Report of the
Lancet Countdown
The latest report from the Lancet Countdown Asia tracks progress on health and climate change in China.
The data attributes the health risks of climate change to human activities and provides examples of feasible and effective climate solutions.
The sixth iteration of the China report, it monitors progress across 33 indicators in five domains. This report was compiled with the contribution of 80 experts from 26 institutions both within and outside of China.
Key Messages
Record–high indicators signal red alerts for climate-related health risks
In 2024, climate-related health risks in China intensified, with 8 of the 13 tracked risks reaching record highs. This included labour capacity loss, reduced physical activity, sleep disruption, rising health threats linked to drought, extreme rainfall, and climate-sensitive diseases.
Despite progress, mitigation must accelerate to meet China’s climate goals.
Despite the urgent need for mitigation, China’s total CO₂ emissions increased by 0.5% in 2024, highlighting the crucial challenge of reversing this trend for China to meet its dual carbon goals and support the global 1.5°C target. Avoiding a high-carbon lock-in from continued coal expansion requires a decisive shift in investment and urgent structural reforms.
Making comprehensive progress and leveraging the power of cities
We present five policy recommendations for city-level adaptation and mitigation, including: prioritizing city-specific, evidence-based action; expanding research and standardizing cost–benefit analysis (CBA); avoiding fossil fuel lock-in and transition risks; implementing integrated, people–centered early warning systems; fostering inter-city cooperation and regional coordination.
Explore key findings of this year’s report
The 2025 China report of the Lancet Countdown on health and climate change: empowering cities for synergistic action
HEALTH HAZARDS, EXPOSURES, AND IMPACTS
A changing climate has profound implications for human health, with more frequent heat waves and extreme weather events, changing patterns of infectious disease transmission, deterioration of food and water resources, impacts on socioeconomic conditions, and the exacerbation of existing health challenges around the world. Indicators in this section track the multiple ways in which climate change threatens human health and wellbeing.
1.1.1 Heatwave Related Mortality
In 2024, more than 20,100 deaths in China were related to heatwave exposure, 1.7 times higher than the annual mean in the baseline period, 1986-2005.
1.2.1 Wildfires
Although wildfire exposure in 2024 was lower than in 2023, the annual average wildfire exposure in person-days still increased by 61.8% in 2020-2024 compared to the baseline period (2001–2005).
1.3 Climate sensitive infectious diseases
From 2004-2023, dengue vector transmission capacity increased across 204 of 375 cities (54.5%), with the greatest increases in Southern China.
ADAPTATION, PLANNING, AND RESILIENCE FOR HEALTH
With climate change increasingly threatening the health and wellbeing of populations in every country, actions to build resilience and adapt to climate change are urgently needed. This section tracks how communities, health systems, and governments are understanding the health risks of climate change, the strategies and resources they are deploying, and how adaptation and resilience measures are being implemented globally.
2.1 Adaptation planning and assessment
19 of 30 responding provinces (63.3%) implemented health adaptation measures in 2024, up from just 5 (16.1%) in 2023.
2.2.3 Urban green space
In 2024, the median NDVI was 0.381 (up 6.36% from 2023) with 68% of cities, especially in the north and west, seeing greenness growth.
2.3 Climate information services for health
Compared to 2023, 15 provinces and institutions newly launched health-meteorological services, with notable increases in the Public Meteorological Service Center of the China Meteorological Administration, Guizhou, Jiangxi, Shandong, and Chongqing.
MITIGATION ACTIONS AND HEALTH CO-BENEFITS
Reducing greenhouse gas emissions is essential to limit the health threats of climate change. Simultaneously, many of the interventions required to mitigate and adapt bring enormous benefits for human health and wellbeing in the form of cleaner air, healthier diets, and more liveable cities. Tackling climate change could be the greatest global health opportunity of the 21st century. Indicators in this section track the world’s efforts to mitigate climate change, and the effective and the health benefits of this response.
3.1: Energy system and health
In 2024, China’s carbon intensity continued its downward trend, decreasing by approximately 5.3% from 2023. Meanwhile, carbon emissions increased by 0.5%.
3.2: Clean household energy
The proportion of coal use decreased by 68.7%, with an absolute reduction of 42.6%, yet it still accounted for 7.8% of total household energy consumption in 2022. Meanwhile, the proportion of electricity use increased by 40.7%, with an absolute increase of 157.7%, reaching 24.3% of the total energy consumption in 2022.
3.3: Air pollution, transport, and energy
The number of cities with PM2.5 levels lower than the WHO’s Interim Target 1 (35 µg/m³) increased from 219 in 2015 to 233 in 2024, highlighting that more urban areas are now meeting air quality targets.
ECONOMICS AND FINANCE
The health impacts of climate change have profound economic implications. This section tracks the economic costs of the health impacts of climate change and its drivers, as well as the extent to which the world’s economy and financial systems are enabling the transition to a health-promoting, zero-carbon economy.
4.1.1 Economic costs of heatwave-related mortality
In 2024, the national economic costs of heatwave-related mortality among working-age individuals reached US$42.7 million, representing a 1.27-times increase from 2023.
4.1.2 Economic costs of heat-related labour productivity loss
In 2024, the national economic costs of heat-related labour productivity loss amounted to $282.6 billion, equivalent to 1.77% of China’s GDP, marking a 23% increase from 2023 ($229.8 billion, 1.45% of GDP).
4.2.1 Investment in new coal and low-carbon energy and energy efficiency
Despite a 52.4% increase in investment in new thermal power generation(from $14.2 billion in 2023 to $21.6 billion in 2024), there was a 12.1% decline in new thermal power generation capacity (from 65.7 GW in 2023 to 57.7 GW in 2024).
4.2.4 Production-based and Consumption-based attribution of CO2 and PM2.5 emissions
In 2017, 24.3% of all of China’s CO2 emissions were attributed to the net trade of goods and services between China’s provinces, and 15.0% were from the net production of goods and services in China exported to other countries.
PUBLIC AND POLITICAL ENGAGEMENT
Public and political engagement underpins the foundations of the world’s collective response to climate change, with reductions in global emissions at the speed required by the Paris Agreement depending on engagement from all sectors of society. This working group tracks key actors’ engagement with the links between health and climate change, including in the media, national governments, the corporate sector, and the broader public. The indicators in this section track the links between health and climate change in the media, national governments, the corporate sector, and the broader public.
5.1.1 Coverage of health and climate change on social media
From 2010 to 2024, climate change-related posts rose from 99 to 2,108 annually, while the share of health-related content peaked at 17% (583 from 1,884) in 2020 but dropped to 4% (84 from 2,108) in 2024.
5.3 Coverage of health and climate change in scientific journals
The number of articles published in both English and Chinese experienced a decline in 2024 compared to 2023, decreasing from 613 and 337 respectively in the previous year to 444 and 290.
5.4 Government engagement in health and climate change
In 2024, 2443 articles were related to climate change and 464 (19·0%) related to a topic on climate and health.The number of articles related to climate change increased by 10.3% compared with 2023.
Pro. Cunrui Huang, the Working Group 1 Lead of the 2025 Lancet Countdown China Report
“Through robust policy leadership, solid scientific evidence, and extensive public engagement, China is translating climate actions into tangible health benefits for its people, paving the way for a more resilient and dynamic development path for future generations.”
Dr. Shaohui Zhang, the Working Group 3 Lead of the 2025 Lancet Countdown China Report
“China, as the world’s largest CO₂ emitter and a rising leader in this field, has the potential to change trajectories. The nation demonstrated significant progress by implement sector-specific strategies policies. Despite this continued decline in carbon intensity and the resulting considerable health benefits achieved by reducing air pollution, it remains imperative to adopt more proactive emission reduction measures to further mitigate the health impacts of future climate change.”
Dr. Yixin Hu, the Working Group 4 Lead of the 2025 Lancet Countdown China Report
“China’s experience shows that the economic and health costs of climate change are already substantial, yet so too are the benefits of decisive climate action. By integrating health and economic evidence into policy design, China can transform the challenge of decarbonisation into an opportunity to enhance well-being, productivity, and sustainable prosperity for the decades ahead.”