Air pollution, healthcare use, and inequality: Evidence from China

• Published in: Economic modelling Vol. 141; p. 106905
• Main Authors: Jin, Bohan, Li, Zheng
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.12.2024
• Subjects: Air pollution; China; Environmental justice; Health inequality; Healthcare use; Q56; Health inequality; China; Air pollution; Q51; I14; Healthcare use; Environmental justice; Q53
• ISSN: 0264-9993
• DOI: 10.1016/j.econmod.2024.106905

This study provides the first investigation into the causal distributional effects of air pollution on healthcare utilization in China. Studies have addressed the average impact of air pollution in developed countries while overlooking its distributional effects in developing nations where inequality is evident. We obtained data from the China Health and Retirement Longitudinal Study and employed wind direction as an instrumental variable. The findings indicate that air pollution significantly increased inpatient care use among individuals aged 60 and above. Moreover, the study documents significant disparities between and within urban and rural populations. The mechanism analysis indicates that accessibility of healthcare services contributes to inequality. Contributing factors include China's Hukou system, health insurance system, and the distance to hospitals in rural areas. The findings indicate that air pollution intensifies health inequality in the developing world while suggesting that policies to increase healthcare equity could generate significant welfare benefits. •We examine the distributional effects of air pollution on healthcare use in China.•Air pollution increases inpatient care among individuals above 60 years.•Significant disparities exist between and within urban and rural populations.•Accessibility and availability of healthcare services contribute to this inequality.•Findings indicate the need for policies promoting healthcare equity in China.