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Abstract Ambient fine particulate matter (PM 2.5) has long been the primary air pollutant with alarming public health risk in China. PM 2.5 pollution control in China still mainly concerned concentration declining. The qualification and identification of PM 2.5 -attributable health loss is crucial for China's air quality improvement and pollution prevention. This study assessed the annual health loss and economic impact attributed to PM 2.5 exposure at a city level in China from 2015 to 2017. The health benefits from achieving specific PM 2.5 concentration control targets were estimated for 2020. The economic value of health loss in China was 3205.05, 3223.51, and 3344.80 billion Yuan in 2015, 2016, and 2017, representing 4.34%, 4.07%, and 3.85% of the gross domestic product of China. The health loss value in Beijing–Tianjin–Hebei (BTH) and surrounding areas and the Yangtze River Delta (YRD) urban agglomeration in 2017 was 731.93 and 520.27 billion Yuan, accounting for 21.88% and 15.56%, respectively, of the total economic value of all assessed cities. The economic value of health loss in provincial cities was high. From 2015 to 2017, high health loss in BTH and surrounding areas showed a diffusion trend toward cities in Henan, Shanxi, and Shaanxi Provinces. High health loss in the YRD urban agglomeration transferred to cities located in the middle and upper reaches of the Yangtze River. If PM 2.5 concentration control targets can be achieved by 2020, premature mortality attributed to PM 2.5 exposure will fall by 91,860 cases, representing 11.20% of which in 2017. This study, for the first time, highlighted the spatial distribution and temporal variation characteristics of health loss in Chinese cities based on ground-monitoring PM 2.5 concentration data and annual real-time population data. Distributional feature and time-trend analysis would provide a measurable assessment of health loss in Chinese cities to policymakers for effective allocating their efforts on air quality improvement. Graphical abstract Economic value of public health loss attributed to PM 2.5 exposure at the city level in 2017. Image 1 Highlights • We assessed the annual health loss and economic impact of PM 2.5 exposure in China. • We used PM 2.5 and population data (2015–2017) of prefecture-level cities or above. • Health loss declined from 0.91 (2015) to 0.82 (2017) million premature mortalities. • Annual economic value of health loss increased but declined as a percent of GDP. • Meeting updated PM 2.5 targets by 2020 could reduce mortality by 11% of 2017 levels. [ABSTRACT FROM AUTHOR]

Air pollution and climate change are issues of worldwide concern. Synergizing air pollution control and climate mitigation have been an important national policy of China. This study develops bivariate and integrated synergy indexes (BSI and ISI) to investigate the synergy states between air pollution and CO 2 emission. The synergy indexes are based on the correlation coefficient and established from exploiting the internal comparability of the data. Using the BSI and ISI , we evaluated the correlation and synergy states between air pollution (involving ambient PM 2.5 and ozone) and CO 2 emission in Chinese cities from 2015 to 2020. The results present the city-level trends and heterogeneities of synergy between air pollution and CO 2 emission. The averaged value of BSI PM2.5-ozone , BSI PM2.5-CO2 , and BSI ozone-CO2 for all cities and assessing years were −0.239, −0.291, and −0.242, indicating a generally and globally weak synergy. The synergy states between air pollution and CO 2 emission were relatively significant and complex in specific regions. Combined with the local spatial association and decoupling analysis, we further identified the primary variables and key areas for synergistic control. This study provides a systematic idea and case demonstration for city-level synergy assessment through transforming and expanding the data usage capacity. The method and process are applicable to various scales and regions, which would be of reference value for synergy assessments in other countries and regions. [Display omitted] • We developed the bivariate and integrated synergy indexes. • We evaluated the synergy between air pollution and CO 2 emission at the city-level. • Local spatial association and decoupling analysis supported the synergy assessment. • Most Chinese cities show insignificant synergy of air pollution and CO 2. • BTHS, YRD, and the JJAH are key areas. [ABSTRACT FROM AUTHOR]