IDEAS home Printed from https://ideas.repec.org/a/eee/ecolet/v192y2020ics0165176520301580.html
   My bibliography  Save this article

The effect of clean air on pharmaceutical expenditures

Author

Listed:
  • Rohlf, Alexander
  • Holub, Felix
  • Koch, Nicolas
  • Ritter, Nolan

Abstract

Airborne emissions are detrimental to health. Low emission zones (LEZs) that restrict pollution-intensive vehicles from entering are popular measures to curb local emissions such as particulate matter. We evaluate how LEZs impact defensive pharmaceutical expenditures. To this end, we use the complete medical histories of 2.7M individuals insured with Germany’s largest public health insurer AOK. We identify causal effects exploiting the quasi-experimental, staggered introduction of LEZs in 49 cities. We find that LEZs reduce annual pharmaceutical expenditures for heart and respiratory diseases by 15.8M€, representing a significant fraction of policy costs.

Suggested Citation

  • Rohlf, Alexander & Holub, Felix & Koch, Nicolas & Ritter, Nolan, 2020. "The effect of clean air on pharmaceutical expenditures," Economics Letters, Elsevier, vol. 192(C).
    • Handle: RePEc:eee:ecolet:v:192:y:2020:i:c:s0165176520301580
    DOI: 10.1016/j.econlet.2020.109221
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0165176520301580
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.econlet.2020.109221?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Olivier Deschênes & Michael Greenstone & Joseph S. Shapiro, 2017. "Defensive Investments and the Demand for Air Quality: Evidence from the NOx Budget Program," American Economic Review, American Economic Association, vol. 107(10), pages 2958-2989, October.
    2. Gehrsitz, Markus, 2017. "The effect of low emission zones on air pollution and infant health," Journal of Environmental Economics and Management, Elsevier, vol. 83(C), pages 121-144.
    3. Pestel, Nico & Wozny, Florian, 2019. "Low Emission Zones for Better Health: Evidence from German Hospitals," IZA Discussion Papers 12545, Institute of Labor Economics (IZA).
    4. Andrew Goodman-Bacon, 2018. "Difference-in-Differences with Variation in Treatment Timing," NBER Working Papers 25018, National Bureau of Economic Research, Inc.
    5. Hendrik Wolff, 2014. "Keep Your Clunker in the Suburb: Low‐emission Zones and Adoption of Green Vehicles," Economic Journal, Royal Economic Society, vol. 124(578), pages 481-512, August.
    6. Kurt Schmidheiny & Sebastian Siegloch, 2023. "On event studies and distributed‐lags in two‐way fixed effects models: Identification, equivalence, and generalization," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 38(5), pages 695-713, August.
    7. Joshua Graff Zivin & Matthew Neidell, 2013. "Environment, Health, and Human Capital," Journal of Economic Literature, American Economic Association, vol. 51(3), pages 689-730, September.
    8. Austin M. Williams & Daniel J. Phaneuf, 2019. "The Morbidity Costs of Air Pollution: Evidence from Spending on Chronic Respiratory Conditions," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 74(2), pages 571-603, October.
    9. Wolff, Hendrik, 2014. "Keep Your Clunker in the Suburb: Low Emission Zones and Adoption of Green Vehicles," IZA Discussion Papers 8180, Institute of Labor Economics (IZA).
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Pestel, Nico & Wozny, Florian, 2021. "Health effects of Low Emission Zones: Evidence from German hospitals," Journal of Environmental Economics and Management, Elsevier, vol. 109(C).
    2. Shuhei Nishitateno & Paul J. Burke, 2024. "Effects of Low Emission Zones on Air Quality, New Vehicle Registrations, and Birthweights: Evidence from Japan," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 87(7), pages 1955-1992, July.
    3. Luis Sarmiento & Nicole Wägner & Aleksandar Zaklan, 2021. "Effectiveness, Spillovers, and Well-Being Effects of Driving Restriction Policies," Discussion Papers of DIW Berlin 1947, DIW Berlin, German Institute for Economic Research.
    4. Kang, Cheolmin & Ota, Mitsuru & Ushijima, Koichi, 2024. "Benefits of diesel emission regulations: Evidence from the World's largest low emission zone," Journal of Environmental Economics and Management, Elsevier, vol. 125(C).
    5. Meng, Meng & Zhang, Wuke & Zhu, Xi & Shi, Qinghua, 2024. "Agricultural mechanization and rural worker mobility: Evidence from the Agricultural Machinery Purchase Subsidies programme in China," Economic Modelling, Elsevier, vol. 139(C).
    6. Hannah Klauber & Felix Holub & Nicolas Koch & Nico Pestel & Nolan Ritter & Alexander Rohlf, 2024. "Killing Prescriptions Softly: Low Emission Zones and Child Health from Birth to School," American Economic Journal: Economic Policy, American Economic Association, vol. 16(2), pages 220-248, May.
    7. Sarmiento, Luis & Wägner, Nicole & Zaklan, Aleksandar, 2023. "The air quality and well-being effects of low emission zones," Journal of Public Economics, Elsevier, vol. 227(C).
    8. Aydin, Eren & Gehrsitz, Markus & Traxler, Christian, 2024. "Greener Fleet, Cleaner Air: How Low Emission Zones Reduce Pollution," IZA Discussion Papers 17144, Institute of Labor Economics (IZA).
    9. Beshir, H.A.; & Fichera, E.;, 2022. "“And Breathe Normally†: The Low Emission Zone impacts on health and well-being in England," Health, Econometrics and Data Group (HEDG) Working Papers 22/09, HEDG, c/o Department of Economics, University of York.
    10. Gruhl, Henri & Volkhausen, Nicolas & Pestel, Nico & aus dem Moore, Nils, 2022. "Air pollution and the housing market: Evidence from Germany's Low Emission Zones," Ruhr Economic Papers 977, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hannah Klauber & Felix Holub & Nicolas Koch & Nico Pestel & Nolan Ritter & Alexander Rohlf, 2024. "Killing Prescriptions Softly: Low Emission Zones and Child Health from Birth to School," American Economic Journal: Economic Policy, American Economic Association, vol. 16(2), pages 220-248, May.
    2. Beshir, H.A.; & Fichera, E.;, 2022. "“And Breathe Normally†: The Low Emission Zone impacts on health and well-being in England," Health, Econometrics and Data Group (HEDG) Working Papers 22/09, HEDG, c/o Department of Economics, University of York.
    3. Margaryan, Shushanik, 2021. "Low emission zones and population health," Journal of Health Economics, Elsevier, vol. 76(C).
    4. Helm, Ines & Koch, Nicolas & Rohlf, Alexander, 2023. "The effects of cash for clunkers on local air quality," Journal of Urban Economics, Elsevier, vol. 138(C).
    5. Nico Pestel & Florian Wozny, 2019. "Low Emission Zones for Better Health: Evidence from German Hospitals," CINCH Working Paper Series 1908, Universitaet Duisburg-Essen, Competent in Competition and Health.
    6. Sarmiento, Luis & Wägner, Nicole & Zaklan, Aleksandar, 2021. "Effectiveness, Spillovers, and Well-Being Effects of Driving Restriction Policies," RFF Working Paper Series 21-13, Resources for the Future.
    7. Pestel, Nico & Wozny, Florian, 2021. "Health effects of Low Emission Zones: Evidence from German hospitals," Journal of Environmental Economics and Management, Elsevier, vol. 109(C).
    8. Isaksen, Elisabeth & Johansen, Bjørn G., 2021. "Congestion pricing, air pollution, and individual-level behavioural responses," LSE Research Online Documents on Economics 111493, London School of Economics and Political Science, LSE Library.
    9. Shuhei Nishitateno & Paul J. Burke, 2024. "Effects of Low Emission Zones on Air Quality, New Vehicle Registrations, and Birthweights: Evidence from Japan," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 87(7), pages 1955-1992, July.
    10. Shihe Fu & V. Brian Viard, 2022. "A mayors perspective on tackling air pollution," Chapters, in: Charles K.Y. Leung (ed.), Handbook of Real Estate and Macroeconomics, chapter 16, pages 413-437, Edward Elgar Publishing.
    11. Austin, Wes & Carattini, Stefano & Gomez-Mahecha, John & Pesko, Michael F., 2023. "The effects of contemporaneous air pollution on COVID-19 morbidity and mortality," Journal of Environmental Economics and Management, Elsevier, vol. 119(C).
    12. Sarmiento, Luis & Wägner, Nicole & Zaklan, Aleksandar, 2023. "The air quality and well-being effects of low emission zones," Journal of Public Economics, Elsevier, vol. 227(C).
    13. Chen, Shiyi & Jiang, Lingduo & Liu, Wanlin & Song, Hong, 2022. "Fireworks regulation, air pollution, and public health: Evidence from China," Regional Science and Urban Economics, Elsevier, vol. 92(C).
    14. Isaksen, Elisabeth T. & Johansen, Bjørn G., 2021. "Congestion pricing, air pollution, and individual-level behavioral responses," Memorandum 1/2021, Oslo University, Department of Economics.
    15. Hongfeng Zhang & Lu Huang & Yan Zhu & Hongyun Si & Xu He, 2021. "Does Low-Carbon City Construction Improve Total Factor Productivity? Evidence from a Quasi-Natural Experiment in China," IJERPH, MDPI, vol. 18(22), pages 1-21, November.
    16. Wang, Chang’an & Liu, Xiaoqian & Li, Han & Yang, Cunyi, 2023. "Analyzing the impact of low-carbon city pilot policy on enterprises' labor demand: Evidence from China," Energy Economics, Elsevier, vol. 124(C).
    17. Xu, Aiting & Zhu, Yuhan & Wang, Wenpu, 2023. "Micro green technology innovation effects of green finance pilot policy—From the perspectives of action points and green value," Journal of Business Research, Elsevier, vol. 159(C).
    18. Xu, Lan & Yang, Jun & Cheng, Jixin & Dong, Hanghang, 2022. "How has China's low-carbon city pilot policy influenced its CO2 abatement costs? Analysis from the perspective of the shadow price," Energy Economics, Elsevier, vol. 115(C).
    19. Bing Kuang & Jinjin Liu & Xiangyu Fan, 2022. "Has China’s Low-Carbon City Construction Enhanced the Green Utilization Efficiency of Urban Land?," IJERPH, MDPI, vol. 19(16), pages 1-20, August.
    20. Lan, Jing & Li, Qiuming & Zheng, Yuqing & Liu, Zhen, 2023. "The impact of the Low-Carbon City Pilots programme on industrial land transfer by local governments in China," Economic Analysis and Policy, Elsevier, vol. 77(C), pages 824-842.

    More about this item

    Keywords

    Air pollution; Driving ban; Quasi-experiment; Pharmaceutical expenditures; Health;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • Q52 - Agricultural and Natural Resource Economics; Environmental and Ecological Economics - - Environmental Economics - - - Pollution Control Adoption and Costs; Distributional Effects; Employment Effects
    • Q53 - Agricultural and Natural Resource Economics; Environmental and Ecological Economics - - Environmental Economics - - - Air Pollution; Water Pollution; Noise; Hazardous Waste; Solid Waste; Recycling
    • Q58 - Agricultural and Natural Resource Economics; Environmental and Ecological Economics - - Environmental Economics - - - Environmental Economics: Government Policy

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:ecolet:v:192:y:2020:i:c:s0165176520301580. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/ecolet .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.