Disproportionate effects of direct air carbon capture and storage on regional health co-benefits from net-zero emissions

Deploying carbon dioxide removal (CDR) can delay the reduction in fossil fuels and associated air pollutants, thereby reducing health co-benefits from climate action. The heterogeneity of these effects, however, remains unclear. By assessing the grid-level (36 km²) air pollution-related mortality in China’s pathway to net-zero CO₂ emissions over 2020–2060, we show that CDR exacerbates health inequity by disproportionally reducing more health co-benefits in developing regions, while improving health equality by aligning mortality rates across all regions. In addition to the differences in CDR deployment, such disproportionate impact is largely attributed to CDR trading, by which developing regions can obtain additional CDR quotas, in turn, decreasing local health co-benefits and hampering national health equity. Nonetheless, CDR trading prevents an even greater exacerbation of health inequity, as CDR trading also transfers CDR quotas and associated health burdens from developing to developed regions. Our results support how health-considered policy can be incorporated into CDR deployment strategies to enhance health co-benefits and promote equitable health outcomes.