Global supply chain relocation reshaped PM2.5 pollution and human health risks.

The current global supply chain (GSC) relocation differs from earlier patterns, as shifts now occur not only from developed to developing economies but increasingly from China to South and Southeast Asia. However, the impacts of current GSC relocation on PM2.5 pollution and the related health burdens across countries remain poorly understood. Here, we quantified these impacts and showed that GSC relocation aggravated global health burdens, leading to a net global increase of 207,105 PM2.5-related premature deaths in 2022. Additional burdens were concentrated in the Global South, particularly in India, China, and Southeast Asia, while major outsourcing countries in Global North such as the United States, Western Europe, and Japan experienced health benefits. We also found that GSC relocation intensified inequality in distribution of PM2.5-related premature deaths across countries. Although North-South trade was the dominant driver, transferring health burdens from developed to developing regions, South-South emerged as a comparably important contributor, exacerbating burdens in India and Southeast Asia but alleviating them in China. These findings highlight the need for supply chain and environmental policies to incorporate health co-benefits and distributional outcomes, ensuring that pollution reduction in one region is not achieved at the cost of greater health burdens elsewhere.