title: Public health impacts of city policies to reduce climate change: findings from the URGENCHE EU-China project.
abstract: BACKGROUND
  Climate change is a global threat to health and wellbeing. Here we provide findings of an international research project investigating the health and wellbeing impacts of policies to reduce greenhouse gas emissions in urban environments.
  
  
  METHODS
  Five European and two Chinese city authorities and partner academic organisations formed the project consortium. The methodology involved modelling the impact of adopted urban climate-change mitigation transport, buildings and energy policy scenarios, usually for the year 2020 and comparing them with business as usual (BAU) scenarios (where policies had not been adopted). Carbon dioxide emissions, health impacting exposures (air pollution, noise and physical activity), health (cardiovascular, respiratory, cancer and leukaemia) and wellbeing (including noise related wellbeing, overall wellbeing, economic wellbeing and inequalities) were modelled. The scenarios were developed from corresponding known levels in 2010 and pre-existing exposure response functions. Additionally there were literature reviews, three longitudinal observational studies and two cross sectional surveys.
  
  
  RESULTS
  There are four key findings. Firstly introduction of electric cars may confer some small health benefits but it would be unwise for a city to invest in electric vehicles unless their power generation fuel mix generates fewer emissions than petrol and diesel. Second, adopting policies to reduce private car use may have benefits for carbon dioxide reduction and positive health impacts through reduced noise and increased physical activity. Third, the benefits of carbon dioxide reduction from increasing housing efficiency are likely to be minor and co-benefits for health and wellbeing are dependent on good air exchange. Fourthly, although heating dwellings by in-home biomass burning may reduce carbon dioxide emissions, consequences for health and wellbeing were negative with the technology in use in the cities studied.
  
  
  CONCLUSIONS
  The climate-change reduction policies reduced CO2 emissions (the most common greenhouse gas) from cities but impact on global emissions of CO2 would be more limited due to some displacement of emissions. The health and wellbeing impacts varied and were often limited reflecting existing relatively high quality of life and environmental standards in most of the participating cities; the greatest potential for future health benefit occurs in less developed or developing countries.
authors.affiliation: School of Geographical Sciences, University of Bristol, Bristol, BS8 1SS, UK. c.sabel@bristol.ac.uk.
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authors.lastname: Sabel
authors.affiliation: School of Geographical Sciences, University of Bristol, Bristol, BS8 1SS, UK.
authors.forename: Rosemary
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authors.affiliation: National Institute for Health and Welfare, FI-70701, Kuopio, Finland.
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authors.affiliation: School of the Environment, Nanjing University, Nanjing, 210023, China.
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authors.affiliation: European Centre for Environment and Human health, University of Exeter Medical School, Exeter, EX1 2LU, UK.
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authors.affiliation: Air Quality Department, DCMR Environmental Protection Agency Rijnmond, Schiedam, The Netherlands.
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authors.affiliation: Institute of Energy Economics and the Rational Use of Energy (IER), University of Stuttgart, 70565, Stuttgart, Germany.
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authors.affiliation: Institute of Energy Economics and the Rational Use of Energy (IER), University of Stuttgart, 70565, Stuttgart, Germany.
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authors.affiliation: IOM (Institute of Occupational Medicine), Riccarton, Edinburgh, Scotland, UK.
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authors.affiliation: Centre for Research and Technology Hellas, Chemical Process and Energy Resources Institute, 57001, Thermi, Greece.
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authors.affiliation: Netherlands Organization for Applied Research (TNO), 3584 CB, Utrecht, The Netherlands.
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authors.affiliation: Department of Geography, University of Canterbury, Christchurch, New Zealand.
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authors.affiliation: Centre for Research and Technology Hellas, Chemical Process and Energy Resources Institute, 57001, Thermi, Greece.
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authors.affiliation: Swiss Tropical and Public Health Institute (Swiss TPH), University of Basel, Basel, Switzerland.
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authors.affiliation: School of the Environment, Nanjing University, Nanjing, 210023, China.
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authors.affiliation: European Centre for Environment and Health, WHO Regional Office for Europe, 53113, Bonn, Germany.
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authors.lastname: Martuzzi
authors.affiliation: School of Geographical Sciences, University of Bristol, Bristol, BS8 1SS, UK.
authors.forename: Katie
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authors.lastname: Morton
authors.affiliation: European Centre for Environment and Health, WHO Regional Office for Europe, 53113, Bonn, Germany.
authors.forename: Pierpaolo
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authors.affiliation: National Institute for Health and Welfare, FI-70701, Kuopio, Finland.
authors.forename: Marjo
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authors.affiliation: Swiss Tropical and Public Health Institute (Swiss TPH), University of Basel, Basel, Switzerland.
authors.forename: Laura
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authors.affiliation: Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece.
authors.forename: Denis
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authors.lastname: Sarigiannis
authors.affiliation: The BMJ, BMA House, London, WC1H 9JP, UK.
authors.forename: Will
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authors.lastname: Stahl-Timmins
authors.affiliation: School of Public Health, University of Bielefeld, Bielefeld, Germany.
authors.forename: Myriam
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authors.lastname: Tobollik
authors.affiliation: National Institute for Health and Welfare, FI-70701, Kuopio, Finland.
authors.forename: Jouni
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authors.affiliation: Air Quality Department, DCMR Environmental Protection Agency Rijnmond, Schiedam, The Netherlands.
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mesh_terms: D000393:Air Pollutants / Q000032:analysis; D000397:Air Pollution / Q000517:prevention & control*; D002681:China; D002947:Cities; D057231:Climate Change; D003430:Cross-Sectional Studies; D005060:Europe; D005062:European Union; D005740:Gases / Q000032:analysis; D033161:Government Regulation; D017752:Greenhouse Effect / Q000517:prevention & control*; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D008137:Longitudinal Studies; D011634:Public Health / Q000331:legislation & jurisprudence*
chemical_list: D000393:Air Pollutants; D005740:Gases