The use of environmental scenarios to project future health effects: a scoping review

Environmental risks are a substantial factor in the current burden of disease, and their role is likely to increase in the future. Model-based scenario analysis is used extensively in environmental sciences to explore the potential effects of human activities on the environment. In this Review, we examine the literature on scenarios modelling environmental effects on health to identify the most relevant findings, common methods used, and important research gaps. Health outcomes and measures related to climate change (n=106) and air pollution (n=30) were most frequently studied. Studies examining future disease burden due to changes or policies related to dietary risks were much less common (n=10). Only a few studies assessed more than two environmental risks (n=3), even though risks can accumulate and interact with each other. Studies predominantly covered high-income countries and Asia. Sociodemographic, vulnerability, and health-system changes were rarely accounted for; thus, assessing the full effect of future environmental changes in an integrative way is not yet possible. We recommend that future models incorporate a broader set of determinants of health to more adequately capture their effect, as well as the effect of mitigation and adaptation efforts.