Spatial disequilibrium of fine particulate matter and corresponding health burden in China.

Some literature has documented ambient fine particulate matter (PM 2.5) pollution and corresponding health burden in China, however, the knowledge of spatial disequilibrium of PM 2.5 and PM 2.5 -induced disease burden is scarce. With the help of gravity center model, spatial autocorrelation analysis as well as the region-specific exposure-response coefficient and ground-based PM 2.5 daily concentrations over 336 cities in China from January 2016 to December 2017, this paper provides a completive assessment for spatial disequilibrium of PM 2.5 -induced health burden. Improving PM 2.5 concentrations and declining PM 2.5 -induced health burden were found in China. The 2-year city-average concentration of the 336 cities was 45 ± 17μg/m3 with a range from 11μg/m3 to 128μg/m3. PM 2.5 -related deaths from stroke, ischemic heart disease, chronic obstructive pulmonary disease, hypertensive heart disease and lower respiratory infection amounted to 0.766 million in 2016 and 0.720 million in 2017. Much higher but decreasing PM 2.5 -induced mortality happened in the west, while higher and increasing PM 2.5 -induced deaths existed in the south. Strong spatial autocorrelation of PM 2.5 and PM 2.5 -induced disease burden existed among cities, illustrated by high-high (HH) clusters with significant spatial homogeneity and spatial spillover effect. The cities included in PM 2.5 concentration HH cluster had average PM 2.5 concentration 68.5 μg/m3, about 1.5 times higher than the national average; the cities involved in combined mortality HH cluster had mortality 90.5/105, 1.8 times as much as the national city-average level; about 46.4% of PM 2.5 -induced combined deaths happened in HH cluster cities. The cities embraced in the HH clusters of PM 2.5 concentration, population, deaths and mortality simultaneously, mostly located in Hebei, Shandong and Henan provinces, should be the top priorities for joint air pollution control. This paper provides important implications for policymakers regarding priority areas of joint air pollution control in China. Image 1 • PM 2.5 pollution contributed to around 0.74 million premature deaths per year. • Improving PM 2.5 levels and declining PM 2.5 -induced health burden were found. • Strong spatial disequilibrium and autocorrelation existed. • Much higher but decreasing PM 2.5 -induced mortality happened in west. • Cities overlapped in HH clusters should be the top priorities for joint control. [ABSTRACT FROM AUTHOR]