Environmental Research Letters (Jan 2024)
Unappreciated healthcare inequality against PM2.5-related mortality risk
Abstract
Understanding the inequality of PM _2.5 -related health is crucial for promoting health, building a just society, and advancing multiple Sustainable Development Goals goals. However, previous research has predominantly concentrated on PM _2.5 exposure inequality, neglecting varied prompt responses and protective behaviors against it. Here, we established the relationship between short-term healthcare expenditure and PM _2.5 concentration using the number and amount of healthcare transactions across all healthcare categories based on the Union Pay data. We also assessed daily city-specific PM _2.5 -related mortality and healthcare expenditures and evaluated their inequalities among cities according to the income inequality index, the Gini coefficient. The results show that short-term exposure to PM _2.5 leads to severe physiological and health-related economic burdens on Chinese residents. From 2017 to 2019, 77.8 (34.5–121.1) thousand deaths were attributed to daily PM _2.5 , with healthcare expenditures reaching 93.7 (69.1–118.3) billion Chinese Yuan. Additionally, there were significant inequalities in PM _2.5 -related mortality and healthcare expenditures among cities. The inequality index for PM _2.5 -related healthcare expenditures was 0.53, while the inequality index for PM _2.5 -related mortality was 0.13. The greater inequality in healthcare expenditures than in mortality, implying inadequate healthcare resources amplify the health inequality related to PM _2.5 exposure. 28.6% of Chinese cities lacked affordable healthcare resources to address the high physiological burden attributable to PM _2.5 . Our multidimensional exploration is essential for formulating effective policies addressing environmental health inequality. Focusing on these cities with disproportionate challenges is crucial for creating a more equitable and sustainable society.
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