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Death rates rise as air pollution goes up. But the flip side is that every incremental improvement in air quality brings health benefits almost immediately.

So, how do we clean up our air? Here are some of the world’s success stories. All are incomplete, but their progress shows what is possible.

LOS ANGELES: Laying down the law

LA’s slow, steady march toward healthier air is part of a larger US story, one that began with the passage of the 1970 Clean Air Act.

That law – and the Environmental Protection Agency (EPA) created to enforce it – is why air quality in the US is significantly better than in Europe. While the Clean Air Act mobilized governmental power to pressure polluting industries to shape up, the well-resourced and technically proficient EPA became its effective enforcement arm. Five decades of progress have saved millions of lives nationwide.

While LA’s ozone pollution is still the country’s highest, it fell by more than 60 per cent from 1980 to 2018. Progress on two other pollutants – particle matter and nitrogen dioxide – led to a 20-per-cent reduction in childhood asthma cases over a period of 13 years.

Facing a more serious problem than the rest of the country, Los Angeles and the state of California, the birthplace of US car culture, have supplemented national efforts. They’ve demanded better pollution controls on trucks, introduced plug-in power so freight ships can turn off their engines in port, restricted the use of toxic dry-cleaning chemicals, and much more.

While researching a book about global air pollution, I heard one thing again and again from longtime Angelenos: previously you weren’t able to see the mountains that surround the city. Now, they’re the craggy backdrop to everyday life.

Today, Los Angeles’ progress, and the country’s, are at risk as the Trump administration rips up pollution rules and eviscerates the EPA.

But the lessons are clear. Science-based regulation, effectively enforced, is the most powerful tool there is for protecting public health.

CHINA: Plummeting particles

It wasn’t long ago that China was the poster child for dirty air. While it still has a serious problem, things have been changing fast. The shift started in 2011, when Beijing residents noticed pollution readings from the US Embassy’s rooftop monitor, shared on Twitter, were far higher than those put out by the Chinese government. It triggered a social-media uprising that gave leaders a glimpse of public anger about pollution.

Progress has zigged and zagged in response to political and economic pressures. But the overall trajectory is clear: in Beijing, particle pollution has fallen 60 per cent since 2010.

Change started with the creation of a national network of air-quality monitors and the public release of data. Next, the government required factories to install smokestack scrubbers to remove harmful pollutants, capped coal usage and made the world’s biggest-ever investment in wind and solar power.

Now, they’re putting big money into electric cars and buses. China’s immense size means that this investment will have global ripple effects, driving down electric vehicles’ cost and speeding up technological advances.

China is on track to shrink its use of coal far sooner than it promised – good news for the health of its people, and for the climate.

However, overseas it’s a different story, with China financing massive new coal-fired power plants through its Belt and Road initiative – thought to be the largest infrastructure project in history.

UTRECHT: Backing the bike

The Netherlands is famous as a cyclists’ paradise, but it hasn’t always been so. Back in the 1970s, cars were as dominant there as anywhere else in Europe.

But a broad, grassroots campaign from activists furious about the number of traffic deaths, particularly among children, forced city authorities to prioritize cycling and walking. The resulting changes have been a boon, not just to the state of urban air, but to quality of life more broadly. Nationwide, one study found, cycling prevents 6,500 premature deaths every year and gives the Dutch six extra months of life expectancy.

The medieval city of Utrecht currently ranks third – after Copenhagen and Amsterdam – on an index of the world’s most bike-friendly cities.

Utrecht has boosted its cycling infrastructure, creating protected bike lanes and dedicated cycle routes. The city is building the world’s biggest high-density, car-free residential district for more than 12,000 people. It’s also home to a massive bike-parking facility, with space for 12,500 bicycles, underneath the train station, which is a hub for the Netherlands’ superb rail network.

Utrecht has become a city built around the needs of human beings, not cars. Space that would otherwise go to parking polluting vehicles can be used for recreation. In a city of about 360,000 people, officials estimate there are 125,000 bike trips a day.

ECUADOR: Cleaner cooking

Smoky cooking fires are a major killer in much of the Global South, cutting short nearly four million lives annually.

Ecuador has been actively tackling that danger. It long ago embraced a solution many scientists are now getting behind: instead of searching for better ways to burn dirty biomass fuels like wood, dung and charcoal, why not provide people with the cooking fuel most in richer countries take for granted – natural gas? ‘Improved’ biomass stoves were failing to deliver the promised health benefits, according to researchers. So, many have embraced the idea of ‘making the clean available,’ rather than ‘making the available clean.’

Ecuador did that decades ago, providing subsidies to make cooking gas affordable. More than 90 per cent of households now rely on it. While gas has a carbon footprint, it is vastly healthier for those using it, and because the old, smoky fuels produce so much soot, the climate impact of switching to a fossil fuel may be minimal.

Now Ecuador is pushing to the next level, aiming to move households away from gas and towards electromagnetic induction stoves, which can be powered by abundant, renewable hydroelectricty.