Yue Xiaonan, Li Yudi
College of Foreign Languages and Cultures, Chengdu University of Technology, Chengdu, China.
Graduate School of Advanced Integrated Studies in Human Survivability, Kyoto University, Kyoto, Japan.
Front Public Health. 2025 Aug 20;13:1649879. doi: 10.3389/fpubh.2025.1649879. eCollection 2025.
As environmental pollution and population aging become increasingly severe, it is especially important to assess the health co-benefits of climate-related urban policies. This study aims to examine the impact of China's Low-Carbon City Pilot Program (LCCP) on the health of the older adults. It focuses on potential mechanisms such as improvements in environmental quality and increases in non-motorized transportation.
This study uses a multi-period Difference-in-Differences (DID) approach to evaluate the health effects of the LCCP. The analysis draws on nationally representative panel data from the China Family Panel Studies (CFPS) between 2012 and 2018. The sample is restricted to individuals aged 60 and above. The main outcome variable is self-rated health, with frequency of medical visits used as a supplementary indicator. The treatment variable is defined based on the official list of low-carbon pilot cities and their launch years. The analysis controls for various individual, intergenerational, and household-level characteristics. To explore possible mechanisms, the study conducts mediation analysis focusing on perceived environmental quality and non-motorized travel behavior. It also includes commuting distance and commuting time as moderating variables to assess the limiting effect of spatial accessibility.
The results show that the LCCP significantly improved the health of older adults. The DID estimates indicate a positive policy effect that remains robust across alternative model specifications and when using other outcome variables such as medical visit frequency. The mediation analysis suggests that improvements in environmental quality-especially in subjective environmental perceptions-and increases in non-motorized travel are key channels for health improvement. In addition, the health benefits of the policy are more pronounced among older adult individuals who face longer commuting distances and times. Subgroup analysis further reveals heterogeneous effects: the policy yields greater health improvements for males, rural residents, and the younger older adults (aged 60-69). Overall, these findings support the proposed hypotheses and highlight both the direct and indirect health benefits of China's low-carbon urban transition.
This study concludes that the LCCP significantly enhanced older adults health by improving environmental quality and travel behavior. The health effects are stronger for groups with better spatial accessibility and are partially realized through household perceptions and increased non-motorized travel. The results emphasize the importance of integrating environmental policies with age-friendly planning in urban governance to promote healthy aging.
随着环境污染和人口老龄化日益严重，评估与气候相关的城市政策对健康的协同效益尤为重要。本研究旨在考察中国低碳城市试点项目（LCCP）对老年人健康的影响。它聚焦于潜在机制，如环境质量的改善和非机动车交通的增加。
本研究采用多期双重差分（DID）方法来评估LCCP的健康影响。分析利用了2012年至2018年中国家庭追踪调查（CFPS）具有全国代表性的面板数据。样本仅限于60岁及以上的个体。主要结果变量是自评健康状况，就诊频率用作补充指标。处理变量根据低碳试点城市的官方名单及其启动年份来定义。分析控制了各种个体、代际和家庭层面的特征。为了探究可能的机制，该研究进行了中介分析，重点关注感知环境质量和非机动车出行行为。它还将通勤距离和通勤时间作为调节变量，以评估空间可达性的限制作用。
结果表明，LCCP显著改善了老年人的健康状况。DID估计表明存在积极的政策效应，在替代模型设定以及使用其他结果变量（如就诊频率）时，该效应依然稳健。中介分析表明，环境质量的改善——尤其是主观环境感知方面的改善——以及非机动车出行的增加是健康改善的关键渠道。此外，该政策对通勤距离和时间较长的老年个体的健康益处更为显著。亚组分析进一步揭示了异质性效应：该政策对男性、农村居民以及较年轻的老年人（60 - 69岁）的健康改善作用更大。总体而言，这些发现支持了所提出的假设，并突出了中国低碳城市转型对健康的直接和间接益处。
本研究得出结论，LCCP通过改善环境质量和出行行为显著增强了老年人的健康。对于空间可达性较好的群体，健康影响更强，且部分是通过家庭感知和增加非机动车出行实现的。结果强调了在城市治理中将环境政策与适老化规划相结合以促进健康老龄化的重要性。
