Publications·December 30, 2023
In 2023, Energy Foundation China supported the California-China Climate Institute to carry out a study on the public health dimensions of air quality and climate change. The results were released in a report titled “The Public Health Dimensions of Air Quality and Climate Change: Highlights of Policy and Technological Options from California and China.”
California has demonstrated that public health co-benefits can serve as measurable, quantitative goals within climate and air quality policies. California has also made significant progress in incorporating environmental justice considerations into its work. On the other hand, China has excelled at developing highly sophisticated air quality monitoring tools and a comprehensive climate policy framework, and should further integrate public health indicators in its policies.
The report highlights that both California and China can achieve great health co-benefits through continued greenhouse gas emissions reduction and improved air quality in their jurisdictions. By synergistically addressing the issues of air pollution and greenhouse gas emissions, policymakers can successfully enhance public health outcomes.
Produced by the California–China Climate Institute, this binational report argues that air pollution and climate change are entwined problems with shared solutions, and that putting public health at the center of policy design unlocks the biggest gains. It synthesizes peer-reviewed evidence, maps policy pathways in California and China, surveys monitoring & analytics technologies (from satellites to machine learning), and distills city case studies (Los Angeles, Beijing, Shenzhen) into a practical set of lessons and opportunities. The headline: coordinated air–climate action reduces mortality and morbidity, yields economic benefits (lower health expenditures, higher productivity), and advances equity when measures explicitly prioritize overburdened communities.
The health stakes and why a joint approach is essential
The report reviews robust evidence linking PM₂.₅, ozone (O₃), and NO₂ to premature death and disease, with PM₂.₅ exerting the largest global burden. Acute rises in PM₂.₅/O₃/NO₂ elevate all-cause mortality within 24–48 hours; long-term PM₂.₅ exposure drives higher risks of cardiovascular and respiratory disease. Compound exposures (e.g., heat + ozone, cold + PM₂.₅) amplify harm beyond single-pollutant effects—an increasingly frequent pattern as climate extremes intensify. Vulnerability is uneven: older adults, infants, people with chronic cardiopulmonary disease, and lower-income communities experience disproportionate impacts. Conclusion: air and climate policy should be co-optimized, because measures that curb fossil fuel use and short-lived climate pollutants (SLCPs) simultaneously lower toxic co-pollutants and health risks.
What “health-first” looks like in practice
The report frames a health-first approach around (i) explicit health metrics in plans and laws; (ii) hybrid monitoring fabrics (reference-grade stations + remote sensing + low-cost sensors, fused with models/ML); (iii) early-warning for heat, wildfire smoke, dust and high-ozone days; and (iv) equity tools that target overburdened communities. It stresses putting results in units, not just AQI colors, and publishing open, machine-readable data to support science, accountability and public guidance.
California: weaving health into air & climate policy
California’s policy fabric combines Clean Air Act implementation (the State Implementation Plan) with state laws that anchor health and environmental justice (EJ) in decision-making. Examples include:
Community Air Protection (AB 617): community-scale monitoring and emission-reduction plans prioritizing health in overburdened neighborhoods; annual reporting of criteria & toxic pollutants for high-priority facilities.
Health-protective standards & programs: health-based CAAQS, anti-ozone air purifier rules, port and freight clean-up programs, Zero-Emission Vehicle mandates, and incentive schemes (e.g., Carl Moyer).
Climate framework (AB 32/SB 32): a five-year Scoping Plan that evaluates public-health co-benefits of GHG measures; SLCP Strategy targeting methane, black carbon, HFCs for near-term climate and immediate health wins; EJ provisions to ensure benefits in the most impacted communities.
Assessment tools: CalEnviroScreen (maps cumulative environmental/health burdens); health-impact methods (premature mortality, hospitalizations, asthma ED visits) used to quantify the health return on air/climate actions.
Lesson: California demonstrates that health benefits can be measurable policy targets—not afterthoughts—and that embedding EJ improves both legitimacy and outcomes.
China: large-scale gains with room to deepen health integration
China’s ambient PM₂.₅ levels fell dramatically from 2013–2021 (national mean ~72 → 30 µg/m³), reflecting comprehensive air-pollution control (e.g., standards, coal control, industrial/transport measures) and a maturing climate policy framework aligned with carbon-intensity and energy-intensity reductions. Major laws—the Environmental Protection Law and Air Pollution Prevention and Control Law—explicitly center public health; standards were updated to include PM₂.₅ and 8-hour O₃. National guidance now includes a health risk assessment protocol for air pollution. The report underscores growing attention to co-control (air & carbon)—for example, the “Blue Sky” campaigns and policies that jointly reduce SO₂/NOₓ/PM/VOCs and CO₂ through energy efficiency, coal-to-clean shifts, and industrial upgrades.
Lesson: China excels at monitoring scale-up and rapid policy execution; the next frontier is to institutionalize health metrics across climate/energy decisions and expand city-level health-impact evaluation of co-control portfolios.
Technology enablers: from satellites to machine learning
The report highlights a toolbox to measure, model, and manage risk:
Satellite remote sensing (LEO & GEO) for AOD/trace-gas mapping and regional transport;
Ground-based networks (regulatory monitors; low-cost sensors with QA/QC) to densify coverage;
Data fusion/ML to blend satellites, models, and in-situ data into decision-grade fields;
Public dashboards & APIs that surface units, coordinates, timeliness for public and professional use;
Early-warning systems for heat, wildfire smoke, dust, and high-ozone events.
These capabilities support evaluation (e.g., policy-effect dashboards), targeting (hotspots/airsheds), and community-facing guidance.
City case studies: Los Angeles, Beijing, Shenzhen
Los Angeles integrates research into policy, tracks health indicators inside air and climate plans, and centers EJ in neighborhood-scale programs (monitoring, localized controls, heat planning).
Beijing institutionalized co-control—tightened fuel/industrial standards, advanced monitoring, and targeted seasonal measures—delivering large PM₂.₅ declines while building health-risk assessment capacity.
Shenzhen pioneered electrified transport (buses/taxis fleets), VOC controls, and digital monitoring; health metrics are emerging as part of climate-aligned urban governance.
Cross-cutting lessons: (i) Codify health indicators in city plans; (ii) run community-scale monitoring with open data; (iii) use co-control portfolios (e.g., clean power + transport electrification + industrial upgrades) to stack air + climate + health wins.
Gaps and research needs
Evidence gaps persist on toxicity by PM components, ultrafines, and compound risks (e.g., heat + smoke). Many policies assert health benefits without common metrics—complicating comparisons. The report calls for more local cohort studies, better exposure metrics, and standardized monitoring & disclosure to turn pilots into operational health services.
Actionable takeaways (for governments & cities)
Make health a binding objective in both air and climate plans; adopt WHO-aligned targets and track health outcomes (mortality/morbidity, hospitalizations, asthma ED).
Stand up hybrid monitoring fabrics (reference-grade + satellites + QA/QC’d sensors) and publish open, unit-based, geolocated, timely data via APIs.
Operationalize early-warning for compound events (heat–ozone, wildfire smoke, dust) with clear response playbooks for agencies and the public.
Invest in equity: target overburdened communities with AB 617-style programs, cumulative-burden mapping, and community-driven plans.
Scale co-control portfolios (clean power, fleet electrification, efficiency, industrial upgrades, methane/SLCP cuts) and evaluate health co-benefits alongside GHG metrics.
Build capacity & exchange: bilateral training, replication of monitoring/analytics tools, and routine California–China best-practice dialogues.
Keywords
Public health; PM₂.₅ / O₃ / NO₂; compound exposure (heat + ozone; cold + PM₂.₅); co-control (air + climate); short-lived climate pollutants (SLCPs); remote sensing + sensors + ML fusion; early warning; environmental justice / vulnerable communities; open, unit-based data & APIs; policy-effect dashboards; Los Angeles / Beijing / Shenzhen.