Future fine particulate matter (PM 2.5 ) concentrations and resulting health impacts will be largely determined by factors such as energy use, fuel choices, emission controls, state and national policies, and demographics. In this study, a human-earth system model is used to estimate PM 2.5 mortality costs (PMMC) due to air pollutant emissions from each US state over the period 2015 to 2050, considering current major air quality and energy regulations. Contributions of various socioeconomic and energy factors to PMMC are quantified using the Logarithmic Mean Divisia Index. National PMMC are estimated to decrease 25% from 2015 to 2050, driven by decreases in energy intensity and PMMC per unit consumption of electric sector coal and transportation liquids. These factors together contribute 68% of the decrease, primarily from technology improvements and air quality regulations. States with greater population and economic growth, but with fewer clean energy resources, are more likely to face significant challenges in reducing future PMMC from their emissions. In contrast, states with larger projected decreases in PMMC have smaller increases in population and per capita GDP, and greater decreases in electric sector coal share and PMMC per unit fuel consumption.