The Impact of Environmental Pollution and Economic Growth on Public Health: Evidence From China

The impact of healthcare industry convergence on the performance of the public health system: a geospatial modeling study of provincial panel data from China

Objective

This paper examines the impact of healthcare industry convergence on the performance of the public health system in the eastern, central, and western regions of China.

Methods

Public health performance was measured by a composite index of three standards: average life expectancy at birth, perinatal mortality, and maternal mortality. The healthcare industry convergence was measured using a coupling coordination degree method. The spatial lag, spatial error, and spatial Durbin models were used to estimate the effect of healthcare industry convergence on public health system performance and this effect's spatial dependence and heterogeneity across eastern, central, and western China using panel data from 30 Chinese provinces from 2002 to 2019.

Results

The convergence of the healthcare industry significantly promotes regional public health [β =0.576, 95% CI: (0.331,0.821)]. However, the convergence does not have a spatial spillover effect on the public health system at the national level. Additionally, analysis of regional heterogeneity shows that the direct effects of healthcare industry convergence on public health are positive and statistically significant for Eastern China, statistically insignificant for Central China, and positive and statistically significant for Western China. The indirect effects are negative, statistically significant, positive, statistically significant, and statistically insignificant for these three regions, respectively.

Conclusion

Policy efforts should strengthen the convergence between the healthcare industry and relevant industries. It can produce more current healthcare services to improve public health and reduce regional health inequality.

Revisiting the relationship between business conditions, climate policy uncertainty, and environmental pollution: evidence from the USA

This paper aims to revisit the interdependency between business conditions, climate policy change, and the environmental pollution of the USA. Interestingly, our paper represents a completion to the existing literature on three levels at least. First, we propose to analyze this issue during normal periods and periods of turmoil, particularly the COVID-19 outbreak. To do so, contrary to previous studies that used economic growth, we employ the ADS index as a real-time business conditions measurement. Second, we employ a frequency approach, based on the continuous wavelet transform, allowing us to understand the nature of the relationship. Understanding whether the relationship holds in the short- or long-term is useful for policymakers in monitoring public policies to achieve CO2 emission reduction as well as to investors interested in high value-added projects. Our analysis shows that, during the last two decades, the relationship between business conditions as well as climate uncertainty index and CO2 emissions is observed during the long- and short-term, and driven through economic conditions. However, during the crisis periods, the effect is detected across various scales and the relationship is bi-directional. Our results have several practical implications for the US policymakers to consider when setting policies for fighting pollution emissions and environmental protection.

Access to sustainable healthcare infrastructure: a review of industrial emissions, coal fires, and particulate matter

Environmental health is critical for the economy's social welfare and environmental sustainability. Using time series data from 1975 to 2020, the research examines the short- and long-run relationship between environmental pollutants and healthcare costs in the context of Pakistan. The study's results reveal that short-term and long-term efforts towards cleaner development in terms of carbon emissions, coal combustion, nitrous oxide (N₂O) emissions, and industrial value-added have resulted in significant reductions in healthcare expenses due to improved management of industrial emissions. However, in the long run, particulate matter (PM_2.5) has a detrimental effect on a country's sustainable healthcare agenda, leading to increased healthcare costs. Furthermore, the increased use of coal-fired power plants that release polycyclic aromatic hydrocarbons (PAH) and revenue generated by contaminated production lead to higher out-of-pocket healthcare costs, increasing a country's risk of morbidity and mortality. The study's Granger causality estimations demonstrate that carbon emissions are responsible for emissions-driven healthcare expenses in a nation. Additionally, economic growth leads to increased carbon emissions and industrial toxins, which are also emission-led. Through variance decomposition analysis (VDA), the study finds that carbon emissions have the highest variance shock of 32.702% on healthcare expenditures in the next ten years. This is followed by polluted income and continued economic growth, which have a variance shock of 13.243% and 8.858%, respectively, over the same period. The findings indicate that the maximum healthcare benefits may be acquired by mitigating environmental pollutants via stringent environmental regulations, reducing industrial toxins through solid waste management techniques, and minimizing coal combustion reliance through renewable fuels. Environmental research is still required to provide more sustainable solutions to the sustainability of the global healthcare agenda.

A nomogram for predicting the 4-year risk of chronic kidney disease among Chinese elderly adults

BACKGROUND

Chronic kidney disease (CKD) has become a major public health problem across the globe, leading to various complications. This study aimed to construct a nomogram to predict the 4-year risk of CKD among Chinese adults.

METHODS

The study was based on the China Health and Retirement Longitudinal Study (CHARLS). A total of 3562 participants with complete information in CHARLS2011 and CHARLS2015 were included, and further divided into the training cohort and the validation cohort by a ratio of 7:3. Univariate and multivariate logistic regression analyses were used to select variables of the nomogram. The nomogram was evaluated by receiver-operating characteristic curve, calibration plots, and decision curve analysis (DCA).

RESULTS

In all, 2494 and 1068 participants were included in the training cohort and the validation cohort, respectively. A total of 413 participants developed CKD in the following 4 years. Five variables selected by multivariate logistic regression were incorporated in the nomogram, consisting of gender, hypertension, the estimated glomerular filtration rate (eGFR), hemoglobin, and Cystatin C. The area under curve was 0.809 and 0.837 in the training cohort and the validation cohort, respectively. The calibration plots showed agreement between the nomogram-predicted probability and the observed probability. DCA indicated that the nomogram had potential clinical use.

CONCLUSIONS

A predictive nomogram was established and internally validated in aid of identifying individuals at increased risk of CKD.

Does environmental regulation improve public health? Evidence from China's Two Control Zones policy

Improving public health is the premise of sustainable human development and an essential condition of economic growth. However, increasing severe environmental pollution poses a threat to public health. Implementing environmental regulation policy has become a meaningful way to control environmental pollution and the basis and guarantee for achieving public health. This paper aims to study the impact of environmental regulation on public health. The Two Control Zones (TCZ) policy is the earliest and stricter environmental regulation in China. Based on the policy experiment of TCZ, this paper analyzes the role of TCZ policy in improving public health using the DID model and data from 112 cities. The study finds that the TCZ policy can significantly improve public health, and this improvement effect was continuous and lagging. The results of benchmark regression show that the implementation of the TCZ policy has reduced the incidence rate of respiratory diseases in TCZ areas by 5.7%. When considering city heterogeneity in terms of economic and geographical conditions, the study further found that the impact of improvement is largest for cities in more heavily non-provincial capital and central and western regions, respectively. In addition, the results of mediating test show that TCZ policy improves public health by reducing environmental pollution. Our research fills the gap in the literature on the micro effects of environmental regulation policy on public health in developing countries. The government should prioritize environmental pollution control through reasonable environmental regulation policies. The government should strengthen environmental information disclosure to remind the public to deal with air pollution. The government and enterprises also should take various environmental protection measures to reduce air pollution emissions.

Can Marketization of Environmental Governance Improve Public Health?-Empirical Analysis Based on the Emission Trading System

To deal with the pollution issue caused by long-term economic development, China has introduced a number of environmental governance measures and made some progress. In the context of the strategy of developing a "Healthy China", the Chinese government proposed to include health in the formulation and implementation of environmental regulation policies, which places a higher demand on the implementation effect of environmental policies. This study attempts to clarify the causal link between market-based environmental governance and public health, and quantify the implementation effects of market-oriented environmental governance, so as to provide accurate assessments for addressing environmental degradation and improving public health. Based on the CHNS database and provincial panel data from 2000 to 2015, this paper constructs a binary logit-based difference-in-difference model to investigate the effects of the emission trading system (ETS) pilot policy on public health measured by the incidence of respiratory diseases, heart disease, and other diseases. The results show that ETS significantly reduces the incidence of respiratory and other diseases but has no significant impact on the incidence of heart diseases. The improvement effects of ETS on public health mainly come from the reduction of SO₂ under the principle of total volume control. However, heterogeneity analysis reveals that the health-improving effects of ETS are not as expected. Although ETS can enhance the health of vulnerable populations, such as workers near pollution sources and rural residents, it has no discernible impact on the health of those far from pollution sources and urban residents.

Haze pollution reduction in Chinese cities: Has digital financial development played a role?

Based on the exogenous shock of digital financial development in China in 2013, a difference-in-differences (DID) model is set up in this paper to investigate the causal relationship between digital financial development and haze pollution reduction. The finding of the paper is that a one standard deviation increase in digital finance after 2013 decreases the PM2.5 concentrations by 0.2708 standard deviations. After a number of robustness checks, like placebo tests, instrumental variable (IV) estimations, eliminating disruptive policies, and using alternative specifications, this causal effect is not challenged. In addition, this paper explores three potential mechanisms of digital finance to reduce haze pollution: technological innovation, industrial upgrading, and green development. Moreover, the heterogeneous effects signify that the usage depth of digital finance works best in haze pollution reduction. Digital finance has more positive effects in cities in the north and those with superior Internet infrastructure and higher levels of traditional financial development. However, the quantile regression estimates suggest that for cities with light or very serious haze pollution, the positive impact of digital finance is limited. These findings supplement the research field on the environmental benefits of digital finance, which provides insights for better public policies about digital financial development to achieve haze pollution reduction.

The Impact of Sustainable Growth and Sustainable Environment on Public Health: A Study of GCC Countries

The current study investigates the impact of economic growth, carbon emission, temperature, and environmental technology on public health in GCC countries. Panel data from 1990 to 2020 is used, and the panel unit root test is used to check the stationarity of the data. After cointegration analysis, the ARDL estimation technique checks the long-run and short-run association between variables. The results have proved that economic growth enhances exposure to PM2.5 and mortality but helps in increasing life expectancy. Likewise, carbon emission also enhances exposure to PM2.5 and mortality but improves life expectancy. As far as temperature is concerned, although it increases the exposure to PM2.5, it also increases life expectancy. It is also found that environmental technology enhances exposure to PM2.5. For policy implication, the study reports that investment in research and development and modifications the energy mix are key measures to enhance the public health in GCC countries.