Policy approaches to decarbonising the transport sector in Aotearoa/NZ: Equity, health and health system impacts

Background Health co-benefits are a key potential advantage of transport decarbonisation policy. However, health impacts will occur in the context of existing transport-health inequities and decarbonisation policies will themselves impact inequities. Methods We modelled the health, health system and environmental impacts of the ‘Behaviour’ and ‘Technology’ pathways developed by the New Zealand Climate Change Commission. Household transport related health impacts were modelled through the pathways of physical activity, air pollution (PM 2·5 and NO 2 ) and injury for the New Zealand population from 2018 to 2050. We modelled impacts for Māori (the Indigenous Peoples of Aotearoa) and non-Māori. Findings Both pathways show improvements in population health, reductions in health system costs and reduced lifecycle greenhouse gas emissions compared to baseline, although health gains were substantially larger in the Behaviour pathway. Health gains were 20-30% larger for Māori than non-Māori in both pathways, although more healthy life years were gained by Māori in the Behaviour pathway. For those aged 0-4 in 2018, healthy life expectancy differences between Māori and non-Māori reduced by 0·5% in the Behaviour pathway. Healthy life years gained by Māori and non-Māori altered substantially depending on assumptions about the equity of the implemented pathway. Interpretation Decarbonising transport may reduce health and healthy life expectancy inequities between Māori and non-Māori if policies supporting decarbonisation are implemented equitably. Pathways that increase physical activity will have a much larger impact on population health than those which rely on low emission vehicles. Funding: Health Research Council of New Zealand (20/151) and University of Otago.