Abstract. Air quality is a major environmental concern in China, where premature deaths due to air pollution exceed 1 million people per year in recent years. Here, using a novel coupling of economic, physical and epidemiological models, we estimate the premature mortality in seven regions of China related to emissions of PM2.5 and precursor gases in 2010 and show for the first time how the distribution of these deaths in China is determined by a combination of economic activities and physical transport of pollution in the atmosphere. We find that 33 % of China’s air pollution deaths in 2010 were caused by pollutants emitted in a different region of the country and transported in the atmosphere, especially from north to south and from east to west. Similarly, 38 % of deaths were related to goods and services consumed in a different region from where they were produced. For example, 36 % of the deaths number associated to emissions in Central region of China were caused by consumption in other regions. As a combined result from atmospheric transport and trade, 56 % of pollution deaths in China were related to consumption in a different region. Among these, 14 % of China’s pollution deaths were caused by international export. Our results indicate that multilateral and multi-stage cooperation under a regional sustainable development framework is in urgent need to mitigate air pollution and health impacts, and efforts to reduce the health impacts of air pollution in China should be prioritized according to the source and location of emissions, the type and economic value of the emitting activities, and the related patterns of consumption.;
