Indirect emissions contribute a quarter of air pollution-related health burden of food systems in China.

Agricultural intensification produces indirect emissions beyond ammonia volatilization from activities such as machinery usage, food processing, transportation, storage and energy inputs. Here we integrate an input-output analysis with air quality modelling approaches, showing that attributable mortality from indirect emissions has risen sixfold in China over the past 37 years. Indirect emissions now account for one-quarter of air pollution-related attributable mortality associated with food consumption. We find a marked redistribution of the indirect health burden, with low-income groups experiencing an additional 58% attributable deaths compared with their expected food consumption burdens, which were initially associated with the food consumption of high-income groups. Targeted strategies using abatement approaches could halve the indirect health burden, thereby mitigating the environmental impact of food consumption amid agricultural intensification.