Dietary shifts drive the slowdown of declining methylmercury related health risk in China.

Chinese population suffers severe health risk from dietary methylmercury (MeHg) exposure. However, the temporal change of such risk and socioeconomic driving factors remain unknown. This study investigates this issue by compiling time-series inventory of China's MeHg-related health risk at the provincial scale and revealing critical socioeconomic influencing factors through structural decomposition analysis. Results show that the per-fetus IQ decrements from dietary MeHg exposure have declined by 60% nationally during 2004-2019. Such decline results from the joint effects of dietary shifts (contributing 44%) and the decrease of MeHg concentrations in foods consumed (contributing 56%). However, the declining trend has slowed down since 2014 and even leveled off after 2016, which is mainly affected by dietary pattern changes. Especially, the increased intake level and proportion of fishes in underdeveloped provinces of China have dominated the slowdown of declining trend after 2016. Moreover, the affluence and education levels have significantly negative associations with per-fetus IQ decrements. Rich and well-educated people have higher ability of risk perception, which indicates the importance of rational consumption patterns. Our findings can help develop socioeconomic regulatory policies on reducing per-fetus IQ decrements from dietary MeHg exposure in China.