For decades, efforts to reduce carbon emissions have largely been presented as a global response to climate change. However, a growing body of research is showing that cutting fossil-fuel use and reducing air pollution can also deliver immediate and measurable health benefits for the communities where emissions decline.

Recent studies from Greece, the United States and Europe indicate that cleaner air can rapidly reduce hospital admissions for cardiovascular diseases, heart attacks and other serious health conditions. The findings offer a powerful local argument for accelerating the transition away from coal and highly polluting vehicles.

The evidence is particularly striking in West Macedonia, a region in northern Greece that spent much of the second half of the 20th century and the beginning of the 21st century as one of Europe’s major lignite-producing areas. Its six coal-fired power stations once generated around 60% of Greece’s electricity.

The extensive mining and burning of lignite came with a substantial pollution burden. But as coal mines were closed and power stations were gradually shut down, researchers gained an opportunity to examine what happened to public health as the air became cleaner.

A study examining the period between 2011 and 2021 found that declining air pollution was accompanied by a substantial reduction in winter hospital admissions for heart-related illnesses. At major hospitals serving more than 200,000 people, winter admissions for cardiovascular problems fell by approximately 22% to 42%.

The changes were particularly notable when compared with a hospital serving a rural population located around 50 to 100 kilometres away. That hospital recorded an increase of about 2% in cardiovascular admissions during the same period.

The researchers also observed a major decline in severe cardiac events. The proportion of patients experiencing heart attacks and serious heart rhythm abnormalities fell considerably, reaching around one-third of 2011 levels at one of the hospitals included in the study.

The improvement in health coincided with a dramatic reduction in pollution. Winter concentrations of sulphur dioxide, a pollutant strongly associated with coal combustion, declined by more than 90%, approaching the limits of detection. Levels of particulate pollution also improved.

The findings provide an important illustration of the health gains that can accompany decarbonisation. Instead of being viewed solely as an investment whose benefits will be realised decades later through reduced global warming, reducing fossil-fuel consumption can improve people’s health in the present.

Similar evidence has emerged from the United States.

Near Pittsburgh, Pennsylvania, the closure of a coal-processing facility in 2016 resulted in an immediate improvement in air quality in surrounding communities. Sulphur dioxide concentrations fell by approximately 90%, while arsenic pollution declined by 66%. Particulate pollution also decreased.

The health response was rapid. Researchers recorded a 42% reduction in emergency-room visits for heart-related problems soon after the facility closed. Cardiovascular emergencies continued to decline during the following three years covered by the study.

Such findings are consistent with a wider understanding of the relationship between air pollution and cardiovascular health. Fine particulate matter and other pollutants can enter the lungs and contribute to inflammation, oxidative stress and changes in blood vessels. Long-term exposure has been associated with increased risks of heart attacks, strokes and other cardiovascular diseases.

The benefits of cleaner air are not limited to areas where large coal plants or industrial facilities have been closed. Transport policies are increasingly being used to reduce exposure to vehicle emissions in urban areas.

Low-emission zones and clean-air zones restrict or discourage the use of older, more polluting vehicles in areas where air pollution is particularly high. By reducing traffic-related emissions, these policies can lower people’s exposure to nitrogen dioxide and particulate matter, pollutants that are associated with respiratory and cardiovascular disease.

Evidence from cities that have introduced such measures suggests that improvements in air quality can be accompanied by improvements in public health. The effects can be especially important for people who are more vulnerable to pollution, including older adults, children and individuals with existing heart or respiratory conditions.

Public attitudes also appear to be changing as the benefits become more visible. A separate survey conducted by the University of West Macedonia found broad agreement among residents that decarbonisation had improved local air quality, although perceptions differed across the region regarding the benefits and impacts of green investments.

These regional differences highlight an important challenge in the transition away from fossil fuels. Communities historically dependent on coal mining and coal-fired power generation can face economic disruption when industries close. Ensuring that cleaner energy delivers jobs, investment and social benefits alongside environmental improvements is therefore essential.

Nevertheless, the emerging health evidence strengthens the case for faster action on air pollution. Cleaner energy, less-polluting transport and stronger air-quality regulations can simultaneously address climate change and reduce illnesses today.

The experience of West Macedonia and Pittsburgh demonstrates that cleaner air is not merely an environmental objective. It can mean fewer people suffering heart attacks, fewer emergency-room visits and fewer patients occupying hospital beds.

As governments pursue climate targets, these immediate health gains could become one of the most compelling reasons to accelerate the transition towards cleaner energy and healthier communities.