摘要：Background In deciding among competing approaches for emissions control, debates often hinge on the potential tradeoffs between efficiency and equity. However, previous health benefits analyses have not formally addressed both dimensions. Objectives We modeled the public health benefits and the change in the spatial inequality of health risk for a number of hypothetical control scenarios for power plants in the United States to determine optimal control strategies. Methods We simulated various ways by which emission reductions of sulfur dioxide (SO2), nitrogen oxides, and fine particulate matter (particulate matter < 2.5 μm in diameter; PM2.5) could be distributed to reach national emissions caps. We applied a source–receptor matrix to determine the PM2.5 concentration changes associated with each control scenario and estimated the mortality reductions. We estimated changes in the spatial inequality of health risk using the Atkinson index and other indicators, following previously derived axioms for measuring health risk inequality. Results In our baseline model, benefits ranged from 17,000–21,000 fewer premature deaths per year across control scenarios. Scenarios with greater health benefits also tended to have greater reductions in the spatial inequality of health risk, as many sources with high health benefits per unit emissions of SO2 were in areas with high background PM2.5 concentrations. Sensitivity analyses indicated that conclusions were generally robust to the choice of indicator and other model specifications. Conclusions Our analysis demonstrates an approach for formally quantifying both the magnitude and spatial distribution of health benefits of pollution control strategies, allowing for joint consideration of efficiency and equity.
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