David Pencheon

The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health

The Lancet Countdown tracks progress on health and climate change and provides an independent assessment of the health effects of climate change, the implementation of the Paris Agreement, 1 and th ...

Health services and climate change: What can be done?:

tives proves problematic in certain contexts, an investigation of alternative rewards might be warranted. For example, employers could try offering an extra half day’s holiday to those who remain smoke-free at the end of each month, assuming, of course, that employers themselves have the necessary incentives to improve the health of their employees, which they might if a healthier workforce equates to greater productivity. The acceptability and effectiveness of using financial incentives to alter personal health-related behaviours are contested. There is a need to examine in some depth whether and when such incentives are ethically acceptable, whether they work in the ways that their architects expect, and whether, when and for whom they have perverse effects, such as encouraging people to take up health-harming activities, or undermining intrinsic motivations to behave in healthy ways. In economic terms, there is also a need to evaluate whether they can produce net savings for health care systems, and for society in general.

Improving health and well-being independently of GDP: dividends of greener and prosocial economies.

Increases in gross domestic product (GDP) beyond a threshold of basic needs do not lead to further increases in well-being. An explanation is that material consumption (MC) also results in negative health externalities. We assess how these externalities influence six factors critical for well-being: (i) healthy food; (ii) active body; (iii) healthy mind; (iv) community links; (v) contact with nature; and (vi) attachment to possessions. If environmentally sustainable consumption (ESC) were increasingly substituted for MC, thus improving well-being and stocks of natural and social capital, and sustainable behaviours involving non-material consumption (SBs-NMC) became more prevalent, then well-being would increase regardless of levels of GDP. In the UK, the individualised annual health costs of negative consumption externalities (NCEs) currently amount to £62 billion for the National Health Service, and £184 billion for the economy (for mental ill-health, dementia, obesity, physical inactivity, diabetes, loneliness and cardiovascular disease). A dividend is available if substitution by ESC and SBs-NMC could limit the prevalence of these conditions.

Sustainable Development Goals (SDGs), and their implementationA national global framework for health, development and equity needs a systems approach at every level

Introduction The Sustainable Development Goals (SDGs) are a set of global goals for fair and sustainable health at every level: from planetary biosphere to local community. The aim is to end poverty, protect the planet and ensure that all people enjoy peace and prosperity, now and in the future. Sources of data The UN has established web-sites to inform the implementation of the SDGs and an Inter-Agency and Expert Group on an Indicator Framework. We have searched for independent commentaries and analysis. Areas of agreement The goals represent a framework that is scientifically robust, and widely intuitive intended to build upon the progress established by the Millennium Development Goals (MDGs). There is a need for system wide strategic planning to integrate the economic, social and environmental dimensions into policy and actions. Areas of controversy Many countries have yet to understand the difference between the MDGs and the SDGs, particularly their universality, the huge potential of new data methods to help with their implementation, and the systems thinking that is needed to deliver the vision. The danger is that individual goals may be prioritized without an understanding of the potential positive interactions between goals. Growing points There is an increasing understanding that sustainable development needs a paradigm shift in our understanding of the interaction between the real economy and quality of life. There would be many social, environmental and economic benefits in changing our current model. Areas timely for developing research We need to develop systems wide understanding of what supports a healthy environment and the art and science of making change.

Local action on outdoor air pollution to improve public health

ObjectivesThe National Institute for Health and Care Excellence, jointly with Public Health England, have developed a guideline on outdoor air pollution and its links to health. The guideline makes recommendations on local interventions that can help improve air quality and prevent a range of adverse health outcomes associated with road-traffic-related air pollution.MethodsThe guideline was based on a rigorous assessment of the scientific evidence by an independent advisory committee, with input from public health professionals and other professional groups. The process included systematics reviews of the literature, expert testimonies and stakeholder consultation.ResultsThe guideline includes recommendations for local planning, clean air zones, measures to reduce emissions from public sector transport services, smooth driving and speed reduction, active travel, and awareness raising.ConclusionsThe guideline recommends taking a number of actions in combination, because multiple interventions, each producing a small benefit, are likely to act cumulatively to produce significant change. These actions are likely to bring multiple public health benefits, in addition to air quality improvements.