BackgroundIn recent years, climate change and environmental pollution have posed significant threats to public health. As environmental policies such as low-carbon city initiatives are progressively implemented, their role in enhancing public health has become a topic of growing interest. This study aimed to investigate the relationship between green low-carbon development and public health and to analyze the underlying mechanisms.MethodsWe utilized data from 271 prefecture-level cities in China spanning from 2007 to 2020, focusing on green low-carbon development, climate change, environmental pollution, and public health. Employing the quasi-natural experimental framework of China’s low-carbon city pilot projects, we constructed a multi-site difference-in-differences (DID) model for empirical analysis. Various robustness checks, including parallel trend tests, placebo tests, sample selection bias checks, and adjustments to the temporal and spatial scope of the samples, were conducted to ensure the reliability of the results. Additionally, we explored the positive effects of green low-carbon development on public health through dual mediation pathways involving climate change mitigation and pollution reduction. Finally, we examined the heterogeneity of the results across different city tiers, economic growth rates, levels of technological investment, and green finance development.ResultsThe findings indicate that green low-carbon development significantly enhances public health, a conclusion supported by robustness tests. Mechanism analysis reveals that the benefits of green low-carbon development on public health are realized through mitigating climate change and reducing environmental pollution. Further analysis reveals that the positive impact on public health is more pronounced in first-and second-tier cities, as well as in cities with faster economic growth, greater technological investment, and more developed green finance sectors.DiscussionThis study highlights the crucial role of urban green low-carbon development in improving environmental quality and public health. In addition to providing empirical evidence that supports the promotion of green low-carbon development in cities, the results point to policy recommendations for enhancing public health. Moreover, the findings contribute to the development of environmental policies and the implementation of the “Healthy China” strategy.