Health Benefits for Middle-Aged and Older Adults Attributed to the Reduction of Air Pollution Rather Than Climate Factors Under China’s Clean Air Act

Environmental policies are associated with a reduction in air pollution and climate risks, yet their benefits to public health remain unclear. This study detects changes in air pollution, climate, and health outcomes after implementing the Clean Air Act (CAA) in China in the period from 2000 to 2020, using data from the China Health and Retirement Longitudinal Study (2011–2020) linked with remotely sensed PM2.5 and O3 concentration datasets, temperature records, and CO2 emissions among 22,561 adults aged 45 years and over. The difference-in-difference (DID) approach was used to identify the effects of the CAA on health outcomes, and the growth curve modeling (GCM) was used to examine the longitudinal relationship between air pollution, climate change, and health outcomes. The results show that while climate conditions were partially linked to poorer health status, health advantages of the CAA were mostly attributable to PM2.5 reduction rather than climate mitigation. Further analyses, interacting air pollution with extreme temperatures, indicate that air pollution would exacerbate detrimental health effects of climate change. This study highlights the importance of public health initiatives and recommends that air pollution and climate change be prioritized jointly in environmental strategies.