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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 long-term exposure to fine particulate air pollution is shortening the average Pakistani’s life expectancy by more than two years, relative to what it would be if the World Health Organization (WHO) guideline was met. Some areas of Pakistan fare much worse: in the most polluted regions, air pollution is shortening lives by more than five years compared to WHO guideline.

“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 enormous gains that can be made with policies to address it,” says Michael Greenstone, the Milton Friedman Distinguished Service Professor in Economics at the University of Chicago, who created the Index along with his colleagues at EPIC. “If Pakistan’s government is successful in following through on their recent plans to reduce air pollution, the reward will be longer and healthier lives for Pakistanis.”

The AQLI finds that in 2016, 98 percent of Pakistan’s more than 200 million people lived in areas where the annual average particulate pollution level exceeded the WHO guideline. Ninety-seven percent lived in areas where it exceeded Pakistan’s own air quality standard. In Lahore, air pollution almost doubled from 1998 to 2016 due to growth in industry and vehicle emissions along with crop burning. If these higher air pollution concentrations are sustained, residents there can expect to see their lives cut short by 5.3 years, relative to air quality that met the WHO guideline. For Faisalabad residents, there life expectancies are being shortened by 4.8 years.

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, Pakistan, 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. For example, China has made tremendous progress since declaring a “war against pollution” in 2014, with cities cutting particulate pollution by 32 percent on average—improving life expectancy by 2.3 years if the reductions persist. If Pakistan were to achieve the same percentage reduction in particulates that China experienced, its residents could live 1.2 years longer on average.

To learn more about the Air Quality Life Index and particulate pollution more broadly, read: “Introducing the Air Quality Life Index: Twelve Facts about Particulate Air Pollution, Human Health, and Global Policy”