Over 3 million people still die every year from diseases caused by exposure to outdoor PM<
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air pollution, and more than a quarter of these premature deaths occur in China. In addition to clean air policies that target pollution emissions, climate policies aimed at reducing fossil-fuel CO<
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emissions (e.g., to avoid 1.5�C of warming) may also dramatically improve air quality and public health. Yet there has been no comprehensive accounting of public health outcomes under different energy pathways and local clean air management decisions in China. In particular, further research is needed to understand the relationships among climate and clean air polices and future health burdens in China, where an aging population will further exacerbate the impacts of air pollution. Using a China-focused integrated assessment model (GCAM-China) and a dynamic emission projection model (DPEC), we project future Chinese air quality in scenarios spanning a range of global climate targets (i.e. 1.5�0C, 2�C, NDC, unambitious, baseline, and 4.5�C) as well as national clean air actions (i.e. 2015-pollution, current-pollution, and ambitious-pollution). We then evaluate the health impacts of PM2�5 air pollution of scenario matrix using the chemical transport model WRF-CMAQ and the latest epidemiological concentration?response (C-R) functions (i.e. GBD2019). We find that, without ambitious climate mitigation (e.g., under current NDC pledges), Chinese deaths related the PM2.5 air pollution do not substantially decrease?and often grow?by mid-century, regardless of clean air policies and air quality improvements. For example, in scenarios that track China?s current NDC pledge and deploy best-available pollution control technologies, PM<
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-related deaths in China decrease slightly by 2030 (to 1.2 million per year) but no further by mid-century (Ambitious-pollution-NDC-goals
1.2 million deaths in 2050) despite substantial and continuous improvements in population-weighted air quality (27.2 to 16.0 �g/m<
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from 2030 to 2050). The contrary trends of improving air quality and increasing PM<
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-related deaths in many of our scenarios reveals the extent to which extra efforts are needed to compensate for the established fact of increasing age of China?s population in future. Substantial decreases in China?s PM<
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-related deaths and age-standardized death rates (e.g., decreasing by 0.3?0.5 million deaths and 10.2?14.2 per 100,000 population age-standardized death rates per year) thus require the sort of large-scale transition in energy sources entailed by scenarios that meet international climate goals to avoid 1.5�C and 2�C of warming (Ambitious-pollution-2�C- and 1.5�C-goals).