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A new analysis of the Air Quality Life Index (AQLI), produced by the Energy Policy Institute at the University of Chicago (EPIC), shows the average Indonesian can expect to lose 1.2 years of life expectancy because air quality fails to meet the World Health Organization’s (WHO) guideline for fine particulate pollution. Some areas of Indonesia fare much worse: the loss of life expectancy in the most polluted regions is more than 5 years.

“As countries navigate the dual challenges of sustaining economic growth and protecting the environment and public health, the AQLI shows not only the damage caused by pollution but also the gains that can be made with policies to address it,” says Michael Greenstone, the Milton Friedman Professor in Economics at the University of Chicago, who created the Index along with his colleagues at EPIC. “Robust Indonesian policies to reduce particulate air pollution would allow people to lead longer and healthier lives.”

Importantly, the AQLI shows that particulate pollution was not a pressing problem in Indonesia just two decades ago. But from 1998 to 2016, particulate pollution concentrations increased 171 percent, making the country one of the twenty most polluted in the world. The greatest spike has happened over just the last few years, with pollution more than doubling from 2013 to 2016 alone. As of 2016, 80 percent of Indonesia’s more than 250 million people lived in areas where the annual average particulate pollution level exceeded the WHO guideline. In Indonesia’s capital Jakarta, home to more than 10 million people, the average resident will live 2.3 years less if these high pollution levels continue, relative to if the WHO guideline was met. In South Sumatra, city-dwellers in Palembang lose 4.8 years of life expectancy on average, and residents of the regency of Ogan Komering Ilir lose 5.6 years of life expectancy.

The AQLI is based on a pair of peer-reviewed studies in which Greenstone and his co-authors exploited a unique natural experiment in China based on China’s Huai River Winter Heating policy. The natural experiment allowed them to isolate the effect of air pollution from other factors that affect health, and to do so at the very high concentrations that prevail in China, India, Thailand, Indonesia, and other countries today. They then combined the results from these studies with hyper-localized, global particulate matter measurements, allowing users to zoom in on any district in the world and understand the impacts of that district’s local air pollution on life expectancy. This improves upon the existing AQI (Air Quality Index), which translates air pollution concentrations into colors without shedding light on what those colors mean for people’s wellbeing.

The AQLI’s insights make clear that air pollution is the greatest threat to human health on the planet, with its effect on life expectancy exceeding that of devastating communicable diseases such as tuberculosis and HIV/AIDS, behavioral killers like cigarette smoking, and even war. However, the benefits of successful regulations are enormous. If, for example, Indonesia achieved sustained improvements in air quality comparable to what China has achieved in the last 5 years, the typical Indonesian could expect to live eight months longer. Those in the most polluted areas would capture even larger benefits, living up to 2.5 years longer on average.