The Lancet Countdown UK case study
Authors: Laurie Laybourn-Langton, Robin Stott
Journal: The Lancet Planetary Health (2018)

Studies on the benefits of tackling climate change abound. In The Lancet Planetary Health, the study by Martin L Williams and colleagues1Williams ML Kitwiroon N Dajnak D et al.The Lancet Countdown on health benefits from the UK Climate Change Act: a modelling study.Lancet Planet Health. 2018; 2: e202-e213Summary Full Text Full Text PDF PubMed Scopus (28) Google Scholar has the great merit of using large datasets to illuminate the possible health benefits of reducing greenhouse gas emissions. In the UK, the necessity to reduce emissions is enshrined in law through the 2008 Climate Change Act. Williams and colleagues rightly acknowledge that the Act was groundbreaking, positioning the UK as a world leader in reacting to climate change. By helping to decouple economic growth from carbon emissions, the Act has had an essential role in sending the UK on a more sustainable, prosperous course.2Committee on Climate ChangeMeeting carbon budgets: closing the policy gap. 2017 report to parliament.https://www.theccc.org.uk/wp-content/uploads/2017/06/2017-Report-to-Parliament-Meeting-Carbon-Budgets-Closing-the-policy-gap.pdfDate: 2017Date accessed: April 3, 2018Google Scholar By providing an estimate of the considerable health benefits from travelling further on this course (eg, 4 892 000–7 178 000 life-years saved from the reduction in nitrogen dioxide concentrations between 2011 and 2154 for two scenarios), the authors have done us a great service, highlighting the essential role the Act has, in this, its tenth year. But, as they point out, unintended consequences might arise, depending on the different policies adopted for decarbonisation. The promotion of diesel fuel in the 1990s—and the resultant air pollution problem—shows how the unintended consequences of well meaning policies can cause great harm, and potentially discredit our attempts to tackle climate change. This Article shows that even if vehicles became cleaner, projected increases in the number of vehicles and, crucially, journeys sees particulate matter air pollution increasing, resulting from factors include wear and tear of tyres. It must be stressed that any potential unintended consequences of decarbonisation are likely to be avoidable and thus are not a necessary result of the Climate Change Act. The Act requires governments to attend, with urgency, to one of the most pressing problems—the need to decarbonise human activity so as to avoid increasingly dangerous climate disruption. Other policies need to identify and then address the unintended consequences. A major virtue of this study is that it developed a method to tackle these unintended consequences—and is one that is transferable to assessments of the public health impacts of decarbonisation policies. In doing so, it affirms that capturing and analysing big data, with the specific intention of identifying unsuspected benefits or unwanted consequences, should be an essential component of any set of policies. Be realistic—demand the impossible was the slogan in the Paris of 1968, and using the method outlined in the study by Williams and colleagues offers policy makers the opportunity to embrace that wisdom. The government could achieve its carbon targets in several ways, from accelerating the replacement of fossil fuels by renewable energy to incentivising walking and cycling over driving—many of which can have attendant health benefits.3Hosking J Mudu P Fletcher E [2011] Health co-benefits of climate change mitigation: transport sector.http://apps.who.int/iris/bitstream/handle/10665/70913/9789241502917_eng.pdf;jsessionid=0D3380F856F8B4B935D454CE0E23B9A2?sequence=1Date accessed: April 4, 2018Google Scholar All demand good data combined with vision and strong guidance and support for those policy makers who will need to implement these policies. These policies must also recognise the wider reality of environmental change. Aggregate human activity has pushed natural systems into unsafe operating spaces, threatening their stability.4Rockström J Steffen W Noone K et al.Planetary boundaries: exploring the safe operating space for humanity.Ecol Soc. 2009; 14: 32Crossref Scopus (3179) Google Scholar A prime example is soil, in which erosion is destroying our ability to grow enough nutritious food.5Watts N Adger WN Ayeb-Karlsson S et al.The Lancet Countdown: tracking progress on health and climate change.Lancet. 2016; 389: 1151-1164Summary Full Text Full Text PDF PubMed Scopus (246) Google Scholar Therefore, the modelling techniques used by William and colleagues' study should be applied to the understanding of the health benefits of policies that act on a number of environmental fronts. In the case of soil, this application could include the potential benefits to health of more sustainable, regenerative agricultural practices, which also increase carbon sequestration and decrease nitrogen run off.6FAOSoil carbon sequestration: SOLAW background thematic report–TR04B.http://www.fao.org/fileadmin/templates/solaw/files/thematic_reports/TR_04b_web.pdfDate accessed: April 4, 2018Google Scholar The use of big data to reflect the financial consequences will be an important next step. Given the obsessive economic interest of policy makers, the system-wide economic benefits of policies will probably be the argument that has the greatest impact. Health professionals have an important role in promoting these policies, and are already creating groups, such as The Lancet Countdown and the UK Health Alliance on Climate Change, to facilitate this endeavour. In doing so, they would do well to support the method developed in Williams and colleagues' study, and to push for more action like that spurred by the UK Climate Change Act. Both authors contributed equally. RS is co-chair of the Climate and Health Council and a board member of the UK Health Alliance on Climate Change. LL-L is director of the UK Health Alliance on Climate Change. The Lancet Countdown on health benefits from the UK Climate Change Act: a modelling study for Great BritainThe modelling infrastructure created will help future researchers explore a wider range of climate policy scenarios, including local, European, and global scenarios. The need to strengthen the links between climate change policy objectives and public health imperatives, and the benefits to societal wellbeing that might result is urgent. Full-Text PDF Open Access