Valuing the mortality burden of climate extremes and air pollution in Asia

Climate change is increasingly intensifying health risks through prolonged heat and cold spells, deteriorating air quality, and rising vulnerability among exposed populations. This study quantifies the economic burden of climate-driven mortality risks across 38 Asian countries during 1990–2023 by combining Years of Life Lost (YLL) with an income-adjusted Value of a Statistical Life (VSL) approach. The analysis examines the effects of warm spell duration index (WSDI), cold spell duration index (CSDI), PM2.5 exposure, urbanization, health expenditure, and population aging on mortality-related losses. Method of Moments Quantile Regression (MM-QR) is employed to capture distributional heterogeneity, while a two-way fixed-effect model with Driscoll-Kraay standard errors is used as a robustness check. The findings show that both warm and cold temperature extremes significantly increase YLL, with stronger effects at higher quantiles, indicating that countries with greater mortality burdens face disproportionately larger climate-related health losses. PM2.5 exposure and population aging further raise mortality costs, whereas urbanization and higher health expenditure are associated with lower YLL, suggesting the protective role of healthcare access and adaptive capacity. Country-level estimates also reveal substantial variation in economic costs across Asia. The study highlights the need for heat- and cold-health action plans, air-quality improvements, decarbonization, and stronger health-system financing to reduce climate-sensitive mortality.