IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v30y2021i4p858-875.html
   My bibliography  Save this article

Effect of air pollution on health care expenditure: Evidence from respiratory diseases

Author

Listed:
  • Ya‐Ming Liu
  • Chon‐Kit Ao

Abstract

Recent reports show that at least 95% of the world's population is breathing polluted air. However, the impact of air quality on air pollution‐related medical expenditure and utilization is sparse. This study estimates the short‐term health care cost impacts of air pollution using a meteorological phenomenon—thermal inversion—as an instrumental variable for air quality. Using information on outpatient care for respiratory diseases from universal health insurance claim data in Taiwan during 2006–2012, our estimates suggest that a one‐unit reduction in the air quality index (AQI) leads to NT$2.3 billion (nearly US$74 million) of savings in respiratory‐related outpatient expenditure per year. Given that the average AQI is equal to 32 during our study period, completely removing air pollution would reduce the national health expenditure by approximately 8% annually. Our results provide the important implication that the cost of controlling air pollutant emissions can be offset by curtailing health care expenditure.

Suggested Citation

  • Ya‐Ming Liu & Chon‐Kit Ao, 2021. "Effect of air pollution on health care expenditure: Evidence from respiratory diseases," Health Economics, John Wiley & Sons, Ltd., vol. 30(4), pages 858-875, April.
  • Handle: RePEc:wly:hlthec:v:30:y:2021:i:4:p:858-875
    DOI: 10.1002/hec.4221
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.4221
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.4221?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
    ---><---

    References listed on IDEAS

    as
    1. Tatyana Deryugina & Garth Heutel & Nolan H. Miller & David Molitor & Julian Reif, 2019. "The Mortality and Medical Costs of Air Pollution: Evidence from Changes in Wind Direction," American Economic Review, American Economic Association, vol. 109(12), pages 4178-4219, December.
    2. Eva Arceo & Rema Hanna & Paulina Oliva, 2016. "Does the Effect of Pollution on Infant Mortality Differ Between Developing and Developed Countries? Evidence from Mexico City," Economic Journal, Royal Economic Society, vol. 126(591), pages 257-280, March.
    3. Jans, Jenny & Johansson, Per & Nilsson, J. Peter, 2018. "Economic status, air quality, and child health: Evidence from inversion episodes," Journal of Health Economics, Elsevier, vol. 61(C), pages 220-232.
    4. Christopher R. Knittel & Douglas L. Miller & Nicholas J. Sanders, 2016. "Caution, Drivers! Children Present: Traffic, Pollution, and Infant Health," The Review of Economics and Statistics, MIT Press, vol. 98(2), pages 350-366, May.
    5. 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.
    6. Janet Currie & Matthew Neidell, 2005. "Air Pollution and Infant Health: What Can We Learn from California's Recent Experience?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 120(3), pages 1003-1030.
    7. Rachel Lu, Jui-Fen & Chiang, Tung-Liang, 2011. "Evolution of Taiwan’s health care system," Health Economics, Policy and Law, Cambridge University Press, vol. 6(1), pages 85-107, January.
    8. Andrews, Donald W K, 1991. "Heteroskedasticity and Autocorrelation Consistent Covariance Matrix Estimation," Econometrica, Econometric Society, vol. 59(3), pages 817-858, May.
    9. Olivier Deschênes & Enrico Moretti, 2009. "Extreme Weather Events, Mortality, and Migration," The Review of Economics and Statistics, MIT Press, vol. 91(4), pages 659-681, November.
    10. Matthew Neidell, 2009. "Information, Avoidance Behavior, and Health: The Effect of Ozone on Asthma Hospitalizations," Journal of Human Resources, University of Wisconsin Press, vol. 44(2).
    11. Panle Jia Barwick & Shanjun Li & Deyu Rao & Nahim Bin Zahur, 2018. "The Morbidity Cost of Air Pollution: Evidence from Consumer Spending in China," Working Papers id:12825, eSocialSciences.
    12. Eben Lazarus & Daniel J. Lewis & James H. Stock & Mark W. Watson, 2018. "HAR Inference: Recommendations for Practice," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 36(4), pages 541-559, October.
    13. 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.
    14. Jiaxiu He & Haoming Liu & Alberto Salvo, 2019. "Severe Air Pollution and Labor Productivity: Evidence from Industrial Towns in China," American Economic Journal: Applied Economics, American Economic Association, vol. 11(1), pages 173-201, January.
    15. Shuai Chen & Paulina Oliva & Peng Zhang, 2018. "Air Pollution and Mental Health: Evidence from China," NBER Working Papers 24686, National Bureau of Economic Research, Inc.
    16. Wolfram Schlenker & W. Reed Walker, 2016. "Airports, Air Pollution, and Contemporaneous Health," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 83(2), pages 768-809.
    17. Eben Lazarus & Daniel J. Lewis & James H. Stock & Mark W. Watson, 2018. "HAR Inference: Recommendations for Practice Rejoinder," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 36(4), pages 574-575, October.
    18. Newey, Whitney & West, Kenneth, 2014. "A simple, positive semi-definite, heteroscedasticity and autocorrelation consistent covariance matrix," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 33(1), pages 125-132.
    19. Sager, Lutz, 2019. "Estimating the effect of air pollution on road safety using atmospheric temperature inversions," Journal of Environmental Economics and Management, Elsevier, vol. 98(C).
    20. Shuai Chen & Paulina Oliva & Peng Zhang, 2017. "The Effect of Air Pollution on Migration: Evidence from China," NBER Working Papers 24036, National Bureau of Economic Research, Inc.
    21. Janke, Katharina, 2014. "Air pollution, avoidance behaviour and children's respiratory health: Evidence from England," Journal of Health Economics, Elsevier, vol. 38(C), pages 23-42.
    22. Enrico Moretti & Matthew Neidell, 2011. "Pollution, Health, and Avoidance Behavior: Evidence from the Ports of Los Angeles," Journal of Human Resources, University of Wisconsin Press, vol. 46(1), pages 154-175.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 29th March 2021
      by Chris Sampson in The Academic Health Economists' Blog on 2021-03-29 11:00:13

    Citations

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


    Cited by:

    1. Manuela Fritz, 2022. "Temperature and non‐communicable diseases: Evidence from Indonesia's primary health care system," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2445-2464, November.
    2. Chen, Fanglin & Zhang, Xin & Chen, Zhongfei, 2023. "Air pollution and mental health: Evidence from China Health and Nutrition Survey," Journal of Asian Economics, Elsevier, vol. 86(C).
    3. Syed Hasan & Odmaa Narantungalag, & Martin Berka, 2022. "The intended and unintended consequences of large electricity subsidies: evidence from Mongolia," Discussion Papers 2202, School of Economics and Finance, Massey University, New Zealand.
    4. Mengna Luan & Zhigang Tao & Hongjie Yuan, 2023. "Alive but not well: The neglected cost of air pollution," Health Economics, John Wiley & Sons, Ltd., vol. 32(11), pages 2535-2567, November.
    5. Wang, Qinyun & Wang, Xuebin & Yan, Qianhui & Zhang, Lvqing, 2024. "Heavy industry regulations, hospitalization, and medical expenditures: Evidence from micro-level medical records in a northeast Chinese city," Energy Economics, Elsevier, vol. 129(C).
    6. Pessôa, Ana Carolina M. & Morello R.S., Thiago F. & Silva-Junior, Celso H.L. & Doblas, Juan & Carvalho, Nathália S. & Aragão, Luiz E.O.C. & Anderson, Liana O., 2023. "Protected areas are effective on curbing fires in the Amazon," Ecological Economics, Elsevier, vol. 214(C).
    7. Fonseca Morello, Thiago, 2023. "Hospitalization due to fire-induced pollution in the Brazilian Amazon: A causal inference analysis with an assessment of policy trade-offs," World Development, Elsevier, vol. 161(C).

    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. Mengna Luan & Zhigang Tao & Hongjie Yuan, 2023. "Alive but not well: The neglected cost of air pollution," Health Economics, John Wiley & Sons, Ltd., vol. 32(11), pages 2535-2567, November.
    2. Gillingham, Kenneth & Huang, Pei, 2021. "Racial disparities in the health effects from air pollution: Evidence from ports," ZEW Discussion Papers 21-058, ZEW - Leibniz Centre for European Economic Research.
    3. Colmer, Jonathan & Lin, Dajun & Liu, Siying & Shimshack, Jay, 2021. "Why are pollution damages lower in developed countries? Insights from high-Income, high-particulate matter Hong Kong," Journal of Health Economics, Elsevier, vol. 79(C).
    4. Deschenes, Olivier & Wang, Huixia & Wang, Si & Zhang, Peng, 2020. "The effect of air pollution on body weight and obesity: Evidence from China," Journal of Development Economics, Elsevier, vol. 145(C).
    5. Huang, Jialin & Xing, Jianwei & Yongchen Zou, Eric, 2023. "(Re)scheduling pollution exposure: The case of surgery schedules," Journal of Public Economics, Elsevier, vol. 219(C).
    6. Wen Hsu & Bing-Fang Hwang & Chau-Ren Jung & Yau-Huo Jimmy Shr, 2021. "Can Air Pollution Save Lives? Air Quality and Risky Behaviors on Roads," Papers 2111.06837, arXiv.org, revised Dec 2021.
    7. Xia, Fan & Xing, Jianwei & Xu, Jintao & Pan, Xiaochuan, 2022. "The short-term impact of air pollution on medical expenditures: Evidence from Beijing," Journal of Environmental Economics and Management, Elsevier, vol. 114(C).
    8. Shr, Yau-Huo & Hsu, Wen & Hwang, Bing-Fang & Jung, Chau-Ren, 2023. "Air quality and risky behaviors on roads," Journal of Environmental Economics and Management, Elsevier, vol. 118(C).
    9. Liao, Liping & Du, Minzhe & Chen, Zhongfei, 2021. "Air pollution, health care use and medical costs: Evidence from China," Energy Economics, Elsevier, vol. 95(C).
    10. Godzinski, Alexandre & Suarez Castillo, Milena, 2021. "Disentangling the effects of air pollutants with many instruments," Journal of Environmental Economics and Management, Elsevier, vol. 109(C).
    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. Qiu, Yun & Liu, Yunning & Shi, Wei & Zhou, Maigeng, 2024. "The impact of ozone pollution on mortality: Evidence from China," Journal of Environmental Economics and Management, Elsevier, vol. 125(C).
    13. Chen, Siyu & Guo, Chongshan & Huang, Xinfei, 2018. "Air Pollution, Student Health, and School Absences: Evidence from China," Journal of Environmental Economics and Management, Elsevier, vol. 92(C), pages 465-497.
    14. Giaccherini, Matilde & Kopinska, Joanna & Palma, Alessandro, 2021. "When particulate matter strikes cities: Social disparities and health costs of air pollution," Journal of Health Economics, Elsevier, vol. 78(C).
    15. Felix Holub & Laura Hospido & Ulrich J. Wagner, 2020. "Urban air pollution and sick leaves: evidence from social security data," Working Papers 2041, Banco de España.
    16. Xin Zhang & Xun Zhang & Yuehua Liu & Xintong Zhao & Xi Chen, 2023. "The morbidity costs of air pollution through the Lens of Health Spending in China," Journal of Population Economics, Springer;European Society for Population Economics, vol. 36(3), pages 1269-1292, July.
    17. Xiaojing Jia & Xin Luo, 2023. "Residents’ Health Effect of Environmental Regulations in Coal-Dependent Industries: Empirical Evidence from China’s Cement Industry," Sustainability, MDPI, vol. 15(3), pages 1-16, January.
    18. 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.
    19. 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).
    20. Julia Mink, 2024. "Putting a Price Tag on Air Pollution: The Social Healthcare Costs of Air Pollution in France," ECONtribute Discussion Papers Series 320, University of Bonn and University of Cologne, Germany.

    More about this item

    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:wly:hlthec:v:30:y:2021:i:4:p:858-875. 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: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    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.