Yuri Cartier1, Tarik Benmarhnia2, Astrid Brousselle3. 1. Ecole des Hautes Etudes en Santé Publique (Sorbonne Paris Cité), Rennes, France.; Canada Research Chair in Evaluation and Health System Improvement, Canada. 2. Ecole des Hautes Etudes en Santé Publique (Sorbonne Paris Cité), Rennes, France.; Canada Research Chair in Evaluation and Health System Improvement, Canada; Département de santé communautaire, Université de Montréal, Montréal, Québec, Canada. 3. Canada Research Chair in Evaluation and Health System Improvement, Canada; Département des sciences de la santé communautaire, Centre de Recherche de l'Hôpital Charles-LeMoyne, Université de Sherbrooke, Longueuil, Québec, Canada. Electronic address: astrid.brousselle@usherbrooke.ca.
Abstract
BACKGROUND: Urban outdoor air pollution (AP) is a major public health concern but the mechanisms by which interventions impact health and social inequities are rarely assessed. Health and equity impacts of policies and interventions are questioned, but managers and policy agents in various institutional contexts have very few practical tools to help them better orient interventions in sectors other than the health sector. Our objective was to create such a tool to facilitate the assessment of health impacts of urban outdoor AP interventions by non-public health experts. METHODS: An iterative process of reviewing the academic literature, brainstorming, and consultation with experts was used to identify the chain of effects of urban outdoor AP and the major modifying factors. To test its applicability, the tool was applied to two interventions, the London Low Emission Zone and the Montréal BIXI public bicycle-sharing program. RESULTS: We identify the chain of effects, six categories of modifying factors: those controlling the source of emissions, the quantity of emissions, concentrations of emitted pollutants, their spatial distribution, personal exposure, and individual vulnerability. Modifiable and non-modifiable factors are also identified. Results are presented in the text but also graphically, as we wanted it to be a practical tool, from pollution sources to emission, exposure, and finally, health effects. CONCLUSION: The tool represents a practical first step to assessing AP-related interventions for health and equity impacts. Understanding how different factors affect health and equity through air pollution can provide insight to city policymakers pursuing Health in All Policies.
BACKGROUND: Urban outdoor air pollution (AP) is a major public health concern but the mechanisms by which interventions impact health and social inequities are rarely assessed. Health and equity impacts of policies and interventions are questioned, but managers and policy agents in various institutional contexts have very few practical tools to help them better orient interventions in sectors other than the health sector. Our objective was to create such a tool to facilitate the assessment of health impacts of urban outdoor AP interventions by non-public health experts. METHODS: An iterative process of reviewing the academic literature, brainstorming, and consultation with experts was used to identify the chain of effects of urban outdoor AP and the major modifying factors. To test its applicability, the tool was applied to two interventions, the London Low Emission Zone and the Montréal BIXI public bicycle-sharing program. RESULTS: We identify the chain of effects, six categories of modifying factors: those controlling the source of emissions, the quantity of emissions, concentrations of emitted pollutants, their spatial distribution, personal exposure, and individual vulnerability. Modifiable and non-modifiable factors are also identified. Results are presented in the text but also graphically, as we wanted it to be a practical tool, from pollution sources to emission, exposure, and finally, health effects. CONCLUSION: The tool represents a practical first step to assessing AP-related interventions for health and equity impacts. Understanding how different factors affect health and equity through air pollution can provide insight to city policymakers pursuing Health in All Policies.
Authors: Nicholas A Mailloux; Colleen P Henegan; Dorothy Lsoto; Kristen P Patterson; Paul C West; Jonathan A Foley; Jonathan A Patz Journal: Int J Environ Res Public Health Date: 2021-12-18 Impact factor: 3.390