title: Quantifying the efficiency and equity implications of power plant air pollution control strategies in the United States.
abstract: BACKGROUND
  In deciding among competing approaches for emissions control, debates often hinge on the potential tradeoffs between efficiency and equity. However, previous health benefits analyses have not formally addressed both dimensions.
  
  
  OBJECTIVE
  We modeled the public health benefits and the change in the spatial inequality of health risk for a number of hypothetical control scenarios for power plants in the United States to determine optimal control strategies.
  
  
  METHODS
  We simulated various ways by which emission reductions of sulfur dioxide (SO(2)), nitrogen oxides, and fine particulate matter (particulate matter < 2.5 microm in diameter; PM(2.5)) could be distributed to reach national emissions caps. We applied a source-receptor matrix to determine the PM(2.5) concentration changes associated with each control scenario and estimated the mortality reductions. We estimated changes in the spatial inequality of health risk using the Atkinson index and other indicators, following previously derived axioms for measuring health risk inequality.
  
  
  RESULTS
  In our baseline model, benefits ranged from 17,000-21,000 fewer premature deaths per year across control scenarios. Scenarios with greater health benefits also tended to have greater reductions in the spatial inequality of health risk, as many sources with high health benefits per unit emissions of SO(2) were in areas with high background PM(2.5) concentrations. Sensitivity analyses indicated that conclusions were generally robust to the choice of indicator and other model specifications.
  
  
  CONCLUSIONS
  Our analysis demonstrates an approach for formally quantifying both the magnitude and spatial distribution of health benefits of pollution control strategies, allowing for joint consideration of efficiency and equity.
authors.affiliation: Department of Environmental Health, Exposure Epidemiology and Risk Program, and Harvard Center for Risk Analysis, Harvard School of Public Health, Boston, Massachusetts 02215, USA. jilevy@hsph.harvard.edu
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Levy
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Wilson
authors.forename: Leonard M
authors.initials: LM
authors.lastname: Zwack
mesh_terms: D000397:Air Pollution / Q000517:prevention & control*; D003198:Computer Simulation; D004777:Environment; D008962:Models, Theoretical; D011210:Power Plants / Q000191:economics* / Q000592:standards* / Q000706:statistics & numerical data; D011634:Public Health; D018570:Risk Assessment; D014481:United States