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Accountability Research Program
11-1 Health Outcomes Research – Assessing the Health Outcomes of Air Quality ActionsHEI has provided a lead role in health outcomes research, further defining concepts and methods and initiating the next stage of new research in this challenging field.

Having completed a first wave of accountability research, HEI built on the lessons learned from those studies through critical review, publications, and collaborative efforts to identify and exploit new data sources (e.g., health tracking). Overall, the next generation of accountability studies is building on but also extends beyond opportunistic studies of shorter-term interventions to address larger regulatory programs implemented over longer periods of time.
Major accomplishments include the publication of 9 reports from the first wave of health outcomes or accountability studies, including studies of measures to reduce traffic during the Atlanta Olympic Games, congestion charging and a low emission zone in London, a wood stove replacement program, legislation to reduce sulfur in fuel in Hong Kong, analysis of Title IV Phase 2 of the 1990 Clean Air Act Amendments, air quality measures during the Beijing Olympic Games, and a ban on the sale of coal in Irish cities. (See Publications, filter on the topic "accountability".)
To effectively carry out the next generation of accountability research, HEI issued RFA 11-1, which focused on long-term national air quality regulations and statistical methods development to evaluate such complex regulations, and on studies of air quality improvement in major port areas. The second wave of research to evaluate long-term actions includes four studies: changes in children’s health in response to air quality improvements in southern California, effects of the Goods Movement Action Plan in California, air quality regulations in the Southeastern US, and statistical methods to assess national air quality regulations.
In 2018, HEI issued RFA 18-1 to solicit a third wave of accountability studies, incorporating lessons learned from the first and second waves.
Four reports from RFA 11-1 are now available:
Cory Zigler et al, Causal Inference Methods for Estimating Long-Term Health Effects of Air Quality Regulations, Research Report 187, 2016
Frank Gilliland et al, The Effects of Policy-Driven Air Quality Improvements on Children’s Respiratory Health, Research Report 190, 2017
Armistead (Ted) Russell et al, Impacts of Regulations on Air Quality and Emergency Department Visits in the Atlanta Metropolitan Area, 1999–2013, Research Report 195, 2018
Ying-Ying Meng et al, Improvements in Air Quality and Health Outcomes Among California Medicaid Enrollees Due to Goods Movement Actions, Research Report 205, 2021
HEI also funded an accountability-related study through the general RFA 17-2, by Amir Hakami and colleagues, who plans to develop and apply a source‐ and location-specific database of mortality benefits per ton emissions reduction of NOx and other pollutants.
In addition to the various HEI Research Reports and Communications mentioned above, HEI staff have published several articles on accountability research:
Burns, J., Boogaard, H., Polus, S., Pfadenhauer Lisa, M., Rohwer, A., Van Erp, A.M., Turley, R., Rehfuess Eva, A., 2019. Interventions to reduce ambient particulate matter air pollution and their effect on health. Cochrane Database Syst. Rev. 5. https://doi.org/10.1002/14651858.CD010919.pub2
Burns, J., Boogaard, H., Polus, S., Pfadenhauer Lisa, M., Rohwer, A., Van Erp, A.M., Turley, R., Rehfuess Eva, A., 2020. Interventions to reduce ambient particulate matter air pollution and their effect on health: An abridged Cochrane systematic review. Environment International 135: 105400 https://doi.org/10.1016/j.envint.2019.105400.
Hanna Boogaard, Annemoon M. van Erp, Katherine D. Walker, and Rashid Shaikh. 2017. Accountability Studies on Air Pollution and Health: the HEI Experience. Current Environmental Health Reports. DOI 10.1007/s40572-017-0161-0. Published online: 07 October 2017.
Annemoon M. van Erp, Aaron J. Cohen, Rashid Shaikh, and Robert O’Keefe. 2012. Recent Progress and Challenges in Assessing the Effectiveness of Air Quality Interventions Toward Improving Public Health. The HEI Experience. EM magazine, October 2012, pp 22-28. http://pubs.awma.org/gsearch/em/2012/10/vanerp.pdf
Annemoon M. van Erp, Frank J. Kelly, Kenneth L. Demerjian, C. Arden Pope III, and Aaron J. Cohen. 2012. Progress in research to assess the effectiveness of air quality interventions towards improving public health. Air Quality, Atmosphere, and Health 5:217–230. DOI 10.1007/s11869-010-0127-y. Published online: 11 January 2011. https://link.springer.com/article/10.1007/s11869-010-0127-y
Annemoon M.M. van Erp, Robert O'Keefe, Aaron J. Cohen, and Jane Warren. 2008. Evaluating the Effectiveness of Air Quality Interventions. Journal of Toxicology and Environmental Health, Part A, 71:9, 583 – 587. Published online: 01 January 2008. http://www.tandfonline.com/doi/abs/10.1080/15287390801997708