Review

. 2021 Jan;6(1):e64-e81.

doi: 10.1016/S2468-2667(20)30256-5. Epub 2020 Dec 2.

The 2020 China report of the Lancet Countdown on health and climate change

Wenjia Cai¹, Chi Zhang², Hoi Ping Suen¹, Siqi Ai³, Yuqi Bai¹, Junzhe Bao⁴, Bin Chen⁵, Liangliang Cheng³, Xueqin Cui¹, Hancheng Dai⁶, Qian Di⁷, Wenxuan Dong⁸, Dejing Dou⁹, Weicheng Fan⁸, Xing Fan¹⁰, Tong Gao¹¹, Yang Geng¹², Dabo Guan¹³, Yafei Guo¹⁴, Yixin Hu¹⁵, Junyi Hua¹⁶, Cunrui Huang¹⁷, Hong Huang⁸, Jianbin Huang¹, Tingting Jiang¹, Kedi Jiao¹⁸, Gregor Kiesewetter¹⁹, Zbigniew Klimont¹⁹, Pete Lampard²⁰, Chuanxi Li¹⁸, Qiwei Li²¹, Ruiqi Li⁸, Tiantian Li²², Borong Lin¹², Hualiang Lin³, Huan Liu²¹, Qiyong Liu²³, Xiaobo Liu²³, Yufu Liu¹, Zhao Liu¹, Zhidong Liu¹⁸, Zhu Liu¹, Shuhan Lou¹, Chenxi Lu¹, Yong Luo¹, Wei Ma²⁴, Alice McGushin²⁵, Yanlin Niu²³, Chao Ren¹⁶, Zhehao Ren¹, Zengliang Ruan³, Wolfgang Schöpp¹⁹, Jing Su²⁶, Ying Tu¹, Jie Wang²⁷, Qiong Wang³, Yaqi Wang²⁸, Yu Wang¹, Nick Watts²⁵, Congxi Xiao²⁹, Yang Xie³⁰, Hui Xiong³¹, Mingfang Xu²³, Bing Xu¹, Lei Xu³², Jun Yang³³, Lianping Yang³, Le Yu¹, Yujuan Yue²³, Shaohui Zhang³⁴, Zhongchen Zhang¹², Jiyao Zhao¹, Liang Zhao³⁵, Mengzhen Zhao¹, Zhe Zhao¹⁸, Jingbo Zhou⁹, Peng Gong³⁶

Affiliations

¹ Department of Earth System Science, Tsinghua University, Beijing, China.
² Institute of Population Research, Peking University, Beijing, China.
³ School of Public Health, Sun Yat-sen University, Guangzhou, China.
⁴ College of Public Health, Zhengzhou University, Zhengzhou, China.
⁵ School of Environment, Beijing Normal University, Beijing, China.
⁶ College of Environmental Sciences and Engineering, Peking University, Beijing, China.
⁷ Vanke School of Public Health, Tsinghua University, Beijing, China.
⁸ Institute of Public Safety Research, Tsinghua University, Beijing, China; Department of Engineering Physics, Tsinghua University, Beijing, China.
⁹ Baidu Research, Baidu, Beijing, China.
¹⁰ Institute of Environment and Ecology, Shandong Normal University, Jinan, China.
¹¹ School of Business, Shandong Normal University, Jinan, China.
¹² School of Architecture, Tsinghua University, Beijing, China.
¹³ Department of Earth System Science, Tsinghua University, Beijing, China; The Bartlett School of Construction and Project Management, Institute for Global Health, University College London, London, UK.
¹⁴ State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; Chinese Center for Disease Control and Prevention Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
¹⁵ Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen, China.
¹⁶ Faculty of Architecture, The University of Hong Kong, Hong Kong Special Administrative Region, China.
¹⁷ School of Public Health, Sun Yat-sen University, Guangzhou, China; College of Public Health, Zhengzhou University, Zhengzhou, China.
¹⁸ Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
¹⁹ Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria.
²⁰ Department of Health Sciences, University of York, York, UK.
²¹ State Key Joint Laboratory of Environmental Simulation and Pollution Control, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environment, Tsinghua University, Beijing, China.
²² Chinese Center for Disease Control and Prevention Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
²³ State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
²⁴ Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Shandong University Climate Change and Health Center, Shandong University, Jinan, China.
²⁵ Institute for Global Health, University College London, London, UK.
²⁶ School of Humanities, Tsinghua University, Beijing, China.
²⁷ State Key Laboratory of Remote Sensing Science, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, China.
²⁸ People's Bank of China School of Finance, Tsinghua University, Beijing, China; Research Center for Public Health, Tsinghua University, Beijing, China.
²⁹ School of Computer Science and Technology, University of Science and Technology of China, Hefei, China.
³⁰ School of Economics and Management, Beihang University, Beijing, China.
³¹ Rutgers Business School, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA.
³² Department of Earth System Science, Tsinghua University, Beijing, China; State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
³³ Institute for Environmental and Climate Research, Jinan University, Guangzhou, China.
³⁴ School of Economics and Management, Beihang University, Beijing, China; Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria.
³⁵ The State Key Laboratory of Numerical Modeling for Atmospheric Sciences and Geophysical Fluid Dynamics, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China.
³⁶ Department of Earth System Science, Tsinghua University, Beijing, China. Electronic address: penggong@mail.tsinghua.edu.cn.

PMID: 33278345
PMCID: PMC7966675
DOI: 10.1016/S2468-2667(20)30256-5

Review

The 2020 China report of the Lancet Countdown on health and climate change

Wenjia Cai et al. Lancet Public Health. 2021 Jan.

. 2021 Jan;6(1):e64-e81.

doi: 10.1016/S2468-2667(20)30256-5. Epub 2020 Dec 2.

Authors

Affiliations

¹ Department of Earth System Science, Tsinghua University, Beijing, China.
² Institute of Population Research, Peking University, Beijing, China.
³ School of Public Health, Sun Yat-sen University, Guangzhou, China.
⁴ College of Public Health, Zhengzhou University, Zhengzhou, China.
⁵ School of Environment, Beijing Normal University, Beijing, China.
⁶ College of Environmental Sciences and Engineering, Peking University, Beijing, China.
⁷ Vanke School of Public Health, Tsinghua University, Beijing, China.
⁸ Institute of Public Safety Research, Tsinghua University, Beijing, China; Department of Engineering Physics, Tsinghua University, Beijing, China.
⁹ Baidu Research, Baidu, Beijing, China.
¹⁰ Institute of Environment and Ecology, Shandong Normal University, Jinan, China.
¹¹ School of Business, Shandong Normal University, Jinan, China.
¹² School of Architecture, Tsinghua University, Beijing, China.
¹³ Department of Earth System Science, Tsinghua University, Beijing, China; The Bartlett School of Construction and Project Management, Institute for Global Health, University College London, London, UK.
¹⁴ State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; Chinese Center for Disease Control and Prevention Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
¹⁵ Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen, China.
¹⁶ Faculty of Architecture, The University of Hong Kong, Hong Kong Special Administrative Region, China.
¹⁷ School of Public Health, Sun Yat-sen University, Guangzhou, China; College of Public Health, Zhengzhou University, Zhengzhou, China.
¹⁸ Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
¹⁹ Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria.
²⁰ Department of Health Sciences, University of York, York, UK.
²¹ State Key Joint Laboratory of Environmental Simulation and Pollution Control, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environment, Tsinghua University, Beijing, China.
²² Chinese Center for Disease Control and Prevention Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
²³ State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
²⁴ Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Shandong University Climate Change and Health Center, Shandong University, Jinan, China.
²⁵ Institute for Global Health, University College London, London, UK.
²⁶ School of Humanities, Tsinghua University, Beijing, China.
²⁷ State Key Laboratory of Remote Sensing Science, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, China.
²⁸ People's Bank of China School of Finance, Tsinghua University, Beijing, China; Research Center for Public Health, Tsinghua University, Beijing, China.
²⁹ School of Computer Science and Technology, University of Science and Technology of China, Hefei, China.
³⁰ School of Economics and Management, Beihang University, Beijing, China.
³¹ Rutgers Business School, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA.
³² Department of Earth System Science, Tsinghua University, Beijing, China; State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
³³ Institute for Environmental and Climate Research, Jinan University, Guangzhou, China.
³⁴ School of Economics and Management, Beihang University, Beijing, China; Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria.
³⁵ The State Key Laboratory of Numerical Modeling for Atmospheric Sciences and Geophysical Fluid Dynamics, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China.
³⁶ Department of Earth System Science, Tsinghua University, Beijing, China. Electronic address: penggong@mail.tsinghua.edu.cn.

PMID: 33278345
PMCID: PMC7966675
DOI: 10.1016/S2468-2667(20)30256-5

Erratum in

Correction to Lancet Public Health 2021; 6: e64-81.
[No authors listed] [No authors listed] Lancet Public Health. 2021 Feb;6(2):e87. doi: 10.1016/S2468-2667(21)00003-7. Epub 2021 Jan 8. Lancet Public Health. 2021. PMID: 33428863 Free PMC article. No abstract available.

No abstract available

PubMed Disclaimer

Figures

**Figure 1**
Change in the number of days of heatwave exposure for each person aged 65 years or older in China, relative to the 1986–2005 average. (A) Country-level trend. (B) Provincial-level results in 2019.

**Figure 2**
Heatwave-related mortality in China (A) Trend of heatwave-related mortality in 1990–2019. (B) Heatwave-related mortality in different provinces in 2019.

**Figure 3**
The key rising health risks from climate change in each province in China Each province in the map is coloured according to the number of indicators with a growth rate larger than 10% between 2000 and 2019. Each colour in the pie chart represents one of the indicators tracked. With each indicator weighted equally, the size of the slice is proportional to the size of the growth rate of each indicator.

**Figure 4**
Comprehensive index measuring health emergencies management ability in different provinces in China

**Figure 5**
Prevented fraction of heatwave-related mortality caused by household air-conditioning use and energy consumption of urban household air-conditioning in China

**Figure 6**
Premature deaths attributable to exposure to PM_2·5 in 2015 and 2018, by key sources of pollution in China PM_2·5=particulate matter with an aerodynamic diameter of 2·5 μm or less.

**Figure 7**
Air pollution emissions intensity of road transport in China from 2000 to 2018 for carbon monoxide, hydrocarbons, nitrogen oxide, and PM₁₀ PM₁₀=particulate matter with an aerodynamic diameter of 10 μm or less.

**Figure 8**
Monetised value of heat-related mortality, by region in China $2015=based on the value of the US$ in 2015.

**Figure 9**
Economic costs of heat-related labour productivity loss. (A) National-level results, by year and industry, in $US billions of $2015. (B) Provincial-level results in 2015, relative to GDP. $2015=based on the value of the US$ in 2015. GDP=gross domestic product.

**Figure 10**
Economic costs of premature deaths from ambient PM_2·5 pollution. (A) National-level result, by year and industry, in $US billions of $2015. (B) Provincial-level result in 2015, relative to GDP. $2015=based on the value of the US$ in 2015. GDP=gross domestic product. PM_2·5=particulate matter with an aerodynamic diameter of 2·5 μm or less.

**Figure 11**
Annual coverage of climate change and health and climate change on Weibo between 2010 and 2019

**Figure 12**
An overview of indicator trends For each indicator, an index is created, ranging from 0 to 1, with the colour in each block representing its score. Darker colours indicate a more concerning effect, and a more ambitious response. For example, index score 1 represents the worst case in the past 20 years for impact factors and the best possible case for response factors.

See this image and copyright information in PMC

Comment in

Climate and COVID-19: converging crises.
The Lancet. The Lancet. Lancet. 2021 Jan 9;397(10269):71. doi: 10.1016/S0140-6736(20)32579-4. Epub 2020 Dec 2. Lancet. 2021. PMID: 33278352 No abstract available.

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References

1. Watts N, Adger WN, Agnolucci P. Health and climate change: policy responses to protect public health. Lancet. 2015;386:1861–1914. - PubMed
1. Watts N, Amann M, Arnell N. The 2019 report of the Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate. Lancet. 2019;394:1836–1878. - PMC - PubMed
1. Promotion Committee for Healthy China Program Healthy China Program (2019–2030) July 15, 2019. http://www.gov.cn/xinwen/2019-07/15/content_5409694.htm
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1. The Intergovernmental Panel on Climate Change Global warming of 1·5°C. An IPCC Special Report on the impacts of global warming of 1·5°C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change. 2019. https://www.ipcc.ch/site/assets/uploads/sites/2/2019/06/SR15_Full_Report...

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The 2020 China report of the Lancet Countdown on health and climate change

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The 2020 China report of the Lancet Countdown on health and climate change

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