52% of the global decrease in air pollution mortality rates was driven by reductions in vulnerability, such as improved access to quality healthcare and poverty reduction, rather than just cleaner air (between 1990 and 2019)
Without these unintended “shields”, 1.7 million more people would have died globally from air pollution in 2019
A major new global modelling study led by researchers at Stockholm Environment Institute (SEI) at the University of York challenges the international focus on air pollution. Published in The Lancet Planetary Health , the study finds that reducing population vulnerability is as important as cutting emissions for saving lives.
The research reveals that while reducing exposure to pollutants is critical, measures such as universal access to quality healthcare and poverty reduction played a crucial, and often overlooked, role in saving lives over the last 30 years.
A population’s risk of harm from air pollution is shaped by a complex set of socioeconomic and health factors, including pre-existing medical conditions, smoking and the quality and accessibility of medical care. In some regions where air quality has not improved, air pollution mortality rates have still dropped exclusively because of reductions in these vulnerability factors.
“While cleaning our air remains a critical goal, our findings demonstrate that reducing emissions is only part of the solution,” said Chris Malley, lead author of the study from SEI at the University of York. “To improve public health, we must also focus on the factors that make people susceptible to harm. Integrating healthcare improvements and poverty reduction into air quality strategies is an essential tool for protecting the world's most vulnerable populations from the deadly effects of air pollution.”
Key findings:
Between 1990 and 2019, global air pollution mortality rates decreased by 45%. Approximately 52% of the decrease in global air pollution mortality rates was due to reductions in vulnerability, rather than just lower pollution levels.
Without the global actions that reduced people's vulnerability to air pollution, an estimated 1.7 million more people would have died from air pollution-related causes in 2019 alone.
Global poverty plummeted from 45% in 1990 to 21% in 2019, acting as a massive, unintended shield against the health burdens of smog.
Public health efforts such as reducing obesity, cutting smoking rates, and treating hypertension are rarely included in air pollution strategies, despite their significant impact on reducing mortality.
The study also highlights the benefits of combining reductions in air pollution exposure with efforts to strengthen resilience. Both Europe and North America saw similar declines in air pollution exposure between 1990 and 2019. However, reductions in air pollution-related mortality were almost twice as large in Europe, reflecting greater progress in reducing vulnerability through health and social improvements.
The study concludes that air quality strategies must evolve to include interventions that reduce non-air-pollution health determinants to complement traditional exposure reduction efforts.
Notes to editors
About the study
“Estimating the vulnerability contribution to 1990–2019 changes in the health burden of ambient air pollution: a global modelling study” was published in The Lancet Planetary Health. It can be read here .
About Stockholm Environment Institute (SEI)
Stockholm Environment Institute is an international non-profit research institute that tackles climate, environment and sustainable development challenges. We empower partners to meet these challenges through cutting-edge research, knowledge, tools and capacity building. Through SEI’s HQ and seven centres around the world, we engage with policy, practice and development action for a sustainable, prosperous future for all.
About the University of York
A member of the prestigious Russell Group, the University of York is a dynamic, research-intensive university committed to institutional excellence and social purpose.
Media contact
Toto Reissland Lichman, Engagement and Research Communications Manager, Stockholm Environment Institute York, toto.reissland@sei.org , +44 (0)7976 098139
The Lancet Planetary Health
Not applicable
Estimating the vulnerability contribution to 1990–2019 changes in the health burden of ambient air pollution: a global modelling study
25-Mar-2026