Does Industrial Air Pollution Increase Health Care Expenditure? Evidence From China

Shen, Jin-Sheng; Wang, Qun; Shen, Han-Pu

doi:10.3389/fpubh.2021.695664

Cited by 16 publications

(12 citation statements)

References 47 publications

(52 reference statements)

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“…In our study, the rst nding was that exposure to PM 2.5 would lead to increased medical expenditures, which was corroborated by previous surveys focused on adults [42][43][44][45][46]. According to the participants models, a ten-µg/m 3 increment in PM 2.5 was associated with 2.23 times (exp (0.80) = 2.23) the possibility of incurring any medical expenditures, the magnitude of estimation was 1.08 times (exp (0.80) = 1.08) in the intensity models; these results were higher than the previous study based on individual microdata from the China Urban Household Survey (UHS) Database and pointed out that increased exposure to PM 2.5 contributed to a 2.94% (95%CI: 1.08%-4.80%) increase in household healthcare expenditure [10].…”

Section: Discussionsupporting

confidence: 88%

Air pollution, residential greenness and medical expenditure in older adults

Zhou

Wang

et al. 2022

Preprint

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Background: Environmental factors have been thought of as potential determinants for human health and would plausibly affect health expenditures. However, little is known about the association between air pollution, greenness, and their combined effect on medical expenditures, let alone, related evidence in older adults is rarely. Method: We used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Medical expenditures were defined as out-of-pocket medical expenditures in the 12 months preceding the survey. A two-year average of PM2.5 concentrations prior to medical expenditures was collected as PM2.5 exposures. Greenness exposure was contemporaneous with PM2.5 and evaluated by residential units’ NDVI value in 250 m buffer. The two-part models were performed to assess the independent influences of PM2.5, greenness, and its combined influence. The first model was a logistic regression model based on the whole sample, called the participation models. Then a log-transformed linear regression model was fitted using samples with nonzero medical expenditures, named intensity models. Result: We found that each 10-µg/m3 increment in PM2.5 increased the odds of incurring any costs (coefficient=0.80, P <0.001) according to the participation models. PM2.5 was associated with an increase in expenditure based on intensity models (coefficient=0.08, P <0.001). Each 0.1-unit increase in greenness decreased the odds of incurring any costs in the participation models (coefficient=-0.77, P <0.05). The risk of increasing medical expenditures attributed to PM2.5was higher in areas with a low level of greenness (coefficient=0.16, P <0.001). While greenness did not present a protective effect for increasing costs in the low level of PM2.5 (coefficient=0.21, P <0.05), increasing greenness could reduce costs in the high and medium level of PM2.5. Uneducated participants and others without pensions were vulnerable to the combined effect. Conclusion: Air pollution is a potential source of medical expenditures; in comparison, expanding greenspace is associated with these societal costs saved. Suppose the combined impact of greenness and PM2.5 was to be replicated in a future study, which would improve the utility of current evidence.

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Section: Discussionsupporting

confidence: 88%

Air pollution, residential greenness and medical expenditure in older adults

Zhou

Wang

et al. 2022

Preprint

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“…Liao et al ( 26 ), however, used data from the 2016 and 2018 China Family Panel Studies (CFPS) and found that PM 2.5 , which increases the cost of air pollution by affecting lifestyle (sleeping time and sedentary activities hours), will increase household health care expenditure and out-of-pocket hospital expenditure, and that the effect is more pronounced in younger age groups. Shen et al ( 27 ) focused on the impact of industrial air pollution on health expenditure by region using province-level panel data for the period 2002–2015. They found that air pollution has a greater effect in central and eastern China and a non-linear impact in western China, with a negative impact below the threshold.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Second, compared to consumer data, the data obtained from hospitals contain richer information about individual medical histories, enabling the study to be conducted in the appropriate pathological context. Furthermore, these data include the specific visit dates for all patients from January 2016 to December 2017; hence, the data better capture daily air quality trends by matching daily air pollution indicators, whereas the annual data of Liao et al ( 26 ) and Shen et al ( 27 ) used only the air quality for the entire year.…”

Section: Literature Reviewmentioning

confidence: 99%

Health Benefits of Air Quality Improvement: Empirical Research Based on Medical Insurance Reimbursement Data

Ding

Han

et al. 2022

Front. Public Health

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Measuring the health benefits of air quality improvement is a new perspective for evaluating government investment in pollution control. Improving air quality can reduce the burden on medical insurance funds and patients themselves; however, patients with higher reimbursement rates are more affected by air quality changes. This study calculated health benefits using medical insurance reimbursement data from a sample city in China. The results show that for every 10 μg/m3 decrease in PM2.5, patients' average medical cost will decrease by CNY 1,699 (USD 263.6), and the loss of ordinary working and living time will decrease by 1.24 days. PM2.5 has a more significant impact on patients with chronic respiratory diseases and inpatients with circulatory diseases. Suppose the city's annual PM2.5 concentration drops to the national standard of 35 μg/m3. In that case, it will bring more than CNY 1.28 billion (USD 198 million) in health benefits, accounting for 18% of the city's annual investment in environmental protection.

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“…Therefore, the purpose of this research is to contribute to the literature by studying the impact of environmental factors (air pollution and temperature) on health expenditures in developing countries. Secondly, previous studies have studied the association between air pollution and health spending using carbon monoxide (CO), carbon dioxide (CO 2 ), nitrogen oxide (NOx) and sulfur dioxide (SO 2 ) as measures of air pollution [ 24 , 25 , 26 , 27 , 28 ], whereas this study used PM 2.5 as a measure of air pollution as it is considered to be a more useful indicator of air pollution. Thirdly, the studies examined the relationship between temperature and health expenditure using cross sectional data, while we use panel data to analyze the role of climate change in affecting health expenditure in developing countries.…”

Section: Introductionmentioning

confidence: 99%

Impact of Environmental Quality on Healthcare Expenditures in Developing Countries: A Panel Data Approach

et al. 2022

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Objective: The deterioration in environmental quality has an economic and social cost. The aim of this study is to analyze the impact of environmental factors on health expenditures in developing countries. Method: To analyze the relationship between environmental quality (air pollution and temperature) and health expenditure in thirty-three developing countries, the study uses system generalized method of moments (GMM) using data from 2000 to 2017. Results: The results suggest a positive effect of both air pollution and temperature on health expenditure. However, the effect is highest for government health expenditure, followed by private and total health expenditure in the studied countries. The results further suggest that the impact of environmental factors is greater in higher-income countries when we divide the studied countries into two groups, i.e., higher- and lower-income countries. Conclusion: Our results are interesting and informative for the policy makers to design such policies to attain better environmental quality and social well-being. The increased healthcare expenditures due to increased air pollution and climate change necessitate for an efficient, reliable, affordable and modern energy policy by emphasizing the use of clean and renewable energy in these countries that ensure better health for the masses. Furthermore, a smart and sustainable environmentally friendly economic growth policy is necessary to ensure better health for the masses.

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Does Industrial Air Pollution Increase Health Care Expenditure? Evidence From China

Cited by 16 publications

References 47 publications

Air pollution, residential greenness and medical expenditure in older adults

Air pollution, residential greenness and medical expenditure in older adults

Health Benefits of Air Quality Improvement: Empirical Research Based on Medical Insurance Reimbursement Data

Impact of Environmental Quality on Healthcare Expenditures in Developing Countries: A Panel Data Approach

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