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The launch of China's new national urbanization plan, coupled with increasing concerns about air pollution, calls for better understandings of the nexus between urbanization and the air pollution-related health. Based on refined estimates of PM2.5 related mortality in China, we developed an Urbanization-Excess Deaths Elasticity (U-EDE) indicator to measure the marginal PM2.5 related mortality caused by urbanization. We then applied statistical models to estimate U-EDE and examined the modification effects of income on U-EDE. Urbanization in China between 2004 and 2012 led to increased PM2.5 related mortality. A 1% increase in urbanization was associated with a 0.32%, 0.14%, and 0.50% increase in PM2.5 related mortality of lung cancer, stroke, and ischemic heart disease. U-EDEs were modified by income with an inverted U curve, i.e., lower marginal impacts at the lowest and highest income levels. In addition, we projected the future U-EDE trend of China as a whole and found that China had experienced the peak of U-EDE and entered the second half of the inverted U-shaped curve. In the near future, national average U-EDE in China will decline along with the improvement of income level if no dramatic changes happen. However, the decreased U-EDE only implies that marginal PM2.5-related mortality brought by urbanization would decrease in China. Total health damage of urbanization will keep going up in the predictable future because the U-EDE is always positive. Copyright © 2017 Elsevier Ltd. All rights reserved.


Miaomiao Liu, Yining Huang, Zhou Jin, Zongwei Ma, Xingyu Liu, Bing Zhang, Yang Liu, Yang Yu, Jinnan Wang, Jun Bi, Patrick L Kinney. The nexus between urbanization and PM2.5 related mortality in China. Environmental pollution (Barking, Essex : 1987). 2017 Aug;227:15-23

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PMID: 28454017

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