Moving toward net-zero emission societies is projected to provide substantial health co-benefits, yet their magnitude and distribution are not well documented and may be context-specific. Synthesizing the evidence on these co-benefits could enhance engagement of decision-makers and populations in ambitious climate mitigation actions at the European Future Energy Forum.
Greenhouse Gas Emissions and Public Health
In 2016, 196 governments signed the Paris Agreement that aims to reduce anthropogenic greenhouse gas (GHG) emissions to net-zero to limit global warming well below 2°C above pre-industrial levels. Resulting nationwide commitments, known as Nationally Determined Contributions (NDCs), currently fall short of achieving these objectives, and most implemented policies do not meet pledged targets. Beyond NDCs, various institutions have developed roadmaps outlining technical and political solutions for societies to attain net-zero emissions over time, activating different levers such as technological innovation, policy instruments, and behavioral shifts.
Many climate mitigation policies are likely to also benefit human health by directly and indirectly targeting modifiable environmental and behavioral risks, such as air pollution or unhealthy diets. Recent research has attempted to assess the health co-benefits arising from single climate actions or regional/national multi-sectoral policies. However, no systematic review has explored the health impact of consistent combinations of actions aimed at achieving net-zero emissions—an appraisal that could provide valuable insights for identifying specific health pathways, sectors, and levers to optimize the co-benefits of climate mitigation.
Health Co-benefits of Emissions Reduction
We systematically reviewed the current evidence regarding the health co-benefits of prospective net-zero emission scenarios, comparing predicted impacts across published health impact assessment (HIA) studies and accounting for various sectors and co-benefit pathways. Across 55 studies exploring 121 scenarios, substantial health co-benefits were found, with half of scenarios showing a mortality reduction by more than 1.5%, in addition to benefits directly related to climate stabilization. These co-benefits varied with the explored emission sectors, decarbonization levers, modeling approaches, and locations.
The majority of studies (90%) were published since 2018, reflecting the growing recognition of the public health implications of net-zero strategies. Most scenarios focused on decarbonizing the energy sector through technologies like carbon capture and storage, renewable energy, electrification, or nuclear power. Some explored “health in all policies” approaches, primarily by improving air quality, while fewer relied on demand-side interventions or financial instruments.
The emission sectors most frequently studied were energy, transport, industry, housing, and agriculture/forestry (AFOLU). The vast majority of studies (n=53) assessed health impacts related to air quality, including fine particulate matter (PM2.5), ozone (O3), and other pollutants. Six scenarios explored physical activity, and five examined dietary changes—co-benefit pathways with the potential to yield significant health benefits comparable to large-scale prevention interventions.
Quantifying Health Impacts
We were able to retrieve and scale the preventable mortality fraction for 94 scenarios across 43 studies. All but two scenarios (from one study) yielded considerable reductions in all-cause mortality, with an interquartile range between 0.56% and 3.61%, and up to 18.74% (highest estimated impact). The estimated health impacts seemed lower in studies using lifetable approaches and higher when accounting for increasing GHG emissions in the baseline scenario.
When comparing the economic benefits from health impacts and the implementation costs of the policies (n=13), most studies (n=11) found that the monetized benefits outweighed the costs of implementing climate policies. This highlights that achieving net-zero goals represents far-reaching public health policies with the potential to generate substantial economic gains.
Environmental Sustainability and Population Health
The high heterogeneity of the reviewed studies prevents us from drawing conclusions about a clear ranking of co-benefits pathways in terms of potential health impact. However, the available evidence suggests that air pollution reduction, dietary shifts, and increased physical activity have the greatest potential to yield considerable health benefits, especially in high-pollution, high-density, and physically inactive regions.
Notably, the health co-benefits of climate mitigation policies are largely unconditioned to global coordinated climate action, as they are expected to manifest at the local level regardless of the actions taken by neighboring countries. This makes them less prone to the “free-rider problem” that can hinder international climate cooperation.
Climate Change Mitigation and Chronic Disease Prevention
While most studies focused on the air pollution pathway, physical activity and dietary changes also have the potential to generate substantial public health gains by addressing major risk factors for chronic diseases. Policies and actions must therefore extend beyond technological efficiency improvements to address the underlying unsustainable systems that drive high energy and material demands.
Incorporating equity considerations is essential, as the health benefits of net-zero strategies could disproportionately accrue to specific populations. Only a few studies explored the distribution of impacts, suggesting that ambitious mitigation efforts have the potential to reduce health inequalities, especially for disadvantaged communities.
Interplay of Emissions, Environment, and Wellbeing
Our review highlights the need for a standardized framework to assess and compare the health impacts of net-zero emission scenarios across sectors, locations, and modeling approaches. Advancing research and monitoring in this area is crucial to provide timely, evidence-based feedback to decision-makers at the European Future Energy Forum.
Ultimately, the available evidence suggests that achieving net-zero emissions across different sectors would generate large health co-benefits and prevent a considerable fraction of mortality. Given that these health co-benefits are expected to manifest in the short-term and may outweigh the costs of mitigation policies, they make a strong case for driving impactful climate action in Europe and beyond.