Response to "Comment on 'Co-Benefits to Children's Health of the U.S. Regional Greenhouse Gas Initiative'".

In their letter, Sacks and Luben (2020) question whether three of the outcomes we considered in our analysis (Perera et al. 2020) of the potential health benefits to children of the U.S. Regional Greenhouse Gas Initiative are scientifically supported as being likely to be causally related to exposure to fine particulate matter (). Our judgment was based on a systematic review of the published literature (Perera et al. 2019) that identified peer-reviewed meta-analyses demonstrating a significant association between exposure and health outcomes in children, including preterm birth, low birth weight, and autism spectrum disorder. Since that review, additional evidence has been published supporting our judgment, including Fu et al. (2019), Jo et al. (2019), Li et al. (2020), and Sheridan et al. (2019).

Our goal was to bring attention to the potential benefits of this major climate mitigation policy for children, a vulnerable population that is often overlooked in analyses of environmental policies. We were clear in our paper that the concentration–response functions used in our analysis were recently published (Perera et al. 2019) and therefore were not included in the Environmental Benefits Mapping and Analysis Program–Community Edition (U.S. Environmental Protection Agency 2019). Our use of these new concentration–response functions represents a more precautionary approach than that conventionally taken in order to demonstrate the potential benefits of air pollution emissions reductions to children.