Addressing inequalities – the unfair and avoidable differences in outcomes across social and ethnic groups – is a key Government policy priority. Assessment of impacts of net zero interventions on inequitable exposure and disproportionate outcomes is essential for ensuring improvements in health and inequalities. This cross-cutting theme is addressing impacts on inequalities in all hub activities and evaluating how solutions can be modified/optimised to reduce existing inequalities. To achieve this ambitious goal, we are, for the first time, operationalising ‘ecosocial theory’, drawing on stakeholder engagements to develop and refine a conceptual model to systematically analyse solutions from an environmental/health justice perspective. Unlike previous approaches for examining inequalities, using ecosocial theory facilitates a systems-wide perspective which identifies and supports action on multi-level drivers of inequalities. This cross-cutting theme is complemented by a PhD studentship (UoE) applying this framework to real-world retrofitting programmes.

We are applying our new conceptual model to identify modifiable factors to reduce inequalities and support the development of solutions tailored to maximise the reduction of inequalities. The conceptual model is being used to develop and apply robust sampling protocols for understanding how home retrofits affect inequalities. Our modelling produces distributions of exposures/health risk metrics (enabling assessment of inequalities in mortality, QALYs, etc.) aggregated to the appropriate scale (local, regional, national) and according to sociodemographic factors, and we are deriving new inequality indicators. We are applying our indoor environment-exposure-health modelling framework to assess ‘win-win’ situations, trade-offs and unintended consequences for inequalities due to new solutions. The conceptual model also helps us to develop interventions that are implemented optimally to reduce inequalities.