Inclusion of health in national determined contributions
Abstract
Background: National Determined Contributions describe the commitments made by each country to reduce their greenhouse gas emissions. It is important to understand how health is considered by those policies, in particular women’s health.
Methods: This policy analysis investigated how health was considered by National Determined Contributions for 189 countries across 7 domains: health co-benefits, health adaptation, health impacts, sustainable healthcare, health inequalities, women’s health, and other. It included a quantitative analysis, which scored policies using a 4-level Likert scale, and a qualitative analysis using content analysis.
Findings: The mean of the total score was 4.1 (SD 3.6) points, with minimum of zero and maximum of 12 points. There were 20 countries with zero points (Monaco, Singapore, Lesotho, New Zealand, Holy See, Argentina, Bahrain, Nauru, Eswatini, Jordan, Albania, Guinea-Bissau, Malawi, Senegal, Democratic People’s Republic of Korea, San Marino, Djibouti, Cook Islands, Guyana, and Palau. There were six countries with 12 points (Maldives, Panama, Guatemala, Nigeria, Lao People’s Democratic Republic, and Cape Verde). Latin American and Caribbean States had the highest total score (mean 6.75 SD 3.44), whilst Western European and Other States had the lowest score (mean 1.24 SD 2.15). Content analysis identified 17 themes for health adaptation, 15 themes for health impacts, 14 themes for health co-benefits, 5 themes for sustainable healthcare, 6 themes for health inequalities, and 4 themes for women’s health.
Conclusions: Although health is considered by National Determined Contributions of most countries, this is often superficial and does not capture the entirety of the health impacts and implications. There is a need to consider health across all domains of climate mitigation and adaptation to prevent climate change from widening health inequalities and have a drastic impact on population health.
Key messages: • Consideration of health by national determined contributions remains patchy with many countries not mentioning it or mentioning only a few of the important aspects.
• Low and middle-income countries performed consistently better than high-income countries.
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BibTeX
@article{pinhogomes2026inclusion,
title = {{Inclusion of health in national determined contributions}},
author = {AC Pinho-Gomes and G Cipriano-Flores and R Hulme and J Gong and J Hirst and A Whitt and K Womersley and C Donovan-Bradley and E Mullins},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.181},
url = {https://doi.org/10.1093/eurpub/ckag169.181},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Inclusion of health in national determined contributions
AU - AC Pinho-Gomes
AU - G Cipriano-Flores
AU - R Hulme
AU - J Gong
AU - J Hirst
AU - A Whitt
AU - K Womersley
AU - C Donovan-Bradley
AU - E Mullins
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.181
UR - https://doi.org/10.1093/eurpub/ckag169.181
AB - Background: National Determined Contributions describe the commitments made by each country to reduce their greenhouse gas emissions. It is important to understand how health is considered by those policies, in particular women’s health. Methods: This policy analysis investigated how health was considered by National Determined Contributions for 189 countries across 7 domains: health co-benefits, health adaptation, health impacts, sustainable healthcare, health inequalities, women’s health, and other. It included a quantitative analysis, which scored policies using a 4-level Likert scale, and a qualitative analysis using content analysis. Findings: The mean of the total score was 4.1 (SD 3.6) points, with minimum of zero and maximum of 12 points. There were 20 countries with zero points (Monaco, Singapore, Lesotho, New Zealand, Holy See, Argentina, Bahrain, Nauru, Eswatini, Jordan, Albania, Guinea-Bissau, Malawi, Senegal, Democratic People’s Republic of Korea, San Marino, Djibouti, Cook Islands, Guyana, and Palau. There were six countries with 12 points (Maldives, Panama, Guatemala, Nigeria, Lao People’s Democratic Republic, and Cape Verde). Latin American and Caribbean States had the highest total score (mean 6.75 SD 3.44), whilst Western European and Other States had the lowest score (mean 1.24 SD 2.15). Content analysis identified 17 themes for health adaptation, 15 themes for health impacts, 14 themes for health co-benefits, 5 themes for sustainable healthcare, 6 themes for health inequalities, and 4 themes for women’s health. Conclusions: Although health is considered by National Determined Contributions of most countries, this is often superficial and does not capture the entirety of the health impacts and implications. There is a need to consider health across all domains of climate mitigation and adaptation to prevent climate change from widening health inequalities and have a drastic impact on population health. Key messages: • Consideration of health by national determined contributions remains patchy with many countries not mentioning it or mentioning only a few of the important aspects. • Low and middle-income countries performed consistently better than high-income countries.
SN - 1101-1262
SN - 1464-360X
ER -