fuels,
but
modelling
studies
suggest
they
would
be
modest
by
comparison
with
strategies
that
promote
active
transport
[49,52

].
Regular
walking
or
cycling
in
place
of
motor
transport,
through
their
effect
on
physical
activity
and
personal
energy
balance,
have
potential
for
comparatively
large
benefits
to
health
with
extensive
epidemiological
evi-
dence
on
the
link
between
physical
activity
and
a
range
of
chronic
diseases
(cardiovascular
disease,
cancer
risks,
dementia),
mental
well-being
and
weight-related
con-
ditions
(especially
diabetes
mellitus)
[45,49

].
Increased
active
travel
and
more
walkable
urban
environments
are
also
likely
to
result
in
large
benefits
to
employment
productivity,
with
additional
associated
health
benefits
[53].
Risk
assessment
models
suggest
substantial
health
gains
if
large
population
uptake
of
walking
and
cycling
can
be
achieved
[52

,54,55
].
However,
as
yet
there
is
only
limited
empirical
evidence
that
active
transport
is
associated
with
overall
greater
levels
of
physical
activity
and
weight
reduction
[56

],
though
there
are
favourable
correlations
at
population
level
[57,58].
Moreover,
the
physical
activity
benefits
may
also
depend
on
who
switches
to
walking
and
cycling,
and
there
is
potential
risk
of
increased
road
injury
without
additional
protection
measures
such
as
the
physical
segregation
of
pedestrians
and
cyclists
from
vehicular
traffic
[52

,54].
Reassuringly,
however,
under
reasonable
assumptions,
the
benefits
of
increased
physical
activity
from
cycling
appear
to
be
substantially
larger
than
the
adverse
effects
associated
with
road
injury
or
inhaled
air
pollution
because
of
physical
activity
[59].
Reduced
prioritization
of
motor
transport
can
also
have
a
role
in
improving
community
coherence.
Bringing
about
substantial
shift
in
transport
behaviour
will
often
entail
significant
infrastructure
investment
and
carry
implications
for
land
use
planning
[60].
There
is,
for
example,
evidence
that
high
density
cities
have
lower
transportation-related
energy
consumption
and
CO
2
e
emissions,
[61]
and
more
compact
cities
may
be
important
for
achieving
high
levels
of
walking
and
cycling.
Electricity
generation
Electricity
generation
is
not
specifically
an
urban
issue
but
renewable
generation
is
crucial
for
meeting
GHG
reduction
targets.
There
have
been
multiple
studies
examining
the
potential
health
effects
of
switching
from
fossil
fuels
to
low
carbon
alternatives
[6281].
Quantitat-
ively
the
largest
direct
ancillary
health
effects
of
mitiga-
tion
occur
through
reductions
in
ambient
air
pollution,
and
change
in
occupational
injuries
relating
to
the
fuel
cycle
[82].
Studies
reviewed
in
the
IPCC
Fourth
Assess-
ment
report
[64]
show
that
moderate
CO
2
reductions
(10
20%)
in
the
next
1020
years
also
reduce
sulphur
dioxide
(SO
2
)
emissions
by
1020%,
and
nitrogen
oxides
(NO
X
)
and
particle
emissions
by
510%.
Depending,
among
other
things,
on
the
population
exposed
in
the
targeted
sectors
and
its
vulnerability,
this
can
lead
to
appreciable
population
reduction
in
years
of
life
lost.
Distributed
power
generation
through
multiple
micro-
generation
facilities
is
expected
to
play
an
increasingly
important
role
in
electricity
generation
in
the
future
[83].
If
low
carbon/renewable
methods
are
not
implemented,
an
important
debate
for
urban
environments
relates
to
the
potential
for
additional
local
emissions
of
air
pollutants.
Whether
this
leads
to
an
overall
increase
in
exposure
to
air
pollution
depends
on
complex
interactions
involving
the
relative
locations
of
facilities
and
local
populations,
atmospheric
chemistry,
meteorology
and
pollution
trans-
port
[84].
However,
there
is
the
potential
for
adverse
impacts
if
distributed
systems
are
widely
implemented
in
Climate
change
and
human
health
Milner,
Davies
and
Wilkinson
401
www.sciencedirect.com
Current
Opinion
in
Environmental
Sustainability
2012,
4:398404
densely
population
urban
areas
[85].
Changing
to
more
efficient
systems
(e.g.
increased
use
of
cogeneration
sys-
tems
instead
of
only
electricity
systems)
has
the
potential
for
improved
fuel
efficiency
and
reduced
GHG
and
pollutant
emissions
[86].
Conclusions
Urban
environments
are
a
vital
focus
for
activities
to
help
reduce
GHG
emissions.
Major
changes
are
required
in
all
sectors
of
the
economy
but
these
changes
offer
the
opportunity
for
interventions
that
benefit
public
health.
There
is
growing
recognition
that
climate
change
mitiga-
tion
measures
in
the
built
environment,
transport
sector,
power
generation,
and
other
areas
can
have
appreciable,
largely
positive,
current
and
near-future
impacts
on
popu-
lation
health.
As
Haines
and
colleagues
note,
‘‘these
ancillary
effects
are
important
not
only
because
they
can
provide
an
additional
rationale
to
pursue
mitigation
strategies,
but
also
because
progress
has
been
slow
to
address
international
health
priorities.
.
.
Mitigation
measures
can
thus
offer
an
opportunity
not
only
to
reduce
the
risks
of
climate
change
but
also,
if
well
chosen
and
implemented,
to
deliver
[substantial]
improvements
in
health.’’[87

].
Acknowledgements
The
research
leading
to
these
results
has
received
funding
from
the
European
Union
Seventh
Framework
Programme
FP7/2007-2013
under
grant
agreement
no
265325
(PURGE).
The
authors
also
wish
to
acknowledge
funding
by
Engineering
&
Physical
Sciences
Research
Council
grants
EP/E016375/1,
EP/E016308/1
and
EP/E016448/1
(LUCID)
and
EP/F007132/1
(PUrE
Intrawise),
and
by
Natural
Environment
Research
Council
grant
NE/I007938/1
(AWESOME).
References
and
recommended
reading
Papers
of
particular
interest,
published
within
the
period
of
review,
have
been
highlighted
as:
of
special
interest

of
outstanding
interest
1.
United
Nations
Department
of
Economic
and
Social
Affairs
Population
Division:
World
urbanization
Prospects:
The
2011
Revision.
New
York:
United
Nations;
2012.
2.
UN
HABITAT
and
International
Urban
Training
Center:
Sustainable
Urban
Energy.
A
Sourcebook
for
Asia.
Nairobi,
Kenya:
United
Nations
Human
Settlements
Programme;
2012.
3.
IPCC
Secretariat/World
Meteorological
Organization/United
Nations
Environment
Programme:
Climate
Change
2007:
The
Physical
Science
Basis.
Contribution
of
Working
Group
I
to
the
Fourth
Assessment
Report
of
the
Intergovernmental
Panel
on
Climate
Change.
Cambridge,
UK
and
New
York,
NY,
USA:
Cambridge
University
Press;
2007.
4.
UK
Climate
Change
Committee:
Building
a
low-carbon
economy
the
UK’s
contribution
to
tackling
climate
change.
Committee
on
Climate
Change;
2008.
5.
OECD
(Organisation
for
Economic
Co-operation
and
Development):
Urban
Energy
Handbook:
Good
Local
Practice.
Paris,
France:
OECD
Publication
Services;
1995.
6.
United
Nations
Human
Settlements
Programme:
Global
Report
on
Human
Settlements
2011.
Cities
and
Climate
Change.
Washington:
UN
Habitat
&
Earthscan;
2011.
7.
Walraven
A:
The
Impact
of
Cities
in
Terms
of
Climate
Change.
United
Nations
Environment
Programme;
2009.
8.
Dodman
D:
Blaming
cities
for
climate
change?
An
analysis
of
urban
greenhouse
gas
emissions
inventories.
Environ
Urban
2009,
21:185-201.
Examines
the
role
of
cities
in
global
climate
change,
suggesting
that
their
per
capita
GHG
emissions
may
be
lower
than
the
average
for
the
countries
in
which
the
cities
are
located.
The
paper
also
considers
the
potential
for
cities
to
reduce
their
emissions.
9.
Haines
A,
Dora
C:
How
the
low-carbon
economy
can
improve
health.
BMJ
2012,
344:e1018.
10.
Smil
V:
Energy
at
the
Crossroads:
Global
Perspectives
and
Uncertainties.
Cambridge,
MA:
MIT
Press;
2005.
11.
Barker
T,
Dagoumas
A,
Rubin
J:
The
macroeconomic
rebound
effect
and
the
world
economy.
Energy
Efficiency
2009,
2:411-427.
12.
Sorrell
S,
Dimitropoulos
J,
Sommerville
M:
Empirical
estimates
of
the
direct
rebound
effect:
a
review.
Energy
Policy
2009,
37:1356-1371.
13.
Bra
¨nnlund
R,
Ghalwash
T,
Nordstro
¨m
J:
Increased
energy
efficiency
and
the
rebound
effect:
effects
on
consumption
and
emissions.
Energy
Econ
2007,
29:1-17.
14.
International
Energy
Agency:
World
Energy
Outlook,
2011.
Paris,
France:
IEA;
2011.
15.
Wilkinson
P,
Smith
KR,
Joffe
M,
Haines
A:
A
global
perspective
on
energy:
health
effects
and
injustices.
Lancet
2007,
370:965-978.
16.
Frumkin
H,
Hess
J,
Parker
CL,
Schwartz
BS:
Peak
petroleum:
fuel
for
public
health
debate.
Am
J
Public
Health
2011,
101:1542.
17.
Wilkinson
P:
Peak
oil:
threat,
opportunity
or
phantom?
Public
Health
2008,
122:664-666
discussion
669670.
18.
Schwartz
BS,
Parker
CL,
Hess
J,
Frumkin
H:
Public
health
and
medicine
in
an
age
of
energy
scarcity:
the
case
of
petroleum.
Am
J
Public
Health
2011,
101:1560-1567.
19.
Murphy
DJ,
Hall
CA:
Energy
return
on
investment,
peak
oil,
and
the
end
of
economic
growth.
Ann
N
Y
Acad
Sci
2011,
1219:52-72.
20.
Cheng
C,
Cheung
K,
Chu
L:
Thermal
performance
of
a
vegetated
cladding
system
on
facade
walls.
Build
Environ
2010,
45:1779-1787.
21.
US
Environmental
Protection
Agency:
Heat
Island
Effect;
2012.
22.
Mavrogianni
A,
Davies
M,
Batty
M,
Belcher
SE,
Bohnenstengel
SI,
Carruthers
D,
Chalabi
Z,
Croxford
B,
Demanuele
C,
Evans
S
et
al.:
The
comfort,
energy
and
health
implications
of
London’s
urban
heat
island.
Build
Serv
Eng
Res
Technol
2011,
32:35-52
ISSN
1477-0849,
doi:1410.1177/0143624410394530.
23.
O’Neill
MS,
Ebi
KL:
Temperature
extremes
and
health:
impacts
of
climate
variability
and
change
in
the
United
States.
J
Occup
Environ
Med
2009,
51:13-25.
24.
McMichael
AJ:
The
urban
environment
and
health
in
a
world
of
increasing
globalization:
issues
for
developing
countries.
Bull
World
Health
Organ
2000,
78:1117-1126.
25.
Rydin
Y,
Bleahu
A,
Davies
M,
Davila
JD,
Friel
S,
De
Grandis
G,
Groce
N,
Hallal
PC,
Hamilton
I,
Howden-Chapman
P
et
al.:
Shaping
cities
for
health:
complexity
in
the
planning
of
urban
environments
in
the
21st
century.
Lancet
2012,
379:2079-2108.
26.
Oikonomou
E,
Davies
M,
Mavrogianni
A,
Biddulph
P,
Wilkinson
P,
Kolokotroni
M:
Modelling
the
relative
importance
of
the
urban
heat
island
and
the
thermal
quality
of
dwellings
for
overheating
in
London.
Build
Environ
2012.
online
12
April
2012.
27.

Wilkinson
P,
Smith
KR,
Davies
M,
Adair
H,
Armstrong
B,
Barrett
M,
Bruce
N,
Haines
A,
Hamilton
I,
Oreszczyn
T
et
al.:
Public
health
benefits
of
strategies
to
reduce
greenhouse-gas
emissions:
household
energy.
Lancet
2009,
374:1917-1929.
This
paper
models
the
effects
on
health
and
CO
2
emissions
of
strategies
to
improve
the
energy
efficiency
of
UK
houses
and
to
introduce
improved
cookstoves
in
India.
The
results
suggest
that
household
energy
interven-
tions
can
provide
potential
benefits
for
health
and
climate
change
mitiga-
tion.
Large
health
benefits
are
suggested
for
cook
stoves.
402
Human
settlements
and
industrial
systems
Current
Opinion
in
Environmental
Sustainability
2012,
4:398404
www.sciencedirect.com
28.
Oreszczyn
T,
Hong
S,
Ridley
I,
Wilkinson
P:
Determinants
of
winter
indoor
temperatures
in
low
income
households
in
England.
Energy
Build
2006,
38:245-252.
29.
Wilkinson
P,
Landon
M,
Armstrong
B,
Stevenson
S,
McKee
M:
Cold
Comfort:
The
Social
and
Environmental
Determinants
of
Excess
Winter
Death
in
England
19861996.
York:
Joseph
Rowntree
Foundation;
2001.
30.
Osman
LM,
Ayres
JG,
Garden
C,
Reglitz
K,
Lyon
J,
Douglas
JG:
A
randomised
trial
of
home
energy
efficiency
improvement
in
the
homes
of
elderly
COPD
patients.
Eur
Respir
J
2010,
35:303-309.
31.
Howden-Chapman
P,
Matheson
A,
Crane
J,
Viggers
H,
Cunningham
M,
Blakely
T,
Cunningham
C,
Woodward
A,
Saville-
Smith
K,
O’Dea
D
et
al.:
Effect
of
insulating
existing
houses
on
health
inequality:
cluster
randomised
study
in
the
community.
BMJ
2007,
334:460.
32.
Gilbertson
J,
Stevens
M,
Stiell
B,
Thorogood
N:
Home
is
where
the
hearth
is:
grant
recipients’
views
of
England’s
home
energy
efficiency
scheme
(Warm
Front).
Soc
Sci
Med
2006,
63:946-956.
33.
Liddell
C,
Morris
C:
Fuel
poverty
and
human
health:
a
review
of
recent
evideence.
Energy
Policy
2010,
38:2987-2997.
34.
Mavrogianni
A,
Wilkinson
P,
Davies
M,
Biddulph
P,
Oikonomou
E:
Building
characteristics
as
determinants
of
propensity
to
high
indoor
summer
temperatures
in
London
dwellings.
Build
Environ
2012,
55:117-130.
This
paper
looks
at
how
building
characteristics
influence
the
probability
of
overheating
in
dwellings.
The
paper
determines
the
effect
of
individual
fabric
attributes
on
indoor
overheating
in
the
London
housing
stock.
35.
Brown
S,
Sim
M,
Abramsom
M,
Gray
C:
Concentrations
of
Volatile
Organic
Compounds
in
indoor
air
a
review.
Indoor
Air
1994,
4:123-134.
36.
Raw
G,
Coward
S,
Brown
V,
Crump
D:
Exposure
to
air
pollutants
in
English
homes.
J
Expo
Anal
Environ
Epidemiol
2004,
14:S85-
S94.
37.
Oreszczyn
T,
Ridley
I,
Hong
S,
Wilkinson
P:
Mould
and
winter
indoor
relative
humidity
in
low
income
households
in
England.
Indoor
Built
Environ
2006,
15:125-135.
38.
Bone
A,
Murray
V,
Myers
I,
Dengel
A,
Crump
D:
Will
drivers
for
home
energy
efficiency
harm
occupant
health?
Perspect
Public
Health
2010,
130:233-238.
39.
Jeuland
MA,
Pattanayak
SK:
Benefits
and
costs
of
improved
cookstoves:
assessing
the
implications
of
variability
in
health,
forest
and
climate
impacts.
PLoS
ONE
2012,
7:e30338.
40.
McCracken
J,
Smith
KR,
Stone
P,
Diaz
A,
Arana
B,
Schwartz
J:
Intervention
to
lower
household
wood
smoke
exposure
in
Guatemala
reduces
ST-segment
depression
on
electrocardiograms.
Environ
Health
Perspect
2011,
119:1562-
1568.
This
paper
describes
an
intervention
to
reduce
cardiovascular
effects
of
indoor
air
pollution
from
household
solid
fuel
use
in
Guatemala
as
a
result
of
replacing
open
stoves
with
chimney
stoves.
41.
Perez-Padilla
R,
Schilmann
A,
Riojas-Rodriguez
H:
Respiratory
health
effects
of
indoor
air
pollution.
Int
J
Tuberc
Lung
Dis
2010,
14:1079-1086.
42.
Hills
J:
Fuel
Poverty:
The
problem
and
its
measurement.
CASE
Report
69.
London:
LSE
for
the
Department
of
Energy
and
Climate
Change;
2012.
43.
Giles-Corti
B,
Foster
S,
Shilton
T,
Falconer
R:
The
co-benefits
for
health
of
investing
in
active
transportation.
N
S
W
Public
Health
Bull
2010,
21:122-127.
44.
Woodcock
J,
Banister
D,
Edwards
P,
Prentice
AM,
Roberts
I:
Energy
and
transport.
Lancet
2007,
370:1078-1088.
45.
World
Health
Organization:
Health
Economic
Assessment
Tools
(HEAT)
for
Walking
and
for
Cycling.
Copenhagen:
World
Health
Organization;
2011.
46.
World
Health
Organization:
Air
quality
guidelines
global
update
2005.
Copenhagen:
World
Health
Organization;
2005.
47.
Shindell
D,
Kuylenstierna
JCI,
Vignati
E,
van
Dingenen
R,
Amann
M,
Klimont
Z,
Anenberg
SC,
Muller
N,
Janssens-
Maenhout
G,
Raes
F
et
al.:
Simultaneously
mitigating
near-term
climate
change
and
improving
human
health
and
food
security.
Science
2012,
335:183-189.
This
paper
examines
the
benefits
for
human
health
and
crop
yields
of
measures
to
control
tropospheric
ozone
and
black
carbon
emissions.
48.
Janssen
NA,
Hoek
G,
Simic-Lawson
M,
Fischer
P,
van
Bree
L,
ten
Brink
H,
Keuken
M,
Atkinson
RW,
Anderson
HR,
Brunekreef
B
et
al.:
Black
carbon
as
an
additional
indicator
of
the
adverse
health
effects
of
airborne
particles
compared
with
PM10
and
PM2.5.
Environ
Health
Perspect
2011,
119:1691-1699.
49.

de
Nazelle
A,
Nieuwenhuijsen
MJ,
Anto
JM,
Brauer
M,
Briggs
D,
Braun-Fahrlander
C,
Cavill
N,
Cooper
AR,
Desqueyroux
H,
Fruin
S
et
al.:
Improving
health
through
policies
that
promote
active
travel:
a
review
of
evidence
to
support
integrated
health
impact
assessment.
Environ
Int
2011,
37:766-777.
A
literature
review
on
the
health
impacts
of
policies
to
promote
active
travel.
50.
Ndrepepa
A,
Twardella
D:
Relationship
between
noise
annoyance
from
road
traffic
noise
and
cardiovascular
diseases:
a
meta-analysis.
Noise
Health
2011,
13:251-259.
51.
Kawada
T:
Noise
and
health
sleep
disturbance
in
adults.
J
Occup
Health
2011,
53:413-416.
52.

Woodcock
J,
Edwards
P,
Tonne
C,
Armstrong
BG,
Ashiru
O,
Banister
D,
Beevers
S,
Chalabi
Z,
Chowdhury
Z,
Cohen
A
et
al.:
Public
health
benefits
of
strategies
to
reduce
greenhouse-
gas
emissions:
urban
land
transport.
Lancet
2009,
374:1930-1943.
This
paper
examines
the
health
effects
of
alternative
urban
land
tranpsort
in
London
and
Delhi.
Lower-emission
motor
vehicles
were
found
to
reduce
the
health
burden
from
urban
air
pollution,
but
increasing
active
travel
had
a
much
larger
impact
on
health.
53.
Trubka
R,
Newman
P,
Bilsborough
D:
GEN
85
the
costs
of
urban
sprawl
physical
activity
links
to
healthcare
costs
and
productivity.
Environ
Des
Guide
2010:1-13.
54.
Rojas-Rueda
D,
de
Nazelle
A,
Tainio
M,
Nieuwenhuijsen
MJ:
The
health
risks
and
benefits
of
cycling
in
urban
environments
compared
with
car
use:
health
impact
assessment
study.
BMJ
2011,
343:d4521.
55.
Grabow
ML,
Spak
SN,
Holloway
T,
Stone
B,
Mednick
AC,
Patz
JA:
Air
quality
and
exercise-related
health
benefits
from
reduced
car
travel
in
the
midwestern
United
States.
Environ
Health
Perspect
2012,
120:68-76.
This
paper
quantifies
the
health
benefits
owing
to
improved
air
quality
and
physical
fitness
of
reducing
the
use
of
motor
vehicles
for
short
and
suburban
journeys.
56.

Wanner
M,
Gotschi
T,
Martin-Diener
E,
Kahlmeier
S,
Martin
BW:
Active
transport,
physical
activity,
and
body
weight
in
adults:
a
systematic
review.
Am
J
Prev
Med
2012,
42:493-502.
This
is
a
systematic
review
on
associations
between
active
transport,
general
physical
activity,
and
body
weight,
suggesting
that
there
is
currently
limited
evidence
that
active
transport
is
associated
with
more
physical
activity
and
lower
body
weight
in
adults.
57.
Pucher
J,
Buehler
R,
Bassett
DR,
Dannenberg
AL:
Walking
and
cycling
to
health:
a
comparative
analysis
of
city,
state,
and
international
data.
Am
J
Public
Health
2010,
100:1986-1992.
58.
Bassett
DR
Jr,
Pucher
J,
Buehler
R,
Thompson
DL,
Crouter
SE:
Walking,
cycling,
and
obesity
rates
in
Europe,
North
America,
and
Australia.
J
Phys
Act
Health
2008,
5:795-814.
59.
Johan
de
Hartog
J,
Boogaard
H,
Nijland
H,
Hoek
G:
Do
the
health
benefits
of
cycling
outweigh
the
risks?
Environ
Health
Perspect
2010,
118:1109-1116.
60.
Capon
AGSE,
Holliday
S:
Urbanism,
climate
change
and
health:
systems
approaches
to
governance.
20(12),
2428.
NSW
Public
Health
Bull
2009,
20:24-28.
61.
Kirby
A:
Kick
the
Habit.
UN
Guide
to
Climate
Neutrality.
Nairobi,
Kenya:
United
Nations
Environment
Programme;
2008.
62.
Gohlke
JM,
Thomas
R,
Woodward
A,
Campbell-Lendrum
D,
Pruss-Ustun
A,
Hales
S,
Portier
CJ:
Estimating
the
global
public
Climate
change
and
human
health
Milner,
Davies
and
Wilkinson
403
www.sciencedirect.com
Current
Opinion
in
Environmental
Sustainability
2012,
4:398404
health
implications
of
electricity
and
coal
consumption.
Environ
Health
Perspect
2011,
119:821-826.
63.
Markandya
A,
Armstrong
BG,
Hales
S,
Chiabai
A,
Criqui
P,
Mima
S,
Tonne
C,
Wilkinson
P:
Public
health
benefits
of
strategies
to
reduce
greenhouse-gas
emissions:
low-carbon
electricity
generation.
Lancet
2009,
374:2006-2015.
64.
IPCC:
Climate
Change
2007:
The
Physical
Science
Basis.
Fourth
Assessment
Report
of
the
Intergovernmental
Panel
on
Climate
Change.
Cambridge,
UK
and
New
York,
NY,
USA:
Contribution
of
IPCC
Working
Group
I;
2007.
[Press
CU
(Series
Editor)].
65.
Bollen
JC,
Brink
CJ,
Eerens
HC,
Manders
AJG:
Co-benefits
of
climate
policy.
Bilthoven,
NL:
Netherlands
Environment
Agency;
2009
[vol
PBL
Report
No.
5001116005].
66.
Aunan
K,
Fang
J,
Vennemo
H,
Oye
K,
Seip
HM:
Co-benefits
of
climate
policy
lessons
learned
from
a
study
in
Shanxi,
China.
Energy
Policy
2004,
32:567-581.
67.
Burtraw
D,
Palmer
K,
Krupnick
A,
Toman
M,
Paul
A,
Bloyd
C:
Ancillary
benefits
of
reduced
air
pollution
in
the
US
from
moderate
greenhouse
gas
mitigation
policies
in
the
electricity
sector.
J
Environ
Econ
Manage
2003,
45:650-673.
68.
Dessus
S,
O’Connor
D:
Climate
policy
without
tears:
CGE-
based
ancillary
benefits
estimates
for
Chile.
Environ
Resour
Econ
2003,
25:287-317.
69.
Holland
M,
Pye
S:
Assessing
the
air
pollution
benefits
of
further
climate
measures
in
the
EU
up
to
2020.
Didcot,
UK:
AEA
Technology;
2006.
70.
Joh
S,
Nam
Y-M,
Shim
S,
Sung
J,
Shin
Y:
Empirical
study
of
environmental
ancillary
benefits
due
to
greenhouse
gas
mitigation
in
Korea.
Int
J
Sustain
Dev
2003,
6:311-327.
71.
Morgenstern
RD,
Krupnick
A,
Zhang
X:
The
ancillary
carbon
benefits
of
SO2
reductions
from
a
small-boiler
policy
in
Taiyuan,
PRC.
J
Environ
Dev
2004,
13:140-155.
72.
Cao
J,
Ho
MS,
Jorgenson
DW:
‘‘Co-benefits’’
of
greenhouse
gas
mitigation
policies
in
China:
an
integrated
top-down
and
bottom-up
modeling
analysis.
Environment
for
Development
discussion
paper;
2008.
73.
Bussolo
M,
O’Connor
D:
Clearing
the
air
in
India:
the
economics
of
climate
policy
with
ancillary
benefits.
OECD
Development
Centre;
2001.
74.
Vennemo
H,
Aunan
K,
Jinghua
F,
Holtedahl
P,
Tao
H,
Seip
HM:
Domestic
environmental
benefits
of
China’s
energy-related
CDM
potential.
Climate
Change
2006,
75:215-239.
75.
McKinley
G,
Zuk
M,
Ho
¨jer
M,
Avalos
M,
Gonza
´lez
I,
Iniestra
R,
Laguna
I,
Martı
´nez
MA,
Osnaya
P,
Reynales
LM
et
al.:
Quantification
of
local
and
global
benefits
from
air
pollution
control
in
Mexico
City.
Environ
Sci
Technol
2005,
39:1954-1961.
76.
EEA:
Air
quality
and
ancillary
benefits
of
climate
change
policies.
Copenhagen,
DK:
European
Environment
Agency;
2006.
77.
Wang
X,
Smith
KR:
Secondary
benefits
of
greenhouse
gas
control:
health
impacts
in
China.
Environ
Sci
Technol
1999,
33:3056-3061.
78.
IPCC:
In
IPCC
Special
Report
on
Carbon
Dioxide
Capture
and
Storage.
Edited
by
Metz
B,
Davidson
O,
Coninck
HCD,
Loos
M,
Meyer
LA.
Cambridge,
UK
and
New
York,
NY,
USA:
Working
Group
III
of
the
Intergovernmental
Panel
on
Climate
Change;
2005.
[Press
CU
(Series
Editor)].
79.
Koornneef
J,
Harmelen
TV,
Horssen
AV,
Gijlswijk
RV,
Ramirez
A,
Faaij
A,
Turkenburg
W:
The
impacts
of
CO
2
capture
on
transboundary
air
pollution
in
the
Netherlands.
Energy
Procedia
2009,
1:3787-3794.
80.
IPCC:
Climate
Change
2001:
Mitigation.
Third
Assessment
Report
of
the
Intergovernmental
Panel
on
Climate
Change.
Cambridge,
UK:
Contribution
of
IPCC
Working
Group
III;
2001.
[Press
CU
(Series
Editor)].
81.
OECD:
Ancillary
benefits
and
costs
of
greenhouse
gas
mitigation:
proceedings
of
the
IPCC
Co-Sponsored
Workshop.
Organisation
for
Economic
Co-operation
and
Development;
2000.
82.
Markandya
A,
Wilkinson
P:
Electricity
generation
and
health.
Lancet
2007,
370:979-990.
83.
UKERC:
UK
Energy
2050.
UK
Energy
Research
Centre
(UKERC);
2009.
84.
Carreras-Sospedra
M,
Vutukuru
S,
Brouwer
J,
Dabdub
D:
Central
power
generation
versus
distributed
generation
an
air
quality
assessment
in
the
South
Coast
Air
Basin
of
California.
Atmos
Environ
2010,
44:3215-3223.
85.
Heath
G,
Granvold
P,
Hoats
A,
Nazaroff
W:
Quantifiying
the
Air
Pollution
Exposure
Consequences
of
Distributed
Electricity
Generation.
Berkeley,
CA:
University
of
California
Energy
Institute;
2005.
86.
Strachan
N,
Farrell
A:
Emissions
from
distributed
vs.
centralized
generation:
the
importance
of
system
performance.
Energy
Policy
2006,
34:2677-2689.
87.

Haines
A,
McMichael
AJ,
Smith
KR,
Roberts
I,
Woodcock
J,
Markandya
A,
Armstrong
BG,
Campbell-Lendrum
D,
Dangour
AD,
Davies
M
et
al.:
Public
health
benefits
of
strategies
to
reduce
greenhouse-gas
emissions:
overview
and
implications
for
policy
makers.
Lancet
2009,
374:2104-2114.
This
paper
provides
an
overview
of
a
series
of
papers
on
the
potential
health
benefits
of
tackling
climate
change.
404
Human
settlements
and
industrial
systems
Current
Opinion
in
Environmental
Sustainability
2012,
4:398404
www.sciencedirect.com