Economic Growth Facilitates Household Fuel Use Transition to Reduce PM2.5-Related Deaths in China

Researchusually focuses on the impact of socioeconomicfactors on ambient PM2.5 and health burden. This studydemonstrates that economic growth promotes the indoor fuel use toreduce PM2.5-related deaths. Exposure to ambient and indoor particle matter (PM2.5) leads to millions of premature deaths in China. In recentyears,indoor air pollution and premature deaths associated with pollutingfuel cooking demonstrate an abrupt decline. However, the driving forcesbehind the mortality change are still unclear due to the uncertaintyin household fuel use prediction. Here, we propose an integrated approachto estimate the fuel use fractions and PM2.5-related deathsfrom outdoor and indoor sources during 2000-2020 across China.Our model estimated 1.67 and 1.21 million premature deaths attributableto PM2.5 exposure in 2000 and 2020, respectively. We findthat the residential energy transition is associated with a substantialreduction in premature deaths from indoor sources, with 100,000 (95%CI: 76,000-122,000) for urban and 265,000 (228,000-300,000)for rural populations during 2000-2020. Economic growth isthe dominant driver of fuel use transition and avoids 21% relateddeaths (357,000, 315,000-402,000) from polluting fuel cookingsince 2000, which offsets the adverse impact of ambient emissionscontributed by economic growth. Our findings give an insight intothe coupled impact of socioeconomic factors in reshaping health burdenin exposure pathways.