The cost of digital convenience: Food delivery platform entry, health, and medical spending

Food-delivery platforms have rapidly expanded in China, but their health consequences remain underexplored. Using six waves of the China Family Panel Studies (CFPS) from 2010 to 2020 matched with city-level phased platform entry, we estimate the effects of food-delivery platform expansion on residents’ health and medical spending using a staggered difference-in-differences design. We find that platform entry robustly reduces self-rated health by 0.029 points on a five-point scale, where higher values indicate better health, and increases annual total medical expenditure and out-of-pocket spending by 12.3% and 13.8%, respectively. The evidence for chronic disease is directionally similar, with an estimated increase of 0.8 percentage points, but is more sensitive to assumptions about pre-treatment trends and is therefore interpreted more cautiously. These adverse effects are more pronounced among men and individuals without tertiary education. To examine potential pathways, we construct a healthy-lifestyle index covering diet quality, physical exercise, smoking and drinking behaviors, and psychological well-being. The results suggest that platform entry is associated with poorer diet quality, less exercise, more smoking and drinking, and worse mental health. Overall, the findings indicate that the health consequences of digital food environments should be incorporated into evaluations of platform economies. They also point to the value of public health interventions embedded in platform governance, including nutrition disclosure, healthier default and ranking designs, and targeted health nudges for more vulnerable groups.