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      Impact of Air Pollution on Residents' Medical Expenses: A Study Based on the Survey Data of 122 Cities in China

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          Abstract

          Background: 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.

          Methods: 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.

          Results: 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.

          Conclusion: 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.

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          Most cited references61

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          Evidence on the impact of sustained exposure to air pollution on life expectancy from China's Huai River policy.

          This paper's findings suggest that an arbitrary Chinese policy that greatly increases total suspended particulates (TSPs) air pollution is causing the 500 million residents of Northern China to lose more than 2.5 billion life years of life expectancy. The quasi-experimental empirical approach is based on China's Huai River policy, which provided free winter heating via the provision of coal for boilers in cities north of the Huai River but denied heat to the south. Using a regression discontinuity design based on distance from the Huai River, we find that ambient concentrations of TSPs are about 184 μg/m(3) [95% confidence interval (CI): 61, 307] or 55% higher in the north. Further, the results indicate that life expectancies are about 5.5 y (95% CI: 0.8, 10.2) lower in the north owing to an increased incidence of cardiorespiratory mortality. More generally, the analysis suggests that long-term exposure to an additional 100 μg/m(3) of TSPs is associated with a reduction in life expectancy at birth of about 3.0 y (95% CI: 0.4, 5.6).
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            On the Concept of Health Capital and the Demand for Health

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              Shadow Prices, Market Wages, and Labor Supply

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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                20 December 2021
                2021
                : 9
                Affiliations
                [1] 1School of Public Administration, Zhejiang University of Finance and Economics , Hangzhou, China
                [2] 2School of Political Science and Public Administration, Wuhan University , Wuhan, China
                Author notes

                Edited by: Xinming Wang, Chinese Academy of Sciences, China

                Reviewed by: Chunlei Han, Binzhou Medical University, China; Mohammadjavad ZareSakhvidi, Shahid Sadoughi University of Medical Sciences and Health Services, Iran

                *Correspondence: Meng Wang wangmengbnugeo@ 123456gmail.com

                This article was submitted to Environmental health and Exposome, a section of the journal Frontiers in Public Health

                †These authors have contributed equally to this work and share first authorship

                Article
                10.3389/fpubh.2021.743087
                8720779
                f3ace107-31bf-4b66-b1fb-aba26a8e09db
                Copyright © 2021 Liu, Hu and Wang.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 1, Tables: 9, Equations: 5, References: 64, Pages: 14, Words: 9677
                Categories
                Public Health
                Original Research

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