COVID-19 pandemic reveals persistent disparities in nitrogen dioxide pollution

Evolution of global O3-NOx-VOCs sensitivity before and after the COVID-19 from the ratio of formaldehyde to NO2 from satellite observations

Ozone production sensitivity is widely used to reveal the chemical dominant precursors of urban ozone rise. Here, we diagnose the impact of the decline in global human production activities level caused by the COVID-19 on ozone sensitivity through the ratio of formaldehyde (HCHO) and NO2 (FNR = HCHO/NO2) observations from the TROPOspheric Monitoring Instrument. We use a relative uncertainty threshold to clean the satellite FNR, and our satellite FNR present a good correlation (R = 0.6248) with U.S. Environmental Protection Agency observations. We found that the outbreak of the COVID-19 did not change the pattern of global ozone sensitivity, while the global regimes was transforming or strengthening to VOC-limited regimes due to the significant decline of human production activities levels. During the COVID-19, ozone sensitivity in Eastern China and East Africa continued to shift to VOC-limited regimes, while India, Western Europe and North America first moved to NOx-limited regimes, and then changed to VOC-limited regimes with the resumption of production and the increase in travel. The clustering results tell that urban ozone sensitivity tends to shift towards NOx-limited regimes as economic growing. The ozone formation in cities with lower FNR and per capita gross domestic product (GDP) are more sensitive to changes in VOCs, while cities with higher FNR and per capita GDP are more sensitive to variations in NOx. Cities with intermediate FNR and GDP are good evidence of the existence of transitional regimes. Our study identifies the driving role of urban economics in orienting the evolution of ozone sensitivity regimes.

Characteristics and sources of PM2.5 in diverse central China cities under various scenarios: Maximum simulated emission reduction based on long-term data

To control COVID-19, strict restrictions were implemented in China, leading to a decline in pollutant emissions. However, in the post-pandemic era, pollutants rebounded rapidly, particularly in the Central Plains region, without PM2.5 concentrations meeting national standard. This study analyzed Water-soluble inorganic ions (WSIIs) concentration and sources across different pandemic periods using long-term high-resolution PM2.5, WSIIs and meteorological data from Zhengzhou (ZZ), Anyang (AY), and Xinyang (XY). Results indicated that during the lockdown, WSIIs concentration in the three cities were significantly lower compared to other periods, but rebounded shortly after lifting of restrictions due to human activity resumption. Positive Matrix Factorization analysis showed that secondary aerosol sources were dominant in all cities. Simulations revealed a 90 % reduction of secondary aerosol sources in ZZ could lead to an additional decrease of 2.6 μg·m⁻³ of PM2.5 due to pH change. In AY, a 30 % reduction of secondary aerosol sources resulted in an extra reduction of 14.9 μg·m⁻³ in PM2.5. When the contribution of secondary aerosol sources in XY was decreased to 18 %, PM2.5 concentration decreased by 30 %, achieving an additional reduction of 9.5 μg·m⁻³ . This study offers strategies for achieving PM2.5 compliance and mitigating its impact on health and environment in the post-pandemic era.

Satellite data to support air quality assessment and management

Satellite data have long been recognized as valuable for air quality applications. These applications are in a stage of rapid growth: new geostationary satellites provide hourly or sub-hourly data; improvements in algorithms convert measured wavelengths into retrievals of atmospheric constituents; advances in machine learning support improved estimates of near-surface pollution; and growing interest among air quality managers has led to a range of new satellite data applications. Considering mainly activities in the United States under the Clean Air Act, we discuss proven applications relevant to air quality management, including: informing epidemiological studies and health risk assessments for setting regulatory standards; evaluating regulatory models; constraining emissions inventories; supporting Exceptional Event Demonstrations through tracking wildfire plumes and other sources; characterizing emission patterns and ozone-forming chemistry for State Implementation Plans; improving air quality forecasting; and tracking long-term trends to evaluate regulatory impact. Air quality professionals are increasingly using satellite data for these and related analyses, but barriers remain. This review provides a summary of satellite products used in applications for air quality and related health assessments; progress in using satellite observations for deriving surface-level air quality information across scales; and their use in air quality management.Implications: The review covers advancements in satellite data for air quality applications over the last 15 years. Success with satellite applications, especially for PM2.5 and NO2, include use in health risk assessment, constraining emissions inventories, and supporting tracking short- and long-term trends with regulatory relevance. Solutions co-developed between researchers and practitioners show promise for continued improvements in the use and value of satellite data for air quality applications.

TROPOMI Satellite Data Reshape NO2 Air Pollution Land-Use Regression Modeling Capabilities in the United States

Nitrogen dioxide (NO2) pollution is associated with adverse health effects, but its spatial variability between ground monitors is poorly characterized. NO2 column observations from the Tropospheric Monitoring Instrument (TROPOMI) have unprecedented spatial resolution and high accuracy over the globe. Land-use regression (LUR) models predict surface-level NO2 with relevance for epidemiological and environmental justice studies. We use TROPOMI NO2 columns in a land use regression (LUR) model to improve surface NO2 concentration estimates over the United States. The TROPOMI LUR predictions have improved correlation with ground monitors (Adj. R 2 = 0.72) and bias (Mean Bias, MB = 14.2%) compared with an existing LUR using less granular NO2 data from a legacy satellite instrument (Adj. R 2 = 0.54 and MB = 49%; for North America). Removing TROPOMI NO2 from the LUR decreased R 2 by 29.1%, 8.1 times the impact of removing road system information. These findings reveal that novel Earth observing satellites can enhance surface NO2 surveillance by capturing pollution variation between monitors without relying heavily on other data sources.

Methods for Quantifying Source-Specific Air Pollution Exposure to Serve Epidemiology, Risk Assessment, and Environmental Justice

Identifying sources of air pollution exposure is crucial for addressing their health impacts and associated inequities. Researchers have developed modeling approaches to resolve source-specific exposure for application in exposure assessments, epidemiology, risk assessments, and environmental justice. We explore six source-specific air pollution exposure assessment approaches: Photochemical Grid Models (PGMs), Data-Driven Statistical Models, Dispersion Models, Reduced Complexity chemical transport Models (RCMs), Receptor Models, and Proximity Exposure Estimation Models. These models have been applied to estimate exposure from sources such as on-road vehicles, power plants, industrial sources, and wildfires. We categorize these models based on their approaches for assessing emissions and atmospheric processes (e.g., statistical or first principles), their exposure units (direct physical measures or indirect measures/scaled indices), and their temporal and spatial scales. While most of the studies we discuss are from the United States, the methodologies and models are applicable to other countries and regions. We recommend identifying the key physical processes that determine exposure from a given source and using a model that sufficiently accounts for these processes. For instance, PGMs use first principles parameterizations of atmospheric processes and provide source impacts exposure variability in concentration units, although approaches within PGMs for source attribution introduce uncertainties relative to the base model and are difficult to evaluate. Evaluation is important but difficult-since source-specific exposure is difficult to observe, the most direct evaluation methods involve comparisons with alternative models.

Neighborhood-Level Nitrogen Dioxide Inequalities Contribute to Surface Ozone Variability in Houston, Texas

In Houston, Texas, nitrogen dioxide (NO2) air pollution disproportionately affects Black, Latinx, and Asian communities, and high ozone (O3) days are frequent. There is limited knowledge of how NO2 inequalities vary in urban air quality contexts, in part from the lack of time-varying neighborhood-level NO2 measurements. First, we demonstrate that daily TROPOspheric Monitoring Instrument (TROPOMI) NO2 tropospheric vertical column densities (TVCDs) resolve a major portion of census tract-scale NO2 inequalities in Houston, comparing NO2 inequalities based on TROPOMI TVCDs and spatiotemporally coincident airborne remote sensing (250 m × 560 m) from the NASA TRacking Aerosol Convection ExpeRiment-Air Quality (TRACER-AQ). We further evaluate the application of daily TROPOMI TVCDs to census tract-scale NO2 inequalities (May 2018-November 2022). This includes explaining differences between mean daily NO2 inequalities and those based on TVCDs oversampled to 0.01° × 0.01° and showing daily NO2 column-surface relationships weaken as a function of observation separation distance. Second, census tract-scale NO2 inequalities, city-wide high O3, and mesoscale airflows are found to covary using principal component and cluster analysis. A generalized additive model of O3 mixing ratios versus NO2 inequalities reproduces established nonlinear relationships between O3 production and NO2 concentrations, providing observational evidence that neighborhood-level NO2 inequalities and O3 are coupled. Consequently, emissions controls specifically in Black, Latinx, and Asian communities will have co-benefits, reducing both NO2 disparities and high O3 days city wide.

Capturing Exposure Disparities with Chemical Transport Models: Evaluating the Suitability of Downscaling Using Land Use Regression

High resolution exposure surfaces are essential to capture disparities in exposure to traffic-related air pollution in urban areas. In this study, we develop an approach to downscale Chemical Transport Model (CTM) simulations to a hyperlocal level (∼100m) in the Greater Toronto Area (GTA) under three scenarios where emissions from cars, trucks and buses are zeroed out, thus capturing the burden of each transportation mode. This proposed approach statistically fuses CTMs with Land-Use Regression using machine learning techniques. With this proposed downscaling approach, changes in air pollutant concentrations under different scenarios are appropriately captured by downscaling factors that are trained to reflect the spatial distribution of emission reductions. Our validation analysis shows that high-resolution models resulted in better performance than coarse models when compared with observations at reference stations. We used this downscaling approach to assess disparities in exposure to nitrogen dioxide (NO2) for populations composed of renters, low-income households, recent immigrants, and visible minorities. Individuals in all four categories were disproportionately exposed to the burden of cars, trucks, and buses. We conducted this analysis at spatial resolutions of 12, 4, 1 km, and 100 m and observed that disparities were significantly underestimated when using coarse spatial resolutions. This reinforces the need for high-spatial resolution exposure surfaces for environmental justice analyses.

Air pollution impacts from warehousing in the United States uncovered with satellite data

Regulators, environmental advocates, and community groups in the United States (U.S.) are concerned about air pollution associated with the proliferating e-commerce and warehousing industries. Nationwide datasets of warehouse locations, traffic, and satellite observations of the traffic-related pollutant nitrogen dioxide (NO2) provide a unique capability to evaluate the air quality and environmental equity impacts of these geographically-dispersed emission sources. Here, we show that the nearly 150,000 warehouses in the U.S. worsen local traffic-related air pollution with an average near-warehouse NO2 enhancement of nearly 20% and are disproportionately located in marginalized and minoritized communities. Near-warehouse truck traffic and NO2 significantly increase as warehouse density and the number of warehouse loading docks and parking spaces increase. Increased satellite-observed NO2 near warehouses underscores the need for indirect source rules, incentives for replacing old trucks, and corporate commitments towards electrification. Future ground-based monitoring campaigns may help track impacts of individual or small clusters of facilities.

Societal Co-benefits of Zero-Emission Vehicles in the Freight Industry

This study was set in the Greater Toronto and Hamilton Area (GTHA), where commercial vehicle movements were assigned across the road network. Implications for greenhouse gas (GHG) emissions, air quality, and health were examined through an environmental justice lens. Electrification of light-, medium-, and heavy-duty trucks was assessed to identify scenarios associated with the highest benefits for the most disadvantaged communities. Using spatially and temporally resolved commercial vehicle movements and a chemical transport model, changes in air pollutant concentrations under electric truck scenarios were estimated at 1-km2 resolution. Heavy-duty truck electrification reduces ambient black carbon and nitrogen dioxide on average by 10 and 14%, respectively, and GHG emissions by 10.5%. It achieves the highest reduction in premature mortality attributable to fine particulate matter chronic exposure (around 200 cases per year) compared with light- and medium-duty electrification (less than 150 cases each). The burden of all traffic in the GTHA was estimated to be around 600 cases per year. The benefits of electrification accrue primarily in neighborhoods with a high social disadvantage, measured by the Ontario Marginalization Indices, narrowing the disparity of exposure to traffic-related air pollution. Benefits related to heavy-duty truck electrification reflect the adverse impacts of diesel-fueled freight and highlight the co-benefits achieved by electrifying this sector.

Racial and ethnic minorities disproportionately exposed to extreme daily temperature variation in the United States

In the history of Homo sapiens, well-populated habitats have featured relatively stable temperatures with generally small daily variations. As the global population is increasingly residing in highly disparate climates, a burgeoning literature has documented the adverse health effects of single-day and day-to-day variation in temperature, raising questions of inequality in exposure to this environmental health risk. Yet, we continue to lack understanding of inequality in exposure to daily temperature variation (DTV) in the highly unequal United States. Using nighttime and daytime land surface temperature data between 2000 and 2017, this study analyzes population exposure to long-term DTV by race and ethnicity, income, and age for the 50 states and the District of Columbia. The analysis is based on population-weighted exposure at the census-tract level. We find that, on average, non-White (especially Black and Hispanic) and low-income Americans are exposed disproportionately to larger DTV. Race-based inequalities in exposure to DTV are larger than income-based disparities, with inequalities heightened in the summer months. In May, for example, the DTV difference by race and ethnicity of 51 states is between 0.20 and 3.01 °C (up to 21.0%). We find that younger populations are, on average, exposed to larger DTV, though the difference is marginal.

Increasing Racial and Ethnic Disparities in Ambient Air Pollution-Attributable Morbidity and Mortality in the United States

BACKGROUND

Ambient nitrogen dioxide (NO 2 ) and fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ) threaten public health in the US, and systemic racism has led to modern-day disparities in the distribution and associated health impacts of these pollutants.

OBJECTIVES

Many studies on environmental injustices related to ambient air pollution focus only on disparities in pollutant concentrations or provide only an assessment of pollution or health disparities at a snapshot in time. In this study, we compare injustices in NO 2 - and PM 2.5 -attributable health burdens, considering NO 2 -attributable health impacts across the entire US; document changing disparities in these health burdens over time (2010-2019); and evaluate how more stringent air quality standards would reduce disparities in health impacts associated with these pollutants.

METHODS

Through a health impact assessment, we quantified census tract-level variations in health outcomes attributable to NO 2 and PM 2.5 using health impact functions that combine demographic data from the US Census Bureau; two spatially resolved pollutant datasets, which fuse satellite data with physical and statistical models; and epidemiologically derived relative risk estimates and incidence rates from the Global Burden of Disease study.

RESULTS

Despite overall decreases in the public health damages associated with NO 2 and PM 2.5 , racial and ethnic relative disparities in NO 2 -attributable pediatric asthma and PM 2.5 -attributable premature mortality have widened in the US during the last decade. Racial relative disparities in PM 2.5 -attributable premature mortality and NO 2 -attributable pediatric asthma have increased by 16% and 19%, respectively, between 2010 and 2019. Similarly, ethnic relative disparities in PM 2.5 -attributable premature mortality have increased by 40% and NO 2 -attributable pediatric asthma by 10%.

DISCUSSION

Enacting and attaining more stringent air quality standards for both pollutants could preferentially benefit the most marginalized and minoritized communities by greatly reducing racial and ethnic relative disparities in pollution-attributable health burdens in the US. Our methods provide a semi-observational approach to track changes in disparities in air pollution and associated health burdens across the US. https://doi.org/10.1289/EHP11900.

Quantifying Disparities in Air Pollution Exposures across the United States Using Home and Work Addresses

While human mobility plays a crucial role in determining ambient air pollution exposures and health risks, research to date has assessed risks on the basis of almost solely residential location. Here, we leveraged a database of ∼128-144 million workers in the United States and published ambient PM2.5 data between 2011 and 2018 to explore how incorporating information on both workplace and residential location changes our understanding of disparities in air pollution exposure. In general, we observed higher workplace exposures relative to home exposures, as well as increased exposures for nonwhite and less educated workers relative to the national average. Workplace exposure disparities were higher among racial and ethnic groups and job types than by income, education, age, and sex. Not considering workplace exposures can lead to systematic underestimations in disparities in exposure among these subpopulations. We also quantified the error in assigning workers home instead of a weighted home-and-work exposure. We observed that biases in associations between PM2.5 and health impacts by using home instead of home-and-work exposure were the highest among urban, younger populations.

Air pollution benefits from reduced on-road activity due to COVID-19 in the United States

On-road transportation is one of the largest contributors to air pollution in the United States. The COVID-19 pandemic provided the unintended experiment of reduced on-road emissions' impacts on air pollution due to lockdowns across the United States. Studies have quantified on-road transportation's impact on fine particulate matter (PM2.5)-attributable and ozone (O3)-attributable adverse health outcomes in the United States, and other studies have quantified air pollution-attributable health outcome reductions due to COVID-19-related lockdowns. We aim to quantify the PM2.5-attributable, O3-attributable, and nitrogen dioxide (NO2)-attributable adverse health outcomes from traffic emissions as well as the air pollution benefits due to reduced on-road activity during the pandemic in 2020. We estimate 79,400 (95% CI 46,100-121,000) premature mortalities each year due to on-road-attributable PM2.5, O3, and NO2. We further break down the impacts by pollutant and vehicle types (passenger [PAS] vs. freight [FRT] vehicles). We estimate PAS vehicles to be responsible for 63% of total impacts and FRT vehicles 37%. Nitrogen oxide (NOX) emissions from these vehicles are responsible for 78% of total impacts as it is a precursor for PM2.5 and O3. Utilizing annual vehicle miles traveled reductions in 2020, we estimate that 9,300 (5,500-14,000) deaths from air pollution were avoided in 2020 due to the state-specific reductions in on-road activity across the continental United States. By quantifying the air pollution public health benefits from lockdown-related reductions in on-road emissions, the results from this study stress the need for continued emission mitigation policies, like the U.S. Environmental Protection Agency's (EPA) recently proposed NOX standards for heavy-duty vehicles, to mitigate on-road transportation's public health impact.

Satellite data for environmental justice: a scoping review of the literature in the United States

In support of the environmental justice (EJ) movement, researchers, activists, and policymakers often use environmental data to document evidence of the unequal distribution of environmental burdens and benefits along lines of race, class, and other socioeconomic characteristics. Numerous limitations, such as spatial or temporal discontinuities, exist with commonly used data measurement techniques, which include ground monitoring and federal screening tools. Satellite data is well poised to address these gaps in EJ measurement and monitoring; however, little is known about how satellite data has advanced findings in EJ or can help to promote EJ through interventions. Thus, this scoping review aims to (1) explore trends in study design, topics, geographic scope, and satellite datasets used to research EJ, (2) synthesize findings from studies that use satellite data to characterize disparities and inequities across socio-demographic groups for various environmental categories, and (3) capture how satellite data are relevant to policy and real-world impact. Following PRISMA extension guidelines for scoping reviews, we retrieved 81 articles that applied satellite data for EJ research in the United States from 2000 to 2022. The majority of the studies leveraged the technical advantages of satellite data to identify socio-demographic disparities in exposure to environmental risk factors, such as air pollution, and access to environmental benefits, such as green space, at wider coverage and with greater precision than previously possible. These disparities in exposure and access are associated with health outcomes such as increased cardiovascular and respiratory diseases, mental illness, and mortality. Research using satellite data to illuminate EJ concerns can contribute to efforts to mitigate environmental inequalities and reduce health disparities. Satellite data for EJ research can therefore support targeted interventions or influence planning and policy changes, but significant work remains to facilitate the application of satellite data for policy and community impact.

Ethnoracial Disparities in Nitrogen Dioxide Pollution in the United States: Comparing Data Sets from Satellites, Models, and Monitors

In the United States (U.S.), studies on nitrogen dioxide (NO2) trends and pollution-attributable health effects have historically used measurements from in situ monitors, which have limited geographical coverage and leave 66% of urban areas unmonitored. Novel tools, including remotely sensed NO2 measurements and estimates of NO2 estimates from land-use regression and photochemical models, can aid in assessing NO2 exposure gradients, leveraging their complete spatial coverage. Using these data sets, we find that Black, Hispanic, Asian, and multiracial populations experience NO2 levels 15-50% higher than the national average in 2019, whereas the non-Hispanic White population is consistently exposed to levels that are 5-15% lower than the national average. By contrast, the in situ monitoring network indicates more moderate ethnoracial NO2 disparities and different rankings of the least- to most-exposed ethnoracial population subgroup. Validating these spatially complete data sets against in situ observations reveals similar performance, indicating that all these data sets can be used to understand spatial variations in NO2. Integrating in situ monitoring, satellite data, statistical models, and photochemical models can provide a semiobservational record, complete geospatial coverage, and increasingly high spatial resolution, enhancing future efforts to characterize, map, and track exposure and inequality for highly spatially heterogeneous pollutants like NO2.

Ambient nitrogen dioxide in 47 187 neighbourhoods across 326 cities in eight Latin American countries: population exposures and associations with urban features

BACKGROUND

Health research on ambient nitrogen dioxide (NO2) is sparse in Latin America, despite the high prevalence of NO2-associated respiratory diseases in the region. This study describes within-city distributions of ambient NO2 concentrations at high spatial resolution and urban characteristics associated with neighbourhood ambient NO2 in 326 Latin American cities.

METHODS

We aggregated estimates of annual surface NO2 at 1 km2 spatial resolution for 2019, population counts, and urban characteristics compiled by the SALURBAL project to the neighbourhood level (ie, census tracts). We described the percentage of the urban population living with ambient NO2 concentrations exceeding WHO air quality guidelines. We used multilevel models to describe associations of neighbourhood ambient NO2 concentrations with population and urban characteristics at the neighbourhood and city levels.

FINDINGS

We examined 47 187 neighbourhoods in 326 cities from eight Latin American countries. Of the roughly 236 million urban residents observed, 85% lived in neighbourhoods with ambient annual NO2 above WHO guidelines. In adjusted models, higher neighbourhood-level educational attainment, closer proximity to the city centre, and lower neighbourhood-level greenness were associated with higher ambient NO2. At the city level, higher vehicle congestion, population size, and population density were associated with higher ambient NO2.

INTERPRETATION

Almost nine out of every ten residents of Latin American cities live with ambient NO2 concentrations above WHO guidelines. Increasing neighbourhood greenness and reducing reliance on fossil fuel-powered vehicles warrant further attention as potential actionable urban environmental interventions to reduce population exposure to ambient NO2.

FUNDING

Wellcome Trust, National Institutes of Health, Cotswold Foundation.

State-of-the-Science Data and Methods Need to Guide Place-Based Efforts to Reduce Air Pollution Inequity

BACKGROUND

Recently enacted environmental justice policies in the United States at the state and federal level emphasize addressing place-based inequities, including persistent disparities in air pollution exposure and associated health impacts. Advances in air quality measurement, models, and analytic methods have demonstrated the importance of finer-scale data and analysis in accurately quantifying the extent of inequity in intraurban pollution exposure, although the necessary degree of spatial resolution remains a complex and context-dependent question.

OBJECTIVE

The objectives of this commentary were to a) discuss ways to maximize and evaluate the effectiveness of efforts to reduce air pollution disparities, and b) argue that environmental regulators must employ improved methods to project, measure, and track the distributional impacts of new policies at finer geographic and temporal scales.

DISCUSSION

The historic federal investments from the Inflation Reduction Act, the Infrastructure Investment and Jobs Act, and the Biden Administration's commitment to Justice40 present an unprecedented opportunity to advance climate and energy policies that deliver real reductions in pollution-related health inequities. In our opinion, scientists, advocates, policymakers, and implementing agencies must work together to harness critical advances in air quality measurements, models, and analytic methods to ensure success. https://doi.org/10.1289/EHP13063.

Climate Change, Air Quality, and Pulmonary Health Disparities

Climate change will alter environmental risks that influence pulmonary health, including heat, air pollution, and pollen. These exposures disproportionately burden populations already at risk of ill health, including those at vulnerable life stages, with low socioeconomic status, and systematically targeted by oppressive policies. Climate change can exacerbate existing environmental injustices by affecting future exposure, as well as through differentials in the ability to adapt; this is compounded by disparities in rates of underlying disease and access to health care. Climate change is therefore a dire threat not only to individual and population health but also to health equity.

Data-Driven Placement of PM2.5 Air Quality Sensors in the United States: An Approach to Target Urban Environmental Injustice

In the United States, citizens and policymakers heavily rely upon Environmental Protection Agency mandated regulatory networks to monitor air pollution; increasingly they also depend on low-cost sensor networks to supplement spatial gaps in regulatory monitor networks coverage. Although these regulatory and low-cost networks in tandem provide enhanced spatiotemporal coverage in urban areas, low-cost sensors are located often in higher income, predominantly White areas. Such disparity in coverage may exacerbate existing inequalities and impact the ability of different communities to respond to the threat of air pollution. Here we present a study using cost-constrained multiresolution dynamic mode decomposition (mrDMDcc) to identify the optimal and equitable placement of fine particulate matter (PM2.5) sensors in four U.S. cities with histories of racial or income segregation: St. Louis, Houston, Boston, and Buffalo. This novel approach incorporates the variation of PM2.5 on timescales ranging from 1 day to over a decade to capture air pollution variability. We also introduce a cost function into the sensor placement optimization that represents the balance between our objectives of capturing PM2.5 extremes and increasing pollution monitoring in low-income and nonwhite areas. We find that the mrDMDcc algorithm places a greater number of sensors in historically low-income and nonwhite neighborhoods with known environmental pollution problems compared to networks using PM2.5 information alone. Our work provides a roadmap for the creation of equitable sensor networks in U.S. cities and offers a guide for democratizing air pollution data through increasing spatial coverage of low-cost sensors in less privileged communities.

A hyperlocal hybrid data fusion near-road PM2.5 and NO2 annual risk and environmental justice assessment across the United States

Exposure to traffic-related air pollutants (TRAPs) has been associated with numerous adverse health effects. TRAP concentrations are highest meters away from major roads, and disproportionately affect minority (i.e., non-white) populations often considered the most vulnerable to TRAP exposure. To demonstrate an improved assessment of on-road emissions and to quantify exposure inequity in this population, we develop and apply a hybrid data fusion approach that utilizes the combined strength of air quality observations and regional/local scale models to estimate air pollution exposures at census block resolution for the entire U.S. We use the regional photochemical grid model CMAQ (Community Multiscale Air Quality) to predict the spatiotemporal impacts at local/regional scales, and the local scale dispersion model, R-LINE (Research LINE source) to estimate concentrations that capture the sharp TRAP gradients from roads. We further apply the Regionalized Air quality Model Performance (RAMP) Hybrid data fusion technique to consider the model's nonhomogeneous, nonlinear performance to not only improve exposure estimates, but also achieve significant model performance improvement. With a R2 of 0.51 for PM2.5 and 0.81 for NO2, the RAMP hybrid method improved R2 by ~0.2 for both pollutants (an increase of up to ~70% for PM2.5 and ~31% NO2). Using the RAMP Hybrid method, we estimate 264,516 [95% confidence interval [CI], 223,506-307,577] premature deaths attributable to PM2.5 from all sources, a ~1% overall decrease in CMAQ-estimated premature mortality compared to RAMP Hybrid, despite increases and decreases in some locations. For NO2, RAMP Hybrid estimates 138,550 [69,275-207,826] premature deaths, a ~19% increase (22,576 [11,288 - 33,864]) compared to CMAQ. Finally, using our RAMP hybrid method to estimate exposure inequity across the U.S., we estimate that Minorities within 100 m from major roads are exposed to up to 15% more PM2.5 and up to 35% more NO2 than their White counterparts.

Ambient nitrogen dioxide in 47,187 neighborhoods across 326 cities in eight Latin American countries: population exposures and associations with urban features

Background

Health research on ambient nitrogen dioxide (NO2) is sparse in Latin America, despite the high prevalence of NO2-associated respiratory diseases in the region. This study describes within-city distributions of ambient NO2 concentrations at high spatial resolution and urban characteristics associated with neighborhood ambient NO2 in 326 Latin American cities.

Methods

We aggregated estimates of annual surface NO2 at 1 km2 spatial resolution for 2019, population counts, and urban characteristics compiled by the SALURBAL project to the neighborhood level (i.e., census tracts). We described the percent of the urban population living with ambient NO2 levels exceeding WHO Air Quality Guidelines. We used multilevel models to describe associations of neighborhood ambient NO2 concentrations with population and urban characteristics at the neighborhood and city levels.

Findings

We examined 47,187 neighborhoods in 326 cities from eight Latin American countries. Of the ≈236 million urban residents observed, 85% lived in neighborhoods with ambient annual NO2 above WHO guidelines. In adjusted models, higher neighborhood-level educational attainment, closer proximity to the city center, and lower neighborhood-level greenness were associated with higher ambient NO2. At the city level, higher vehicle congestion, population size, and population density were associated with higher ambient NO2.

Interpretation

Almost nine out of every 10 residents of Latin American cities live with ambient NO2 concentrations above WHO guidelines. Increasing neighborhood greenness and reducing reliance on fossil fuel-powered vehicles warrant further attention as potential actionable urban environmental interventions to reduce population exposure to ambient NO2.

Funding

Wellcome Trust, National Institutes of Health, Cotswold Foundation.

Combining Satellite-Derived PM2.5 Data and a Reduced-Form Air Quality Model to Support Air Quality Analysis in US Cities

Air quality models can support pollution mitigation design by simulating policy scenarios and conducting source contribution analyses. The Intervention Model for Air Pollution (InMAP) is a powerful tool for equitable policy design as its variable resolution grid enables intra-urban analysis, the scale of which most environmental justice inquiries are levied. However, InMAP underestimates particulate sulfate and overestimates particulate ammonium formation, errors that limit the model's relevance to city-scale decision-making. To reduce InMAP's biases and increase its relevancy for urban-scale analysis, we calculate and apply scaling factors (SFs) based on observational data and advanced models. We consider both satellite-derived speciated PM2.5 from Washington University and ground-level monitor measurements from the U.S. Environmental Protection Agency, applied with different scaling methodologies. Relative to ground-monitor data, the unscaled InMAP model fails to meet a normalized mean bias performance goal of <±10% for most of the PM2.5 components it simulates (pSO4: -48%, pNO3: 8%, pNH4: 69%), but with city-specific SFs it achieves the goal benchmarks for every particulate species. Similarly, the normalized mean error performance goal of <35% is not met with the unscaled InMAP model (pSO4: 53%, pNO3: 52%, pNH4: 80%) but is met with the city-scaling approach (15%-27%). The city-specific scaling method also improves the R 2 value from 0.11 to 0.59 (ranging across particulate species) to the range of 0.36-0.76. Scaling increases the percent pollution contribution of electric generating units (EGUs) (nationwide 4%) and non-EGU point sources (nationwide 6%) and decreases the agriculture sector's contribution (nationwide -6%).

Disparities in ambient nitrogen dioxide pollution in the United States

Average ambient concentrations of nitrogen dioxide (NO2), an important air pollutant, have declined in the United States since the enactment of the Clean Air Act. Despite evidence that NO2 disproportionately affects racial/ethnic minority groups, it remains unclear what drives the exposure disparities and how they have changed over time. Here, we provide evidence by integrating high-resolution (1 km × 1 km) ground-level NO2 estimates, sociodemographic information, and source-specific emission intensity and location for 217,740 block groups across the contiguous United States from 2000 to 2016. We show that racial/ethnic minorities are disproportionately exposed to higher levels of NO2 pollution compared with Whites across the United States and within major metropolitan areas. These inequities persisted over time and have worsened in many cases, despite a significant decrease in the national average NO2 concentration over the 17-y study period. Overall, traffic contributes the largest fraction of NO2 disparity. Contributions of other emission sources to exposure disparities vary by location. Our analyses offer insights into policies aimed at reducing air pollution exposure disparities among races/ethnicities and locations.

Short- and long-term impacts of the COVID-19 epidemic on urban PM2.5 variations: Evidence from a megacity, Chengdu

As the new coronavirus pandemic enters its third year, its long-term impact on the urban environment cannot be ignored, especially in megacities with more than millions of people. Here, we analyzed the changes in the concentration levels, emission sources, temporal variations and holiday effects of ambient fine particulate matter (PM2.5) and its chemical components in the pre- and post-epidemic eras based on high-resolution, long time-series datasets of PM2.5 and its chemical components in Chengdu. In the post-epidemic era, the PM2.5 concentration in Chengdu decreased by 7.4%, with the components of PM2.5 decreasing to varying degrees. The positive matrix factorization (PMF) results indicated that the emissions from soil dust and industrial production were significantly lower during the COVID-19 lockdown period and post-epidemic era than those in the pre-epidemic era. In contrast, the contribution of secondary aerosols to PM2.5 during these two periods increased by 2.7% and 6.6%, respectively. Notably, we found that PM2.5 and its components substantially decreased on workdays and holidays in the post-epidemic era due to the reduced traffic volume and outdoor activities. This provides direct evidence that changes in the habitual behavior patterns of urban residents in the post-epidemic era could exert an evident positive impact on the urban environment. However, the higher PM2.5 concentration was observed due to the increased consumption of regular (As4S4, Xionghuang in Chinese) and "sulfur incense" during the Dragon Boat Festival holiday in the post-epidemic era. Finally, we examined the potential effects of sporadic COVID-19 outbreaks on the PM2.5 concentration in Chengdu, and there was no decrease in PM2.5 during two local COVID-19 outbreak events due to the strong influence of secondary pollution processes.

Wildfire-induced pollution and its short-term impact on COVID-19 cases and mortality in California

Globally, wildfires have seen remarkable increase in duration and size and have become a health hazard. In addition to vegetation and habitat destruction, rapid release of smoke, dust and gaseous pollutants in the atmosphere contributes to its short and long-term detrimental effects. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged as a public health concern worldwide that primarily target lungs and respiratory tract, akin to air pollutants. Studies from our lab and others have demonstrated association between air pollution and COVID-19 infection and mortality rates. However, current knowledge on the impact of wildfire-mediated sudden outburst of air pollutants on COVID-19 is limited. In this study, we examined the association of air pollutants and COVID-19 during wildfires burned during August-October 2020 in California, United States. We observed an increase in the tropospheric pollutants including aerosols (particulate matter [PM]), carbon monoxide (CO) and nitrogen dioxide (NO2) by approximately 150%, 100% and 20%, respectively, in 2020 compared to the 2019. Except ozone (O3), similar proportion of increment was noticed during the peak wildfire period (August 16 - September 15, 2020) in the ground PM2.5, CO, and NO2 levels at Fresno, Los Angeles, Sacramento, San Diego and San Francisco, cities with largest active wildfire area. We identified three different spikes in the concentrations of PM2.5, and CO for the cities examined clearly suggesting wildfire-induced surge in air pollution. Fresno and Sacramento showed increment in the ground PM2.5, CO and NO2 levels, while San Diego recorded highest change rate in NO2 levels. Interestingly, we observed a similar pattern of higher COVID-19 cases and mortalities in the cities with adverse air pollution caused by wildfires. These findings provide a logical rationale to strategize public health policies for future impact of COVID-19 on humans residing in geographic locations susceptible to sudden increase in local air pollution.

Environmental Health, Racial/Ethnic Health Disparity, and Climate Impacts of Inter-Regional Freight Transport in the United States

We quantify and compare three environmental impacts from inter-regional freight transportation in the contiguous United States: total mortality attributable to PM2.5 air pollution, racial-ethnic disparities in PM2.5-attributable mortality, and CO2 emissions. We compare all major freight modes (truck, rail, barge, aircraft) and routes (∼30,000 routes). Our study is the first to comprehensively compare each route separately and the first to explore racial-ethnic exposure disparities by route and mode, nationally. Impacts (health, health disparity, climate) per tonne of freight are the largest for aircraft. Among nonaircraft modes, per tonne, rail has the largest health and health-disparity impacts and the lowest climate impacts, whereas truck transport has the lowest health impacts and greatest climate impacts─an important reminder that health and climate impacts are often but not always aligned. For aircraft and truck, average monetized damages per tonne are larger for climate impacts than those for PM2.5 air pollution; for rail and barge, the reverse holds. We find that average exposures from inter-regional truck and rail are the highest for White non-Hispanic people, those from barge are the highest for Black people, and those from aircraft are the highest for people who are mixed/other race. Level of exposure and disparity among racial-ethnic groups vary in urban versus rural areas.

Geographic disparities in COVID-19 testing and outcomes in Florida

BACKGROUND

Understanding geographic disparities in Coronavirus Disease 2019 (COVID-19) testing and outcomes at the local level during the early stages of the pandemic can guide policies, inform allocation of control and prevention resources, and provide valuable baseline data to evaluate the effectiveness of interventions for mitigating health, economic and social impacts. Therefore, the objective of this study was to identify geographic disparities in COVID-19 testing, incidence, hospitalizations, and deaths during the first five months of the pandemic in Florida.  METHODS: Florida county-level COVID-19 data for the time period March-July 2020 were used to compute various COVID-19 metrics including testing rates, positivity rates, incidence risks, percent of hospitalized cases, hospitalization risks, case-fatality rates, and mortality risks. High or low risk clusters were identified using either Kulldorff's circular spatial scan statistics or Tango's flexible spatial scan statistics and their locations were visually displayed using QGIS.

RESULTS

Visual examination of spatial patterns showed high estimates of all COVID-19 metrics for Southern Florida. Similar to the spatial patterns, high-risk clusters for testing and positivity rates and all COVID-19 outcomes (i.e. hospitalizations and deaths) were concentrated in Southern Florida. The distributions of these metrics in the other parts of Florida were more heterogeneous. For instance, testing rates for parts of Northwest Florida were well below the state median (11,697 tests/100,000 persons) but they were above the state median for North Central Florida. The incidence risks for Northwest Florida were equal to or above the state median incidence risk (878 cases/100,000 persons), but the converse was true for parts of North Central Florida. Consequently, a cluster of high testing rates was identified in North Central Florida, while a cluster of low testing rate and 1-3 clusters of high incidence risks, percent of hospitalized cases, hospitalization risks, and case fatality rates were identified in Northwest Florida. Central Florida had low-rate clusters of testing and positivity rates but it had a high-risk cluster of percent of hospitalized cases.

CONCLUSIONS

Substantial disparities in the spatial distribution of COVID-19 outcomes and testing and positivity rates exist in Florida, with Southern Florida counties generally having higher testing and positivity rates and more severe outcomes (i.e. hospitalizations and deaths) compared to Northern Florida. These findings provide valuable baseline data that is useful for assessing the effectiveness of preventive interventions, such as vaccinations, in various geographic locations in the state. Future studies will need to assess changes in spatial patterns over time at lower geographical scales and determinants of any identified patterns.

Fifteen Years of Community Exposure to Heavy-Duty Emissions: Capturing Disparities over Space and Time

Disparities in exposure to traffic-related air pollution have been widely reported. However, little work has been done to simultaneously assess the impact of various vehicle types on populations of different socioeconomic/ethnic backgrounds. In this study, we employed an extreme gradient-boosting approach to spatially distribute light-duty vehicle (LDV) and heavy-duty truck emissions across the city of Toronto from 2006 to 2020. We examined associations between these emissions and different marginalization indices across this time span. Despite a large decrease in traffic emissions, disparities in exposure to traffic-related air pollution persisted over time. Populations with high residential instability, high ethnic concentration, and high material deprivation were found to reside in regions with significantly higher truck and LDV emissions. In fact, the gap in exposure to traffic emissions between the most residentially unstable populations and the least residentially unstable populations worsened over time, with trucks being the larger contributor to these disparities. Our data also indicate that the number of trucks and truck emissions increased substantially between 2019 and 2020 whilst LDVs decreased. Our results suggest that improvements in vehicle emission technologies are not sufficient to tackle disparities in exposure to traffic-related air pollution.

Daily Satellite Observations of Nitrogen Dioxide Air Pollution Inequality in New York City, New York and Newark, New Jersey: Evaluation and Application

Urban air pollution disproportionately harms communities of color and low-income communities in the U.S. Intraurban nitrogen dioxide (NO₂) inequalities can be observed from space using the TROPOspheric Monitoring Instrument (TROPOMI). Past research has relied on time-averaged measurements, limiting our understanding of how neighborhood-level NO₂ inequalities co-vary with urban air quality and climate. Here, we use fine-scale (250 m × 250 m) airborne NO₂ remote sensing to demonstrate that daily TROPOMI observations resolve a major portion of census tract-scale NO₂ inequalities in the New York City-Newark urbanized area. Spatiotemporally coincident TROPOMI and airborne inequalities are well correlated (r = 0.82-0.97), with slopes of 0.82-1.05 for relative and 0.76-0.96 for absolute inequalities for different groups. We calculate daily TROPOMI NO₂ inequalities over May 2018-September 2021, reporting disparities of 25-38% with race, ethnicity, and/or household income. Mean daily inequalities agree with results based on TROPOMI measurements oversampled to 0.01° × 0.01° to within associated uncertainties. Individual and mean daily TROPOMI NO₂ inequalities are largely insensitive to pixel size, at least when pixels are smaller than ∼60 km², but are sensitive to low observational coverage. We statistically analyze daily NO₂ inequalities, presenting empirical evidence of the systematic overburdening of communities of color and low-income neighborhoods with polluting sources, regulatory ozone co-benefits, and worsened NO₂ inequalities and cumulative NO₂ and urban heat burdens with climate change.

Understanding Air Quality Changes after Implementation of Mitigation Measures during a Pandemic: A Scoping Review of Literature in the United States

Traffic-related emissions continue to be a significant source of air pollution in the United States (US) and around the globe. Evidence has shown that previous policies implemented to restrict-traffic flows have affected air pollution levels. Thus, mitigation strategies associated with the COVID-19 pandemic that modified population-level mobility patterns provide a unique opportunity to study air pollution change across the US. For instance, to slow the spread of the pandemic, state and local governments started implementing various mitigation actions, including stay-at-home directives, social distancing measures, school closures, and travel restrictions. This scoping review aimed to summarize the existing evidence about how air quality changed through mitigation practices throughout the pandemic in the US. We found 66 articles that fit our inclusion criteria. Generally, the consolidated results revealed that nitrogen dioxide (NO2) and carbon monoxide (CO) decreased across the country. Studies observed mixed directions and magnitudes of change for fine and coarse particulate matter (PM2.5, PM10), ozone (O3), and sulfur dioxide (SO2). Few articles tried to explain this notable heterogeneity in air quality changes by associating contextual factors, such as mobility, traffic flow, and demographic factors. However, all studies agreed that the change in air pollution was nonuniform across the US and even varied within a city.

National and Intraurban Air Pollution Exposure Disparity Estimates in the United States: Impact of Data-Aggregation Spatial Scale

Air pollution exposure disparities by race/ethnicity and socioeconomic status have been analyzed using data aggregated at various spatial scales. Our research question is this: To what extent does the spatial scale of data aggregation impact the estimated exposure disparities? We compared disparities calculated using data spatially aggregated at five administrative scales (state, county, census tract, census block group, census block) in the contiguous United States in 2010. Specifically, for each of the five spatial scales, we calculated national and intraurban disparities in exposure to fine particles (PM_2.5) and nitrogen dioxide (NO₂) by race/ethnicity and socioeconomic characteristics using census demographic data and an empirical statistical air pollution model aggregated at that scale. We found, for both pollutants, that national disparity estimates based on state and county scale data often substantially underestimated those estimated using tract and finer scales; in contrast, national disparity estimates were generally consistent using tract, block group, and block scale data. Similarly, intraurban disparity estimates based on tract and finer scale data were generally well correlated for both pollutants across urban areas, although in some cases intraurban disparity estimates were substantially different, with tract scale data more frequently leading to underestimates of disparities compared to finer scale analyses.

Mortensen L, Requia W, Lange T, Loft S, Kuenzli N, Schwartz J, Amini H. Stringency of COVID-19 Containment Response Policies and Air Quality Changes: A Global Analysis across 1851 Cities

The COVID-19 containment response policies (CRPs) had a major impact on air quality (AQ). These CRPs have been time-varying and location-specific. So far, despite having numerous studies on the effect of COVID-19 lockdown on AQ, a knowledge gap remains on the association between stringency of CRPs and AQ changes across the world, regions, nations, and cities. Here, we show that globally across 1851 cities (each more than 300 000 people) in 149 countries, after controlling for the impacts of relevant covariates (e.g., meteorology), Sentinel-5P satellite-observed nitrogen dioxide (NO₂) levels decreased by 4.9% (95% CI: 2.2, 7.6%) during lockdowns following stringent CRPs compared to pre-CRPs. The NO₂ levels did not change significantly during moderate CRPs and even increased during mild CRPs by 2.3% (95% CI: 0.7, 4.0%), which was 6.8% (95% CI: 2.0, 12.0%) across Europe and Central Asia, possibly due to population avoidance of public transportation in favor of private transportation. Among 1768 cities implementing stringent CRPs, we observed the most NO₂ reduction in more populated and polluted cities. Our results demonstrate that AQ improved when and where stringent COVID-19 CRPs were implemented, changed less under moderate CRPs, and even deteriorated under mild CRPs. These changes were location-, region-, and CRP-specific.

On the frontlines : An exploratory analysis of unequal exposure to air pollution and COVID-19 in the United States

Recent literature has suggested a link between poor air quality and worse COVID-19 outcomes. In the United States, this link is particularly noteworthy because of residential sorting along ethnic lines within the US population; minorities are disproportionately exposed to health hazards, including air pollution. The impacts of the COVID-19 pandemic have also been disproportionately concentrated amongst minorities. We explore the association between air quality and COVID-19 outcomes, using county level data for the United States from the first wave of the pandemic in 2020, and test whether exposure to more polluted air can account for some of the observed disparities in COVID-19 outcomes among minorities.

Long-term trends in urban NO2 concentrations and associated paediatric asthma incidence: estimates from global datasets

BACKGROUND

Combustion-related nitrogen dioxide (NO₂) air pollution is associated with paediatric asthma incidence. We aimed to estimate global surface NO₂ concentrations consistent with the Global Burden of Disease study for 1990-2019 at a 1 km resolution, and the concentrations and attributable paediatric asthma incidence trends in 13 189 cities from 2000 to 2019.

METHODS

We scaled an existing annual average NO₂ concentration dataset for 2010-12 from a land use regression model (based on 5220 NO₂ monitors in 58 countries and land use variables) to other years using NO₂ column densities from satellite and reanalysis datasets. We applied these concentrations in an epidemiologically derived concentration-response function with population and baseline asthma rates to estimate NO₂-attributable paediatric asthma incidence.

FINDINGS

We estimated that 1·85 million (95% uncertainty interval [UI] 0·93-2·80 million) new paediatric asthma cases were attributable to NO₂ globally in 2019, two thirds of which occurred in urban areas (1·22 million cases; 95% UI 0·60-1·8 million). The proportion of paediatric asthma incidence that is attributable to NO₂ in urban areas declined from 19·8% (1·22 million attributable cases of 6·14 million total cases) in 2000 to 16·0% (1·24 million attributable cases of 7·73 million total cases) in 2019. Urban attributable fractions dropped in high-income countries (-41%), Latin America and the Caribbean (-16%), central Europe, eastern Europe, and central Asia (-13%), and southeast Asia, east Asia, and Oceania (-6%), and rose in south Asia (+23%), sub-Saharan Africa (+11%), and north Africa and the Middle East (+5%). The contribution of NO₂ concentrations, paediatric population size, and asthma incidence rates to the change in NO₂-attributable paediatric asthma incidence differed regionally.

INTERPRETATION

Despite improvements in some regions, combustion-related NO₂ pollution continues to be an important contributor to paediatric asthma incidence globally, particularly in cities. Mitigating air pollution should be a crucial element of public health strategies for children.

FUNDING

Health Effects Institute, NASA.

Global fine-scale changes in ambient NO2 during COVID-19 lockdowns

Nitrogen dioxide (NO2) is an important contributor to air pollution and can adversely affect human health1-9. A decrease in NO2 concentrations has been reported as a result of lockdown measures to reduce the spread of COVID-1910-20. Questions remain, however, regarding the relationship of satellite-derived atmospheric column NO2 data with health-relevant ambient ground-level concentrations, and the representativeness of limited ground-based monitoring data for global assessment. Here we derive spatially resolved, global ground-level NO2 concentrations from NO2 column densities observed by the TROPOMI satellite instrument at sufficiently fine resolution (approximately one kilometre) to allow assessment of individual cities during COVID-19 lockdowns in 2020 compared to 2019. We apply these estimates to quantify NO2 changes in more than 200 cities, including 65 cities without available ground monitoring, largely in lower-income regions. Mean country-level population-weighted NO2 concentrations are 29% ± 3% lower in countries with strict lockdown conditions than in those without. Relative to long-term trends, NO2 decreases during COVID-19 lockdowns exceed recent Ozone Monitoring Instrument (OMI)-derived year-to-year decreases from emission controls, comparable to 15 ± 4 years of reductions globally. Our case studies indicate that the sensitivity of NO2 to lockdowns varies by country and emissions sector, demonstrating the critical need for spatially resolved observational information provided by these satellite-derived surface concentration estimates.

Climate Solutions Double as Health Interventions

The climate crisis threatens to exacerbate numerous climate-sensitive health risks, including heatwave mortality, malnutrition from reduced crop yields, water- and vector-borne infectious diseases, and respiratory illness from smog, ozone, allergenic pollen, and wildfires. Recent reports from the Intergovernmental Panel on Climate Change stress the urgent need for action to mitigate climate change, underscoring the need for more scientific assessment of the benefits of climate action for health and wellbeing. Project Drawdown has analyzed more than 80 solutions to address climate change, building on existing technologies and practices, that could be scaled to collectively limit warming to between 1.5° and 2 °C above preindustrial levels. The solutions span nine major sectors and are aggregated into three groups: reducing the sources of emissions, maintaining and enhancing carbon sinks, and addressing social inequities. Here we present an overview of how climate solutions in these three areas can benefit human health through improved air quality, increased physical activity, healthier diets, reduced risk of infectious disease, and improved sexual and reproductive health, and universal education. We find that the health benefits of a low-carbon society are more substantial and more numerous than previously realized and should be central to policies addressing climate change. Much of the existing literature focuses on health effects in high-income countries, however, and more research is needed on health and equity implications of climate solutions, especially in the Global South. We conclude that adding the myriad health benefits across multiple climate change solutions can likely add impetus to move climate policies faster and further.