The synergistic effects of the Air Clean Plan and carbon mitigation on air quality and public health in China from 2014 to 2060

Ambient fine particulate matter (PM_2.5) induces serious environmental health risks worldwide, particularly in developing countries like Mexico, India and China. Despite the fact that China has achieved tremendous progress by implementing tough air pollution control measures since 2013, there is still a clear gap between the World Health Organization (WHO) guidelines. In order to meet the goals of PM_2.5 control and ensure the public health in the context of global climate change, it is critical to well understand the effects of current policy and carbon mitigation on reducing PM_2.5 concentrations and attributable health risk. To fill this gap, in this study we integrate remote sensing data, the logarithmic mean Divisia index (LMDI) method, disease-specific concentration-response functions (CRFs) and scenarios setting to comprehensively estimating the PM_2.5 and related-death change during Air Clean Plan (ACP, 2014 to 2020), air clean policy effectiveness, carbon-related co-benefits and future related death across mainland China. During ACP (2014-2020), PM_2.5 concentrations and attributable death in mainland China reduced by 13.41 μg m^-3 and 0.16 million (~11.85%), respectively, indicating the substantial effectiveness and health benefits of ACP. Clean production made the highest contribution among the ACP measures. Since the signing of the Nationally Determined Contribution (NDC) in 2016, the synergistic effects of carbon emission reduction have been emerging as one of the key factors to address the air pollution and its related disease burden in China. Nevertheless, the PM_2.5-related disease burden are still severe in 2020, with ~1.19 million premature deaths in mainland China, accounting for ~17.84% of the global air pollution-related death. Under the China carbon neutrality pathway, 0.18 million (~15.13 %) and 0.35 million (~29.41%) premature deaths can be averted by 2030 and 2060, respectively. In addition, holding the air pollution control measures and health care level constant, the maximum low-carbon measures (i.e., 1.5℃ target scenarios) will bring higher health benefits in 2060. However, the population aging accompanies socio-economic development is still the major threat to the public health in long term. Our results could provide important implication for future development pathway setting to achieve the WHO AQG target, the United Nation’s Sustainable Development Goal (SDG) Target and NDC goal in China under the dual pressure from air clean and carbon emission mitigation.