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The Morbidity Cost of Air Pollution: Evidence from Consumer Spending in China


  • Panle Jia Barwick
  • Shanjun Li
  • Deyu Rao
  • Nahim Bin Zahur


Developing and fast-growing economies have some of the worse air pollution in the world, but there is a lack of systematic evidence on the health especially morbidity impact of air pollution in these countries. Based on the universe of credit and debit card transactions in China from 2013 to 2015, this paper provides to our knowledge the first analysis of the morbidity cost of PM2.5 for the entire population of a developing country. To address potential endogeneity in pollution exposure, we construct an instrumental variable by modeling the spatial spillovers of PM2.5 due to long-range transport. We propose a flexible distributed-lag model that incorporates the IV approach to capture the dynamic response to past pollution exposure. Our analysis shows that PM2.5 has a significant impact on healthcare spending in both the short and medium terms that survives an array of robustness checks. The annual reduction in national healthcare spending from complying with the World Health Organization’s annual standard of 10 mg/m3 would amount to $42 billion, or nearly 7% of China’s total healthcare spending in 2015. In contrast to the common perception that the morbidity impact is modest relative to the mortality impact, our estimated morbidity cost of air pollution is about two-thirds of the mortality cost from the recent literature.

Suggested Citation

  • Panle Jia Barwick & Shanjun Li & Deyu Rao & Nahim Bin Zahur, 2018. "The Morbidity Cost of Air Pollution: Evidence from Consumer Spending in China," NBER Working Papers 24688, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:24688
    Note: EEE

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    Cited by:

    1. Li, Pei & Lu, Yi & Wang, Jin, 2020. "The effects of fuel standards on air pollution: Evidence from China," Journal of Development Economics, Elsevier, vol. 146(C).
    2. Guidetti, Bruna & Pereda, Paula & Severnini, Edson R., 2020. "Health Shocks under Hospital Capacity Constraint: Evidence from Air Pollution in Sao Paulo, Brazil," IZA Discussion Papers 13211, Institute of Labor Economics (IZA).
    3. Fu, Shihe & Viard, Brian & Zhang, Peng, 2019. "Trans-Boundary Air Pollution Spillovers: Physical Transport and Economic Costs by Distance," MPRA Paper 102438, University Library of Munich, Germany, revised 14 Aug 2020.
    4. Yi, Fujin & Ye, Haijian & Wu, Ximing & Zhang, Y. Yvette & Jiang, Fei, 2020. "Self-aggravation effect of air pollution: Evidence from residential electricity consumption in China," Energy Economics, Elsevier, vol. 86(C).
    5. Julia Rechlitz & Luis Sarmiento & Aleksandar Zaklan, 2020. "Make Sure the Kids are OK: Indirect Effects of Ground-Level Ozone on Well-Being," Discussion Papers of DIW Berlin 1877, DIW Berlin, German Institute for Economic Research.
    6. He, Guojun & Liu, Tong & Zhou, Maigeng, 2020. "Straw burning, PM2.5, and death: Evidence from China," Journal of Development Economics, Elsevier, vol. 145(C).
    7. Luis Sarmiento, 2020. "I Am Innocent: Hourly Variations in Air Pollution and Crime Behavior," Discussion Papers of DIW Berlin 1879, DIW Berlin, German Institute for Economic Research.
    8. Chi-Yo Huang & Pei-Han Chung & Joseph Z. Shyu & Yao-Hua Ho & Chao-Hsin Wu & Ming-Che Lee & Ming-Jenn Wu, 2018. "Evaluation and Selection of Materials for Particulate Matter MEMS Sensors by Using Hybrid MCDM Methods," Sustainability, MDPI, Open Access Journal, vol. 10(10), pages 1-35, September.

    More about this item

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • Q51 - Agricultural and Natural Resource Economics; Environmental and Ecological Economics - - Environmental Economics - - - Valuation of Environmental Effects
    • Q53 - Agricultural and Natural Resource Economics; Environmental and Ecological Economics - - Environmental Economics - - - Air Pollution; Water Pollution; Noise; Hazardous Waste; Solid Waste; Recycling

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