School of Public Administration, Zhejiang University of Finance and Economics, Hangzhou, China.
School of Political Science and Public Administration, Wuhan University, Wuhan, China.
Front Public Health. 2021 Dec 20;9:743087. doi: 10.3389/fpubh.2021.743087. eCollection 2021.
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. 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. 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. 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.
随着社会经济的发展，空气污染导致了社会成本的增加。因空气污染而产生的医疗费用和健康问题是各国环境治理的重要方面。本研究使用中国 122 个城市的日常空气污染监测数据，采用 Heckman 两阶段和工具变量法，结合 2018 年中国健康与养老追踪调查（CHARLS）的数据，实证研究了空气污染对居民医疗费用的影响。研究发现，空气质量指数（AQI）衡量的空气质量差显著增加了慢性肺病、心脏病和自评健康状况差的概率。此外，AQI（影响为 4.51%）显著影响了寻医行为和医疗费用。轻度、中度、重度和严重污染天的医疗支出效应分别为 3.27%、7.21%、8.62%和 42.66%。从长期来看，空气质量指数较高地区的居民健康状况受到负面影响，表明空气质量较差。污染越严重，居民就医的概率越高，医疗费用也随之增加。群体和区域异质性也在空气污染对医疗费用的影响中发挥作用。与现有文献相比，本研究基于 15 岁及以上的个体，得出了可靠的研究结论。
