Uncovering the indoor health co-benefits of rural residential energy transition in Northern China

Solid fuel combustion in rural residences constitutes a critical environmental determinant of population health disparities in northern China. While multiple initiatives promoting clean energy adoption have been implemented, the geographical heterogeneity in policy-derived indoor health benefits and their distributional equity remain poorly understudied. By integrating the technology optimization model with the health economy model, this study evaluated how rural household energy transitions influence indoor pollution exposure, population health outcomes, and the distribution of health improvements across provinces. Findings demonstrate that, besides reducing CO₂ emissions, transitioning to clean fuels would substantially avoid approximately 76,000 pollution-related mortalities in 2035, and substantially narrow interprovincial disparities in health outcomes. Specifically, Shandong would achieve the most considerable absolute cumulative health benefits (206 billion USD, 26.8 % of the regional total), and Beijing shows the highest relative gain (138.8 %). Tianjin attains the highest benefit-cost ratio (6.64) by 2035 in the Rapid scenario, whereas Shanxi's ratio is the lowest due to high transition costs. Results underscore the need for regionally tailored clean energy policies targeting the rural residential sector to maximize emission reductions, enhance public health, and promote interprovincial health equity in clean energy transitions.