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An astounding two million lives were lost to air pollution related diseases in India in 2023, according to the State of Global Air (SoGA) 2025 report released by the Health Effects Institute (HEI) and the Institute for Health Metrics and Evaluation (IHME), United States. This is a staggering rise from 1.4 million deaths in 2000, a 43 per cent increase. Nearly nine out of 10 of these deaths were linked to non-communicable diseases (NCDs) such as heart disease, lung cancer, diabetes, and even dementia.
Globally, air pollution is responsible for eight million deaths annually — about one in eight deaths world-wide. More than half of these deaths (about 4.9 million) are due to outdoor air pollution, 2.8 million due to household air pollution and the rest due to ozone pollution.
A big shocker this time is the firmer evidence on the link between air pollution and growing risk of dementia, causing as many as 626,000 deaths and 40 million healthy years of life lost globally.
Air pollution death rates in India are now over 10 times higher than in high-income countries with 186 deaths per 100,00 people, compared to 17 deaths per 100,000 in wealthier nations. States such as Maharashtra, Uttar Pradesh, Rajasthan, Bihar, and West Bengal have recorded the largest impacts, each reporting more than 100,000 deaths in 2023.
This report highlights the growing incidence of NCDs due to air pollution. As much as 89 per cent of all air pollution deaths in India in 2023 were attributable to NCDs including heart and lung disease, lung cancer, diabetes, and dementia.
According to the SoGA report, air pollution is responsible for seven out of 10 chronic obstructive pulmonary disease (COPD) deaths, one in three lung cancer deaths, more than one in four heart disease deaths and nearly one in five diabetes deaths. More than two-thirds of all COPD deaths are attributable to air pollution exposure. This points towards a growing risk for India’s ageing population.
Even globally, 95 per cent of air pollution-related deaths in adults over the age of 60 are due to NCDs. Between 2000 and 2023, global NCD deaths linked to air pollution rose by 13 per cent, increasing from 5.99 million to 6.8 million.
However, deaths from household air pollution (from use of solid fuels for cooking) have continued to decline in India. But deaths due to both ambient PM2.5 and ozone have increased significantly. The magnitude of the risk is evident in the fact that 75 per cent of the country’s population lives in areas where annual PM2.5 exposure exceeds the WHO Air Quality Interim Target of 35 µg/m3.
A key highlight of this year’s SoGA report is the inclusion of dementia as a new indicator of air pollution’s health toll. In 2023, air pollution contributed to 626,000 dementia deaths worldwide and an estimated 40 million healthy years of life lost. Scientists warn that long term exposure to fine particulate matter (PM 2.5) may damage brain tissue and accelerate cognitive decline.
In India, where life expectancy is rising and elderly care systems remain underdeveloped, this finding poses a significant concern. The country’s dementia-related deaths linked to pollution that were over 54,000 in 2024 marks a growing threat to families, healthcare systems and caregivers. The report notes that women are disproportionately affected, both as primary caregivers and as those at higher risk of developing dementia themselves.
Air pollution’s disease burden is concentrated in low- and middle-income countries (LMICs) where rapid industrialisation, industrial emissions and limited healthcare access amplify risks. South Asia remains the world’s worst affected region with India at the epicentre of the crisis.
In 2018, the United Nations High-Level Meeting on NCDs officially recognised air pollution as one of five major risk factors from chronic diseases, alongside tobacco use, unhealthy diets, physical inactivity and harmful alcohol consumption.
Following this, the World Health Assembly incorporated air pollution into its global NCD framework, marking a turning point in government addressing the intersection between health and environment. Yet, progress has been uneven. Most LMICs, including India, are unlikely to meet the UN Sustainable Development Goal (SDG) 3.4 which calls for reducing NCD deaths by one third by 2030 without strong and sustained air pollution control efforts.
For India, this means integrating clean air strategies directly into national health and development planning.
The SoGA report underscores the dual opportunity that air pollution control presents, saving lives while supporting broader climate and health goals. Reducing exposure to PM2.5 and ozone not only lowers the risk of NCDs and dementia but also contributes to greenhouse gas reductions, energy efficiency and improved productivity. This demands coordinated policy efforts across health, environment, transport and energy sectors.
The SoGA 2025 findings indicate a ‘silent epidemic’ driven by air pollution. While infectious diseases once dominated India’s health agenda, chronic and degenerative diseases linked to air pollution now represent the country’s largest and most persistent threat to well-being. Without decisive policy action, this growing public health crisis will be difficult to tame.