Cost-benefit assessment of health benefits of local climate action: scoping review

BACKGROUND: Local climate strategies are often linked to current priorities for transport, housing and planning but the health benefits of these strategies are often neglected in decision making. Economic information on the health benefits of climate action, including return on investment (RoI), would help support adaptation in Local Government. AIM: To review methods for economic evaluation of the health benefits of local climate action (adaptation and mitigation) in high income countries. METHODS: We undertook a scoping review of full economic assessments that considered the health impacts of local climate action. We first reviewed climate actions and strategy documents to identify climate policies, practices and measures. We searched four electronic databases (Global Health, Web of Science, ECONLIT, and MEDLINE via OVID) for studies published from 2000 to 2022. RESULTS: 26 studies were identified. The economic assessments covered a range of interventions, mostly for mitigation objectives: active travel (n = 10); housing (n = 6), green infrastructure (n = 4), heatwave warning systems (n = 3), transport (n = 1), and food waste (n = 1). A limited range of economic methods were used, with most using benefit-cost ratios (BCR) as a measure of cost effectiveness (n = 14). The range of health outcomes that were monetised was even more limited, either benefits from reduction in indoor or ambient heat and/or air pollutants (PM) on mortality or increased physical activity. CONCLUSIONS: Currently there is limited economic evidence to support decision-making for local climate action that takes health into consideration. Climate actions may also incorporate nature-based solutions but these have specific challenges for evaluation and valuation. There is a need to develop standard methods to allow decision makers to evaluate the most appropriate strategies.