Elsevier

The Lancet

Volume 370, Issue 9593, 29 September–5 October 2007, Pages 1175-1187
The Lancet

Series
Energy, energy efficiency, and the built environment

https://doi.org/10.1016/S0140-6736(07)61255-0Get rights and content

Summary

Since the last decades of the 19th century, technological advances have brought substantial improvements in the efficiency with which energy can be exploited to service human needs. That trend has been accompanied by an equally notable increase in energy consumption, which strongly correlates with socioeconomic development. Nonetheless, feasible gains in the efficiency and technology of energy use in towns and cities and in homes have the potential to contribute to the mitigation of greenhouse-gas emissions, and to improve health, for example, through protection against temperature-related morbidity and mortality, and the alleviation of fuel poverty. A shift towards renewable energy production would also put increasing focus on cleaner energy carriers, especially electricity, but possibly also hydrogen, which would have benefits to urban air quality. In low-income countries, a vital priority remains the dissemination of affordable technology to alleviate the burdens of indoor air pollution and other health effects in individuals obliged to rely on biomass fuels for cooking and heating, as well as the improvement in access to electricity, which would have many benefits to health and wellbeing.

Section snippets

Energy efficiency—an important goal for health

Efficient use of energy is seemingly a very attractive means to reduce energy-related effects on the environment and health. To achieve the same services with less energy use should, in theory, reduce burdens on infrastructure, decrease occupational risks, lower costs, cut emissions of local pollutants and greenhouse gases, and lessen harmful exposures. Efficiency improvement also seems to have enormous potential: currently only 20–30% of the chemical energy of the fuel burned is typically

Urban structure

Urban design and infrastructure has bearing on various aspects of energy use and health effects. First, it is an important determinant of energy use in buildings and of choices in transport (as described in the third article of this Series). Compact urban areas that avoid large distances between buildings and with few physical barriers are among the most important factors that could make the urban environment more conducive to physical activity, including walking and cycling.10, 11, 12

High-income countries

Because of the long lifespan of housing, in most countries, most of the existing stock (which typically accounts for more than a quarter of carbon emissions) predates modern energy and thermal comfort standards. In consequence, not only is it inefficient in energy use, but the cost and difficulty of space heating seem to contribute to ill health and even mortality risk, although research evidence remains notably sparse.37 For example, a study of mortality patterns in England found that people

Transition to clean energy

The contrast in the energy needs and priorities of rich and poor countries highlights a central tension that has been referred to earlier in this Series: in health terms, the poorest populations would gain from improved access to electricity and other modern energy sources, yet improved, access to energy also means increased consumption and potently increased emissions of greenhouse gases.

The solution lies not only in international agreements about equitable CO2 emissions targets, but also in

Co-benefits to outdoor air quality of greenhouse-gas reductions and clean energy technology

Estimation of the effect of greenhouse-gas mitigation policies on air quality is an uncertain process. However, several theoretical calculations have been attempted, on the basis that good evidence now exists about the associations between outdoor air pollution and health, and reasonable models of the contribution of emission sources to air pollution concentrations. One such study was done by Cifuentes and colleagues,69, 70 who developed scenarios for Mexico City, Santiago de Chile, Sao Paulo,

Conclusions

As with so many aspects of the energy debate, the factors that can and do have bearing on future policies for the built environment are innumerable. However, the mechanisms to include proper assessment of the health costs and benefits of those complex choices so far have not been developed and are often not sought. Scientific evidence is always imperfect, but for many questions, such as the effects of indoor air pollution, the evidence of health links is already strong and partly quantified;

References (90)

  • G Fuller et al.

    An empirical approach for the prediction of daily mean PM10 concentrations

    Atmospher Environ

    (2002)
  • D Carslaw et al.

    An empirical approach for the prediction of annual mean nitrogen dioxide concentrations in London

    Atmospher Environ

    (2001)
  • G Hoek et al.

    Association between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort study

    Lancet

    (2002)

  • World Urbanization Prospects. The 2001 revision. Data tables and highlights

    (2002)
  • M Flood

    Energy without end

    (1991)
  • K Smith et al.

    How environmental health risks change with development. The Epidemiologic and Environmental Risk Transitions revisited

    Ann Rev Energy Res

    (2005)

  • Data services website

  • Online reference tables

  • V Smil
  • N Stern

    The economics of climate change

    (2007)

  • Building health. Creating and enhancing places for healthy, active lives

  • J Norman et al.

    Comparing high and low residential density: life-cycle analysis of energy use and greenhouse gas emissions

    J Urban Plng Dev

    (2006)
  • JO Hill et al.

    Obesity and the environment: where do we go from here?

    Science

    (2003)
  • A Dannenberg et al.

    The impact of community design and land-use choices on public health: a scientific research agenda

    Public Health Matters

    (2003)
  • C Foster et al.

    Changing the environment to promote health-enhancing physical activity

    J Sports Sci

    (2004)
  • B Giles-Corti et al.

    Understanding physical activity environmental correlates: increased specificity for ecological models

    Exerc Sport Sci Rev

    (2005)
  • T Oke

    The energetic basis of the urban heat island

    Q J R Meteorol Soc

    (1982)
  • G Meehl et al.

    More intense, more frequent, and longer lasting heat waves in the 21st century

    Science

    (2004)
  • D Campbell-Lendrum et al.

    Climate change and developing-country cities: implications for environmental health and equity

    J Urban Health

    (2007)
  • R Basu et al.

    Relation between elevated ambient temperature and mortality: a review of the epidemiologic evidence

    Epidemiol Rev

    (2002)
  • A Le Tertre et al.

    Impact of the 2003 heatwave on all-cause mortality in 9 French cities

    Epidemiology

    (2006)
  • JC Semenza et al.

    Heat-related deaths during the July 1995 heat wave in Chicago

    N Engl J Med

    (1996)
  • AG Barnett

    Temperature and cardiovascular deaths in the US elderly: changes over time

    Epidemiology

    (2007)
  • MS O'Neill et al.

    Disparities by race in heat-related mortality in four US cities: the role of air conditioning prevalence

    J Urban Health

    (2005)
  • M Medina-Ramon et al.

    Temperature, temperature extremes and mortality: a study of acclimatization and effect modification in 50 United States cities

    Occup Environ Med

    (2007)
  • J Hacker et al.

    Beating the heat: keeping UK buildings cool in a warming climate

    (2005)

  • Health aspects of air pollution with particulate matter, ozone and nitrogen dioxide. Report on a WHO working group, EUR/03/5042688

    (2003)
  • ML Bell et al.

    The exposure-response curve for ozone and risk of mortality and the adequacy of current ozone regulations

    Environ Health Perspect

    (2006)
  • K Ito et al.

    Associations between ozone and daily mortality: analysis and meta-analysis

    Epidemiology

    (2005)
  • J Schwartz

    How sensitive is the association between ozone and daily deaths to control for temperature?

    Am J Respir Crit Care Med

    (2005)
  • AQE Group

    Air quality and climate change: a UK perspective

    (2007)
  • L Filleul et al.

    The relation between temperature, ozone, and mortality in nine French cities during the heat wave of 2003

    Environ Health Perspect

    (2006)
  • P Wilkinson et al.

    Cold comfort: the social and environmental determinants of excess winter death in England, 1986–1996

    (2001)
  • JD Healy

    Excess winter mortality in Europe: a cross country analysis identifying key risk factors

    J Epidemiol Community Health

    (2003)

    • Cited by (143)

    • Designing with nature: Advancing three-dimensional green spaces in architecture through frameworks for biophilic design and sustainability

      2023, Frontiers of Architectural Research

    • Increasing energy efficiency in Smart Building through Internet of Things retrofitting intervention

      2023, Procedia Computer Science

    • Role of renewable, non-renewable energy consumption and carbon emission in energy efficiency and productivity change: Evidence from G20 economies

      2023, Geoscience Frontiers

    • Social movements and entrepreneurial activity: A study of the U.S. solar energy industry

      2023, Research Policy

    • Association of energy poverty and catastrophic health expenditure

      2022, Energy

    • Moisture-participating MOF thermal battery for heat reallocation between indoor environment and building-integrated photovoltaics

      2021, Nano Energy
    View all citing articles on Scopus
    View full text
    Copyright © 2007 Elsevier Ltd. All rights reserved.