Clean energy and fuel sales influenced the association between exposure to PM2.5 and diabetes, asthma and high blood pressure in Canada. In a study of 117 Canadian health regions (excluding the far north) between 2007 and 2014, researchers examined the cross-sectional association between exposure to PM2.5 derived from satellite remote sensing observations, and health endpoints from the Canadian community health survey for people aged 44 or older. Among the covariates, the location, type, and size of power plants was used to estimate clean energy production, while data on sales of gasoline was used to compare the intensity of emissions from motor vehicles, for each health region. A 10 μg/m3 increase in PM2.5 (2-year average) was associated with a 5% increase in diabetes, a 2% increase in asthma incidence, and an 8% increase in high blood pressure incidence, similarly to previous findings. A sensitivity analysis suggests higher risks in areas with lower rates of clean energy generation: for example the risk of incident diabetes was 700% higher where clean energy production is low, compared to regions where clean energy is more prevalent. Furthermore, comparing the effects of low clean energy generation with the effect of low fuel sales showed a 66% lower effect for diabetes, indicating the importance of traffic emissions. While the study has limitations due to study design, these findings can provide some guidance for the formulation of energy and public health policy.