Abstract: Objective To assess the coupling coordination degree and its influencing factors between carbon emission and atmospheric pollutant emission in China in recent years, and to evaluate the burden of death from long-term exposure to fine particulate matter (PM_2.5) under pollution and carbon reduction policies. Methods This study employed the coupling coordination degree model and panel regression model to examine the spatial-temporal distribution of and the coupling coordination degree between carbon emissions and atmospheric pollutants as well as the influencing factors in China. The global exposure mortality model was used to estimate the number of premature deaths from five major diseases (ischemic heart disease, stroke, chronic obstructive pulmonary disease, lung cancer, and lower respiratory infection) attributed to long-term PM_2.5 exposure in China from 2014 to 2019. Results From 2006 to 2020, total atmospheric pollutant emissions in China decreased annually, while carbon emissions continued to rise at a slower growth rate. Coordinated governance for pollution and carbon reduction improved overall, although significant regional disparities in the coupling coordination level persisted. Energy consumption structure, per capita GDP, and transportation structure were key factors influencing the coupling coordination degree between pollution and carbon reduction. Between 2014 and 2019, mean annual premature deaths attributed to long-term PM_2.5 exposure in China were estimated at 1.378 6 (95% confidence interval: 1.197 2, 1.574 0) million, primarily from ischemic heart disease (43.1%), chronic obstructive pulmonary disease (20.1%), and stroke (19.0%). Conclusion Pollution and carbon reduction policies have made significant progress in improving environmental governance. However, substantial regional disparities persist, and the health co-benefits needs to be further strengthened. Future policy design should focus on reducing regional disparities and incorporating the synergistic relationship between pollution and carbon reduction and human health into governance frameworks.