A Socioeconomic Assessment of Projected Health Impacts From Outdoor Air Pollution Under Current European Climate Policy: A Modelling Study

Background Outdoor air pollution poses a major threat to human health and is closely interlinked to climate change, as both stem largely from the same emission sources and pollutants, affecting both health and climate. Despite sustained mitigation efforts, over 239,000 premature deaths in Europe were attributed to PM 2.5 exposure in 2022, while climate policies are projected to yield substantial yet insufficient co-benefits by 2030, with uneven impacts across regions and socioeconomic groups. Methods We applied GCAM-Europe to model emission pathways under the National Energy and Climate Plans (NECPs) and Fit-for-55 (FF55) policy package. Premature mortality attributable to PM 2.5 was estimated at both 1 km 2 grid and NUTS3 levels using rfasst. Results were further analysed through socioeconomic lens, both between and within countries, using quantitative assessments and machine learning techniques. Findings Despite implementing the NECPs and FF55 packages, significant health risks persist by 2030, with average PM 2.5 levels exceeding the World Health Organisation guidelines in all but seven European countries. The Balkan region and northern Italy emerge as the most affected areas, with national averages reaching up to 12.4 μg m −3 . Urban populations face the greatest health risks, with disproportionate burdens among low- and high-income groups and areas with average concentrations of elderly residents. Within-country analyses reveal distinct, country-specific vulnerability patterns. Interpretation Incorporating social and health dimensions into environmental policymaking is essential for designing strategies that jointly advance decarbonisation, reduce air pollution, and promote environmental justice. Attention to spatial resolution and geographic scale is critical, as coarse analyses risk obscuring vulnerable populations and regional disparities. Funding Funded as part of the DIAMOND Horizon Program.