OP76 The Impact of low carbon transport interventions on health inequalities: findings from a scoping review

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Background Transport is a major contributor to greenhouse gas emissions and a key target for decarbonisation. Low carbon transport interventions have the potential to improve health through pathways such as improved air quality, increased physical activity and improved social cohesion. However, these benefits may not be distributed evenly and may result in unintended adverse consequences, raising the possibility of widening existing inequalities. This scoping review examines how studies have measured health inequality outcomes in evaluations of low carbon transport interventions. Methods The scoping review followed JBI methodology and PRISMA-ScR guidelines. We included studies that reported an appropriate health outcome or proxy measure, assessed differences across inequality groups defined using the PROGRESS-Plus framework, and applied a targeted, gap, or gradient approach to evaluating inequalities. Eligible studies reported an absolute, relative, or population attributable measure of difference between inequality groups. We identified and screened studies through searches across nine databases, and screened them using predefined inclusion criteria. Papers were assessed for eligibility by one reviewer, with full-text screening including quality appraisal conducted by two reviewers. A third reviewer randomly screened 10% of papers. We extracted data using a structured tool and synthesised narratively. Results We identified 26,422 records and removed 5,110 duplicates. After screening 21,333 titles and abstracts, the full text of 252 articles was assessed for eligibility, resulting in 31 studies included in the final review. Most studies were conducted in high-income countries (n=28). The most common decarbonisation interventions were active travel (n=8), low-emission zones (n=6), and vehicle electrification (n=3). Health outcomes most frequently assessed were physical health (n=15), quality of life (n=7), and air quality (n=4). Socioeconomic (n=21), place-based (n=14), and race/ethnicity (n=13) inequality metrics were the most commonly used. Intersectional perspectives and public involvement were largely absent. In many studies, health inequalities were treated as a secondary focus (n=17). Overall, interventions often had uneven impacts across socioeconomic, ethnic, gender, and age groups. Some measures, such as bike-share programmes and low-traffic zones, showed more consistent effects across all groups, while others including congestion charging, air-quality management, and long-range transport planning tended to provide greater benefits for low-income and minority communities. Conclusion There is substantial methodological inconsistency in how health inequalities are assessed in evaluations of low carbon transport interventions. Future research should adopt more explicitly equity focused approaches to better understand how decarbonisation affects different population groups.

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