The political will needed to implement ambitious climate action is inadequate for many governments. Under the leadership of the Obama administration, however, the United States (US) arguably demonstrated ambitious climate change mitigation policies with health as a core focus. While a focus on health outcomes alone will not adequately address climate change, the consideration of positive health outcomes that result from the implementation of climate change emissions reduction policies may provide a path to ambitious climate mitigation policy. 

This paper defines health outcomes as:

• health co-benefits (shorter-term): result from environmental changes such as improved air quality, and can assist governments to reframe climate change from longer-term global issue to short-term local issue
• Health benefits (longer-term): result from a reduction in health impacts associated with climate-related events

Extreme weather events induced by climate change such as heatwaves, tornadoes and hurricanes resulted in 3,300 fatalities between 2004 and 2013 with economic and health costs of USD$500 billion. 

An Act to Improve, Strengthen, and Accelerate Programs for the Prevention and Abatement of Air Pollution (1963) (Clean Air Act; CAA) and related amendments is pivotal in the development of mitigation measures for both greenhouse gas emissions (GHG) and non-GHG emissions under the Obama administration.

In 2014, the US released its intended Nationally Determined Contribution (NDC) for the 21st Conference of the Parties to the United Nations Frame-work Convention on Climate Change (COP21) held in Paris, committing to an economy-wide GHG emissions reduction target of 26%–28% below 2005 levels by 2025.

The NDC outlined carbon pollution standards for fossil fuel-powered plants. The standards were introduced to reduce carbon emissions from power plants by 32% by 2030 compared with 2005 levels. The regulation was heralded for its prioritisation of health. 

Through analysis of related policy documents published between 2007 and 2017 the report finds that the consideration of human health-related evidence arguments facilitated the introduction of comparatively ambitious mitigation policies in the US under the Obama administration. This was achieved through:

• an integrated approach to regulating GHGs and air pollutants highlighting the shorter-term and longer-term health benefits
• reframing climate action as presenting the US economy and citizens with benefits and opportunities, as opposed to costs and burdens
• strong political will and leadership which is critical for the integration of health into policy agendas

Enablers to the consideration of health in mitigation policy

• using credible individuals to communicate the health implications of a changing climate
• EPA’s determination that GHG emissions negatively impacted human health
• demonstrating economic benefit of health cost-savings as a result of the policy 

Barriers 

• lack of reliable data to account for health benefits
• lack of funding dedicated to climate change and health research 

Limitations of the research include its narrow focus on health without further analysis of other potentially relevant policies or the socioeconomic implications of implementing mitigation policies. The authors recommend further research in this area.

1. Under the Obama administration’s leadership from 2009 until 2016, the consideration of health constituted a core component of the development of climate change mitigation policies by strategically utilising an available legislative lever.
2. Analysis of Obama-led climate policies and policy-making strategies provides valuable insight into the utility of health as a motivator for climate action. It also reaffirms that strong political leadership constitutes an essential element in the pursuit of increasingly ambitious climate change policies, particularly in the face of strong opposition.
3. With GHGs classified as air pollutants, the U.S. EPA and other federal agencies developed a suite of emissions and fuel efficiency standards for both existing and new stationary and mobile sources of fossil fuel emissions.
4. An Act to improve, strengthen, and accelerate Programs for the prevention and abatement of air pollution (1963) (Clean Air Act; CAA) and related amendments given its pivotal role in the development of mitigation measures for both GHG and non-GHG emissions under the Obama administration.
5. The U.S. government analyses the anticipated economic effects of its proposed standards and policies. A key element of these analyses has been the estimation of the potential economic and human welfare benefits of reduced GHGs. Specifically, federal agencies use a metric known as the social cost of carbon (SCC) to estimate the dollar value of the benefits of regulatory actions that affect CO2 emissions.
6. Extreme weather events induced by climate change such as heatwaves, tornadoes and hurricanes resulted in 3300 fatalities between 2004 and 2013 with economic and health costs of USD$500 billion.
7. Enablers to the consideration of health in mitigation policy include using credible individuals to communicate the health implications of a changing climate, the EPA’s determination that GHG emissions negatively impact human health and demonstrating the economic benefit of health cost-savings.
8. Barriers to the consideration of health in mitigation policy include a lack of reliable data to account for health benefits and inadequate funding dedicated to climate change and health research.
   
9. It is important to also note that energy policy under the Obama administration has come under scrutiny. For example, the facilitated expansion of oil and gas production in the U.S., and the continued exploitation of domestic fossil fuel subsidies at a cost of USD$2 billion annually.