New analysis by the Global Alliance on Health and Pollution finds that despite declines in deaths from household air and water pollution, pollution overall still causes 1 in 6 deaths worldwide every year, claiming the lives of more than 9 million people.

The 2017 Lancet Commission on Pollution and Health concluded that pollution is the world’s largest environmental risk factor for disease and premature death. Now, this updated analysis — to which Jessica Seddon, senior air quality fellow at WRI Ross Center for Sustainable Cities, contributed as an author — shows the impact of pollution remains devastating, and annual deaths have not decreased since 2015. Air pollution in particular is the single-largest contributor to pollution-related deaths, accounting for 6.7 million or nearly 3 in 4 of the 9 million total pollution-related deaths worldwide — and this number is increasing. The report notes that improvements in water quality and indoor air quality have been offset by increasing industrial pollution.

Although impoverished and marginalized communities are disproportionately harmed — more than 90% of pollution-related deaths occur in low-income and middle-income countries — pollution is a planetary threat.

The report also highlights the importance of a coordinated global approach to addressing pollution. A growing body of evidence shows pollutants, including air pollution, travel long distances via wind and water as well as trade in food and consumer products. Transboundary chemical pollution is also a growing concern, with toxic metals being found more often in globally traded products. Pollution footprints — the areas affected by pollution stemming from production of goods and services — are also growing faster than carbon footprints.

“Pollution has long been thought of as a local regulatory problem, but it’s increasingly clear that both its drivers and impacts are global and deeply intertwined with our choices about energy, food and infrastructure,” said Seddon. “Our approach to solutions needs to change.”

Urgent support is needed to reduce air pollution as well as lead poisoning and exposure to hazardous chemicals. The drivers, dispersion and health impact of pollution transcend national boundaries and demand a worldwide response. Read more in the full report.