Children's health impacts from a proposed decarbonization policy in the transportation sector in the Eastern United States

Health impact assessments have estimated substantial health co-benefits of climate change mitigation strategies due to reductions in air pollution in the US; however, few studies have considered children's health impacts and related equity implications. We estimated the potential health co-benefits to children related to improved air quality associated with various emissions cap and investment scenarios for the transportation sector in the Northeastern and Mid-Atlantic US proposed under the Transportation and Climate Initiative (TCI). We modeled changes in ambient fine particulate matter and nitrogen dioxide between 2022 and 2032 associated with on-road transportation sector emissions under nine hypothetical carbon dioxide (CO2) emissions cap and investment scenarios proposed under TCI using the Community Multiscale Air Quality (CMAQ) model version 5.2. We estimated potential health co-benefits for adverse birth and pediatric respiratory and neurodevelopmental outcomes using an expanded version of the Environmental Benefits Mapping and Analysis Program, known as BenMAPR. We also examined impacts on pediatric asthma exacerbations across racial/ethnic groups. We found that health benefits to children increased as the CO2 emission caps became more ambitious. The combination of the highest emissions cap (25%) and the investment scenario which prioritized public transit improvement (Diversified strategy) conferred the greatest children's health benefits for the majority of health outcomes considered, resulting in approximately $82 million per year in economic savings. Assessment of the distribution of avoided pediatric asthma exacerbations showed benefits across all racial and ethnic groups, with a slightly greater reduction in cases for non-White populations. Decarbonization policies in the transportation sector in the Eastern US have the potential to provide important air quality and pediatric health co-benefits.