Conservation International, Arlington, VA 22202, USA.
Int J Environ Res Public Health. 2024 Oct 5;21(10):1322. doi: 10.3390/ijerph21101322.
Although the effects of the environment on human health are well-established, the literature on the relationship between the quality of the environment and expenditures on healthcare is relatively sparse and disjointed. In this study, the Environmental Quality Index developed by the Environmental Protection Agency and heatwave days were compared against per capita Medicare spending at the county level. A general additive model with a Markov Random Field smoothing term was used for the analysis to ensure that spatial dependence did not undermine model results. The Environmental Quality Index was found to hold a statistically significant ( < 0.05), multifaceted nonlinear association with spending, as was the average seasonal maximum heat index. The same was not true of heatwave days, however. In a secondary analysis on the individual domains of the index, the social and built environment components were significantly related to spending, but the air, water, and land domains were not. These results provide initial support for the simultaneous benefits of healthcare financing systems to mitigate some dimensions of poor environmental quality and consistently high air temperatures.
尽管环境对人类健康的影响已得到充分证实，但关于环境质量与医疗保健支出之间关系的文献相对较少且不连贯。在这项研究中，将环境保护署开发的环境质量指数与县级人均医疗保险支出进行了比较，并采用具有马尔可夫随机场平滑项的广义加性模型进行分析，以确保空间相关性不会破坏模型结果。结果发现，环境质量指数与支出之间存在统计学上显著（<0.05）的多方面非线性关系，平均季节性最高热指数也是如此。然而，热浪天数并非如此。在对该指数的各个领域的二次分析中，社会和建筑环境组成部分与支出显著相关，但空气、水和土地领域则没有。这些结果初步支持了医疗保健融资系统的综合效益，即减轻环境质量较差和气温持续偏高的一些方面的影响。
