Population aging challenge future mitigation of deaths attributable to PM2.5 pollution in China

Abstract

Estimating the health burden of air pollution in China against the background of population aging is of great significance for the well-being of elderly individuals and achieving the United Nations Sustainable Development Goals (SDGs). Since previous studies did not fully consider the differences on drivers of deaths attributable to PM2.5 pollution (DAPP) (i.e., socioeconomic factors, climate factors, and disease mortalities) among provinces in China, the impact of future population aging on DAPP cannot be comprehensively and objectively estimated. In this study, we estimated and verified the spatiotemporal changes of DAPP in China from 2005 to 2017 based on a risk assessment framework. Then, using the latest climate projections, we estimated the changes and drivers in DAPP under four scenarios in China from 2018 to 2035 based on decomposition analysis. The results show that from 2017 to 2035, DAPP in China will decrease between 31.9 (26.6–45.6) thousand and 178.8 (152.5-210.5) thousand across three scenarios (sustainable development (SSP1-2.6), business as usual (SSP2-4.5), and fossil fuel development (SSP5-8.5). We found that population aging will be the leading driver contributing to the increase in DAPP and offset the positive gains achieved by improvement in air pollution and healthcare. In the future, reducing the exposure to air pollution and improving healthcare of the elderly is necessary to mitigate the global health burden of air pollution and this requires mutual cooperation and long-term efforts among countries worldwide.