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Women from Majhora Village, in the Mahottari District of Nepal, make themselves warm during the evening. There was not any sun for one week in the village due to the winter fog. During the winter fog people burn agriculture byproducts more and more to keep them warm. The more they burn the more black carbon is produced, prolonging the fog and increasing its impact on the people of the Terai region during the winter season.
Journal article

Estimating the vulnerability contribution to 1990–2019 changes in the health burden of ambient air pollution: a global modelling study

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Journal article

Estimating the vulnerability contribution to 1990–2019 changes in the health burden of ambient air pollution: a global modelling study

Reducing PM2.5 exposure is important for addressing the health effects of air pollution. However, population vulnerability varies with health conditions, access to healthcare, and other factors. This study examines how changes in PM2.5 vulnerability influenced PM2.5 linked deaths from 1990 to 2019 across 193 countries.

Chris Malley, Drew T Shindell / Published on 25 March 2026

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Citation

Malley, C., & Shindell, D. T. (2026). Estimating the vulnerability contribution to 1990–2019 changes in the health burden of ambient air pollution: a global modelling study. The Lancet Planetary Health, 10(3), 101442. https://doi.org/10.1016/j.lanplh.2026.101442

Long-term exposure to PM2.5 in the air raises the risk of early death from several diseases, so most air quality efforts aim to lower pollution. But this study shows that the same exposure level can affect people differently, depending on a population’s overall health and social conditions.

The study looks at how changes in vulnerability have affected worldwide trends in deaths related to PM2.5 from 1990 to 2019. In this context, vulnerability means the part of death rates that comes from things other than just PM2.5 exposure. These include people’s health, income, access to good healthcare, smoking, and other factors that affect health. The authors measured how much changes in vulnerability influenced death rates after accounting for changes in PM2.5 exposure.

The authors studied data from 193 countries, using death rates from the Global Burden of Disease Study 2021, population data from the United Nations, and PM2.5levels from the State of Global Air. They used a model to estimate how deaths linked to PM2.5 would have changed if only exposure levels had changed. By comparing these estimates with real trends, they could see how much changes in vulnerability affected total deaths.
The results show that lowering health risks from air pollution requires a broader approach.

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.

Chris Malley, SEI researcher and lead author of the study

Reducing PM2.5 exposure remains important, but improving overall health can also make people less vulnerable to pollution.

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Open access

SEI authors

Chris Malley

Senior Research Fellow

SEI York

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The Lancet Planetary Health Open access
Topics and subtopics
Air : Pollution
Related centres
SEI York
Regions
Africa, Europe, Asia, Americas