Impact of Air Pollution on Residents' Medical Expenses: A Study Based on the Survey Data of 122 Cities in China

Abstract

Background: With the development of the social economy, air pollution has resulted in increased social costs. Medical costs and health issues due to air pollution are important aspects of environmental governance in various countries.Methods: This study uses daily air pollution monitoring data from 122 cities in China to empirically investigate the impact of air pollution on residents' medical expenses using the Heckman two-stage and instrumental variable methods, matching data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) survey.Results: The study found that poor air quality, measured by the air quality index (AQI), significantly increased the probability of chronic lung disease, heart disease, and self-rated poor health. Additionally, the AQI (with an effect of 4.51%) significantly impacted health-seeking behavior and medical expenses. The medical expenditure effects of mild, moderate, severe, and serious pollution days were 3.27, 7.21, 8.62, and 42.66%, respectively.Conclusion: In the long run, residents' health in areas with a higher air pollution index, indicating poor air quality, is negatively impacted. The more extreme the pollution, the higher the probability of residents' medical treatment and the subsequent increase in medical expenses. Group and regional heterogeneity also play a role in the impact of air pollution on medical expenses. Compared with the existing literature, this study is based on individuals aged 15 years and above and produces reliable research conclusions.

Determining the effect of air quality on activities of daily living disability: using tracking survey data from 122 cities in China

“…This study also empirically reveals the theoretical basis for the social governance of residents’ ADL disability and the optimization of long-term care insurance. Specifically, the findings of this study provide insights into environmental governance of residents with ADL disability [ 47 – 49 ]. For example, investigating the changes in the disability rate and factors of disability risk of local residents and the effective regulations of air pollution could be undertaken for environmental governance.…”

The impact of national comprehensive medical reform on residents' medical expenses: Evidence from China

“…Therefore, the influencing factors of residents' medical expenses are important topics that scholars have paid attention to for a long time. For example, the existing literature investigated the above issue from the perspective of air pollution (10)(11)(12)(13)(14), environmental regulation (15,16), fiscal decentralization (17), and energy use (18).…”

“…(1) Economic development level (ln Pgdp ). Economic development level is an important factor affects residents' medical expenses ( 10 , 35 ). Therefore, we take the actual per capita GDP as a control variable.…”

“…In general, the existing literature comprehensively investigated the influencing factors of residents' medical expenses from multiple perspectives. Some studies believed that serious air pollution is not conducive to residents' health, which may increase residents' medical expenses (10)(11)(12)(13)(14), while strict environmental regulations can alleviate this adverse effect to a certain extent (15,16). Other studies explained residents' high medical expenses from the perspectives of fiscal decentralization (17) and energy use (18).…”

“…Ecological endowment may indirectly affect residents' medical expenses by affecting their health. Therefore, we also introduce this as a control variable, which is measured by forest coverage (10). ( 6) Medical support (Health-expenses).…”