Substantial differences in source contributions to carbon emissions and health damage necessitate balanced synergistic control plans in China.

China's strategy to concurrently address climate change and air pollution mitigation is hindered by a lack of comprehensive information on source contributions to health damage and carbon emissions. Here we show notable discrepancies between source contributions to CO emissions and fine particulate matter (PM)-related mortality by using adjoint emission sensitivity modeling to attribute premature mortality in 2017 to 53 sector and fuel/process combinations with high spatial resolution. Our findings reveal that monetized PM health damage exceeds climate impacts in over half of the analyzed subsectors. In addition to coal-fired energy generators and industrial boilers, the combined health and climate costs from energy-intensive processes, diesel-powered vehicles, domestic coal combustion, and agricultural activities exceed 100 billion US dollars, with health-related costs predominating. This research highlights the critical need to integrate the social costs of health damage with climate impacts to develop more balanced mitigation strategies toward these dual goals, particularly during fuel transition and industrial structure upgrading.