The dual impact of carbon neutrality and population aging on PM2.5-related mortality and economic burden in China

Jianhui Guo; Lin Lin; Petros Koutrakis; Jianlin Hu; Shaodong Xie; Carolina L. Zilli Vieira; Yi Fan; Zhaokun Wang; Yaqi Wang; Xinyao Lian; Jinling You; Lijun Wang; Maigeng Zhou; Jing Li; Shaodan Huang; Peng Yin

doi:10.59717/j.xinn-med.2026.100259

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The dual impact of carbon neutrality and population aging on PM_2.5-related mortality and economic burden in China

1.
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
2.
National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
3.
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
4.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston MA 02115, USA
5.
School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Nanjing 210044, China
6.
State Key Joint Laboratory of Environment Simulation and Pollution Control, Peking University, Beijing 100871, China
7.
College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
8.
Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
9.
Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
10.
These authors contributed equally
11.
The senior author supervised the work

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Corresponding authors: yinpeng@ncncd.chinacdc.cn (P.Y.); shhuang@bjmu.edu.cn (S.H.); jing.li@hsc.pku.edu.cn (J.L.)
Received Date: February 18, 2026

Accepted Date: September 10, 2026

Published Online: September 12, 2026

The Innovation Medicine https://doi.org/10.59717/j.xinn-med.2026.100259 | Cite this article

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PUBLIC SUMMARY

PUBLIC SUMMARY
1. Achieving carbon neutrality could reduce PM_2.5-related mortality by about 84% among those aged <65 years.
  
  By 2050, older adults are expected to account for more than 69% of PM_2.5-related economic losses.
  
  Rapid aging will offset health gains from carbon neutrality in older adults.

ABSTRACT

ABSTRACT

Despite considerable regulatory interventions to mitigate air pollution, fine particulate matter (PM_2.5) remains a critical health threat across China. Carbon neutrality strategies, though primarily aimed at mitigating climate change, may also yield substantial co-benefits for air quality and public health. However, the scale of these benefits may be undermined by rapid population aging. Here, we used a two-stage time-series analysis to quantify the exposure-response relationship between short-term PM_2.5 exposure and mortality, using 50.9 million non-accidental deaths in mainland China. We then applied an air quality model to project future PM_2.5 concentrations and estimate the associated disease burden under three carbon emissions scenarios. From 2013 to 2020, short-term PM_2.5 exposure was attributable to 2.38% of all-cause mortality. By 2060, PM_2.5 concentrations are projected to decline by 75.8%, 67.8%, and 40.1%, respectively, under three emission pathways: SSP119 (carbon neutrality), SSP126 (carbon peaking), and SSP245 (business as usual), compared with the baseline period. Consequently, excess mortality among individuals under 65 years of age is expected to decrease by 83.9%, 78.6%, and 60.1%, respectively. However, among adults aged 85 and over, PM_2.5-attributable mortality is projected to increase by 15.6%, 53.5%, and 182.6%, respectively. By 2050, older adults are expected to account for more than 69% of PM_2.5-related economic costs under the SSP119 scenario, reflecting the growing age-related burden in all scenarios. These findings underscore the health and financial benefits of achieving carbon neutrality and highlight the need to integrate demographic change into future climate and air quality policy frameworks.

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Guo J., Lin L., Koutrakis P., et al. (2026). The dual impact of carbon neutrality and population aging on PM2.5-related mortality and economic burden in China. The Innovation Medicine 4:100259. https://doi.org/10.59717/j.xinn-med.2026.100259

Guo J., Lin L., Koutrakis P., et al. (2026). The dual impact of carbon neutrality and population aging on PM_2.5-related mortality and economic burden in China. The Innovation Medicine 4:100259. https://doi.org/10.59717/j.xinn-med.2026.100259

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The dual impact of carbon neutrality and population aging on PM_2.5-related mortality and economic burden in China

GRAPHICAL ABSTRACT

PUBLIC SUMMARY

ABSTRACT