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Background: Hypertension is rapidly increasing in China, but control rates are significantly low. There is a pressing need for effective management models in primary community health settings. Methods: In April 2023, 459 patients from six communities in Jinan City were enrolled using a multi-stage random sampling method and assigned to either a control group comprising 243 participants or an intervention group comprising 216 participants. The control group received standard hypertension care, whereas the intervention group participated in a novel IoT-based remote blood pressure monitoring program for 6 months. Data collection was conducted through detailed questionnaire surveys, cloud platform records, and community management records, both before and after the intervention period. The study employed difference-in-differences (DID) and mediation effect models to assess the effects of the IoT-based management model. Results: The DID model demonstrated that the intervention significantly reduced systolic blood pressure by 9.883 mm Hg and diastolic blood pressure by 6.553 mm Hg. The mediation effect model showed that the frequency of blood pressure measurement and attitudes and beliefs toward hypertension treatment had mediating effects, accounting for 5.82 and 8.07% of the total effect, respectively. The heterogeneity analysis revealed significant regional differences: rural residents experienced a greater decrease in systolic and diastolic blood pressures by 14.85 mm Hg and 6.591 mm Hg, respectively, compared to urban residents, whose diastolic pressure decreased by 6.046 mm Hg. Recommendations: It is advisable to develop differentiated hypertension management strategies tailored to specific regional needs to promote the deep integration and widespread application of smart blood pressure monitoring technology. Enhancing patient awareness and capabilities in managing their health condition is crucial for improving the blood pressure control level among community hypertension patients.
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Monitorização Ambulatorial da Pressão Arterial , Hipertensão , Humanos , Hipertensão/terapia , Feminino , Masculino , Pessoa de Meia-Idade , China , Idoso , Inquéritos e Questionários , Adulto , Serviços de Saúde Comunitária , Pressão Sanguínea/fisiologiaRESUMO
The establishment of green finance reform and innovation pilot zone (GFRIPZ) is a pivotal strategy for harmonizing the twin goals of economic prosperity and environmental preservation. By applying panel data on Chinese A-share listed firms from 2011 to 2022, this study examines the influence of China's green finance pilot policy on corporate environmental social responsibility (ESR) using a difference-in-differences (DID) model. The study's findings indicate that the green finance pilot policy promotes corporate environmental social responsibility. The results remain robust after a series of robustness tests. Moreover, mechanism analysis reveals that the pilot policy promotes firms' ESR through three key channels: financing constraints, green innovation, and corporate governance mechanisms. Additionally, analyst attention can positively moderate the promotional effect of the green finance pilot policy on corporate ESR. Furthermore, this study reveals that the green finance pilot policy's impact on corporate ESR is more pronounced among large-scale firms and firms operating in regions characterized by stringent environmental regulations and greater marketization. The empirical findings present evidence for enhancing ESR through the implementation of the green finance pilot policy in China and offer insights for refining the green finance system.
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A new direction for China in exploring sustainable development is the Innovative City Pilot Policy (ICPP), which provides policy guidance for accelerating carbon peaking and carbon neutrality by reducing carbon emissions. With data from 282 cities spanning 2006-2018, this paper examines ICPP's effect on carbon intensity (CI) through a multi-period difference-in-differences (DID) model, as well as exploring the mediating effect, moderating effect, heterogeneity, and spatial spillover effects. The results show that ICPP reduces CI significantly by enhancing technology innovation (TI), and when industrial structure (IS) is added, the effect of ICPP is expanded. The ICPP gains additional advantages in reducing CI by optimizing the efficiency of resource allocation (ERA). Compared with the concentration of human capital (HCL), the amount of scientific research institutes (SRI) has a slightly greater moderating effect. ICPP impacts considering location, size, and hierarchy heterogeneity. ICPP has a greater impact on mitigating CI in the western, larger size, and provincial capital cities. There are positive spillover effects of the ICPP on neighboring CI. To support the idea that ICPP can effectively contribute to CI reduction, this paper provides empirical evidence and theoretical guidelines.
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The investment decisions of enterprises are affected by environmental regulations designed to protect the environment, so environmental regulations may change companies' investment behavior in environmental protection. This study focuses on the River Chief System (RCS)1, an innovative environmental regulation related to river governance which officially launched in China in 2014. Based on data collected from heavy-polluting companies in the Yangtze River Delta, we use the difference-in-differences model (DID Model)2 and focus on RCS's impacts on micro-environmental protection investments. Our findings reveal that the RCS is conducive to expanding the scale of enterprises' environmental protection investments. Industrial structural upgrades appear to have a masking effect wherein the one-sided pursuit of industrial structural upgrades may slow economic growth and cause enterprises to reduce the scale of environmental investments. We recommend that the allocation of environmental investment should be based on the characteristics of local markets and public participation, and maintain a balance between secondary and tertiary industries, government and business incentives.
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Under the "dual-carbon" strategic goals, it is urgent to examine whether the energy consumption permit trading scheme ï¼ECPTSï¼, as an innovative system in China's market-oriented reform of the energy sector, can promote the synergistic enhancement of pollution reduction and carbon abatement. Based on provincial panel data of China from 2008 to 2019, this study adopted a difference-in-differences model to examine the impacts of the ECPTS on the synergistic enhancement of pollution reduction and carbon abatement. The results demonstrated that the ECPTS improved the level of pollution reduction and carbon abatement in pilot areas. Specifically, the ECPTS led to a reduction of 13.3% in CO2 emissions and 3.1% in PM2.5 concentration in the pilot areas and resulted in an overall improvement of pollution reduction and carbon abatement by 0.237 units. Mechanism analysis revealed that energy efficiency served as a pathway through which the ECPTS empowered the synergistic enhancement of pollution reduction and carbon abatement. Moreover, the strengthening of local government environmental protection goals enhanced the pollution reduction and carbon abatement effects of the ECPTS. Surprisingly, the effectiveness of the ECPTS was not undermined by the goal of economic growth. This study provides new empirical evidence for understanding the relationship between market-based environmental regulation and collaborative governance and provides strong support for China to achieve its "dual-carbon" strategic goals.
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Background: Residents' health plays an important role in economic prosperity and national development. Methods: The research analyzes data from 262 prefecture-level cities in China spanning the period from 2010 to 2021. Utilizing the implementation of green credit policy in China as a quasi-natural experiment, the paper employs the time-varying Differences-in- Differences (DID) model to evaluate the influence of green credit policy on residents' health. Results: The paper results show that: (1) the green credit policy significantly improves residents' health, and this conclusion still holds after a series of robustness tests. (2) Mechanism analysis reveals that the green credit policy affects residents' health through the improvements of the environment and the elevation of public services standards in demonstration cities. (3) Heterogeneity analysis shows that the impact of green credit policy on residents' health is more significant in the western cities and resource-based cities than in the central-eastern cities and non-resource-based cities. This paper explains the specific path and realization of green credit policy to enhance residents' health, which provides a reference for further designing and improving effective green credit policy. Discussion: The deficiencies within the green credit policy has resulted in limited improvements. It is recommended that China should broaden the ambit of the green credit policy and refine the criteria for its execution.
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Cidades , Políticas , Saúde Pública , Humanos , China , Desenvolvimento EconômicoRESUMO
This paper explores the effects and influence mechanisms of environmental centralization on enterprise technological progress and productivity in China. Taking the reform of vertical environmental governance (VEG) as a quasi-natural experiment, this paper compares the differences in total factor productivity (TFP) of enterprises in environmental centralization regions and environmental decentralization regions by adopting the staggered difference-in-differences (DID) method. The empirical results show that: (1) The average TFP of enterprises in the environmental centralization areas is 0.0598 higher than that in the environmental decentralization areas, and this average effect increases with the extension of the reform duration. (2) Environmental centralization strengthens government intervention in environmental issues. The improvement in the intensity of environmental regulation and the willingness of firm green innovation are the intermediate causes of the improvement in enterprise TFP. (3) VEG's effect is heterogeneous regarding regional development, industry type, and enterprise characteristics. This study has empirical implications for further refining the fiscal system to leverage the role of public finance on environmental governance and enterprise development.
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"National Civilized City" (NCC) is regarded as China's highest honorary title and most valuable city brand. To win and maintain the "golden city" title, municipal governments must pay close attention to various key appraisal indicators, mainly environmental ones. In this study we verify whether cities with the title are more likely to mitigate SO2 pollution. We adopt the spatial Durbin difference-in-differences (DID) model and use panel data of 283 Chinese cities from 2003 to 2018 to analyze the local (direct) and spillover effects (indirect) of the NCC policy on SO2 pollution. We find that SO2 pollution in Chinese cities is not randomly distributed in geography, suggesting the existence of spatial spillovers and possible biased estimates. Our study treats the NCC policy as a quasi-experiment and incorporates spatial spillovers of NCC policy into a classical DID model to verify this assumption. Our findings show: (1) The spatial distribution of SO2 pollution represents strong spatial spillovers, with the most highly polluted regions mainly situated in the North China Plain. (2) The Moran's I test results confirms significant spatial autocorrelation. (3) Results of the spatial Durbin DID models reveal that the civilized cities have indeed significantly mitigated SO2 pollution, indicating that cities with the honorary title are acutely aware of the environment in their bid to maintain the golden city brand. As importantly, we notice that the spatial DID term is also significant and negative, implying that neighboring civilized cities have also mitigated their own SO2 pollution. Due to demonstration and competition effects, neighboring cities that won the title ostensibly motivates local officials to adopt stringent policies and measures for lowering SO2 pollution and protecting the environment in competition for the golden title. The spatial autoregressive coefficient was significant and positive, indicating that SO2 pollution of local cities has been deeply affected by neighbors. A series of robustness check tests also confirms our conclusions. Policy recommendations based on the findings for protecting the environment and promoting sustainable development are proposed.
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Poluição do Ar , Cidades , Análise Espacial , Dióxido de Enxofre , China , Poluição do Ar/prevenção & controle , Poluição do Ar/legislação & jurisprudência , Poluição do Ar/análise , Humanos , Dióxido de Enxofre/análise , Política Ambiental/legislação & jurisprudência , Poluentes Atmosféricos/análiseRESUMO
The trading of carbon emissions is a crucial regulatory method to address environmental pollution issues. This study takes China's carbon emission trading pilot policy established in 2013 as a quasi-natural experiment and uses the DID model to empirically test the urban panel data from 2006 to 2019. The results show that the carbon emission trading pilot policy can effectively reduce urban environmental pollution, and this effect is more noticeable in mid-western cities, northern cities, cities with fewer resources, and large-scale cities. In addition, to address the urban environmental pollution problem through this policy, the government is encouraged to raise its environmental protection awareness and put more effort into the innovation of technology. In general, this study uses carbon emission trading policies from China to confirm that market-based incentive environmental regulation tools can effectively reduce environmental pollution in urban areas. These findings can provide more theoretical support and empirical evidence for the government to use mechanisms of the market to effectively solve pollution problems, improve ecological environment quality, and accelerate the realization of green economy.
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Carbono , Cidades , Poluição Ambiental , China , Poluição Ambiental/legislação & jurisprudência , Poluição Ambiental/prevenção & controle , Carbono/análise , Política Ambiental/legislação & jurisprudência , Projetos PilotoRESUMO
With the deep application of automation and digitalization technologies, the global automobile value chains are undergoing a new round of large-scale restructuring, and the traditional supply chain structure taken vehicle manufacturers as the core has been broken. The dual-credit policy (DCP), taking over the subsidies for new energy vehicles (NEVs), plays a vital role in reconstructing, transforming, and upgrading the automobile industry. The target group of DCP is passenger vehicle manufacturers, but it is unclear how its implementation will affect the NEV industry chain. To address this issue, this study examined the impact of the DCP on the innovation performance of automobile manufacturing enterprises using a DID (difference-in-difference) model based on the data of 693 listed advanced manufacturing enterprises in China A-shares from 2014 to 2021. The empirical results show that the DCP has significantly promoted the innovation performance of automobile manufacturing enterprises. In terms of supply chain role heterogeneity, the impact of the DCP on the innovation performance of parts manufacturers is more significant. Regarding enterprise ownership heterogeneity, the DCP has a greater impact on the innovation performance of SOEs(state-owned enterprises). In addition, regarding regional heterogeneity, enterprises in eastern and middle regions are significantly affected by the DCP to improve innovation performance.
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China's carbon emission trading policy plays a crucial role in achieving both its "3060" dual carbon objectives and the United Nations Sustainable Development Goal 13 (SDG 13) on climate action. The policy's effectiveness in reducing pollution and mitigating carbon emissions holds significant importance. This paper investigated whether China's carbon emission trading policy affects pollution reduction (PM2.5 and SO2) and carbon mitigation (CO2) in pilot regions, using panel data from 30 provinces and municipalities in China from 2005 to 2019 and employing a multi-period difference-in-differences (DID) model. Furthermore, it analyzed the heterogeneity of carbon market mechanisms and regional variations. Finally, it examined the governance pathways for pollution reduction and carbon mitigation from a holistic perspective. The results indicate that: (1) China's carbon emission trading policy has reduced CO2 emissions by 18% and SO2 emissions by 36% in pilot areas, with an immediate impact on the "carbon mitigation" effect, while the "pollution reduction" effect exhibits a time lag. (2) Higher carbon trading prices lead to stronger "carbon mitigation" effect, and larger carbon market scales are associated with greater "pollution reduction" effects on PM2.5. Governance effects on pollution reduction and carbon mitigation vary among pilot regions: Carbon markets of Beijing, Chongqing, Shanghai, and Tianjin show significant governance effects in both "pollution reduction" and "carbon mitigation", whereas Guangdong's carbon market exhibits only a "pollution reduction" effect, and Hubei's carbon market demonstrates only a "carbon mitigation" effect. (3) Currently, China's carbon emission trading policy achieves pollution reduction and carbon mitigation through "process management" and "end-of-pipe treatment". This study could provide empirical insights and policy implications for pollution reduction and carbon mitigation, as well as for the development of China's carbon emission trading market.
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Poluentes Atmosféricos , Poluição do Ar , Política Ambiental , China , Poluição do Ar/prevenção & controle , Poluição do Ar/legislação & jurisprudência , Poluição do Ar/análise , Política Ambiental/legislação & jurisprudência , Poluentes Atmosféricos/análise , Carbono/análise , Dióxido de Carbono/análise , Material Particulado/análiseRESUMO
The environmental hazards resulting from the excessive application of pesticides and fertilizers have been an inevitable agricultural production issue in various countries around the world. New technologies and policies are constantly trying to improve their application efficiency. This paper utilizes panel data of the provincial level in China from 2009 to 2019 to empirically study the effect of green finance reform policies on the chemical fertilizer application intensity (FAI) and pesticide application intensity (PAI). Standard difference-in-differences (DID), synthetic DID, difference-in-difference-in differences (DDD), and spatial DID models are constructed for specific empirical analysis. The findings can be concluded as follows: (1) A unit of the green finance reform policy reduces FAI by 0.0144 and PAI by 1.7921 by promoting green technology innovation. (2) Government financial extractive capacity hinders the reduction effect of green finance on PAI. (3) Coastal geographical location is conducive to reducing PAI through green finance reform. (4) FAI and PAI show positive spatial autocorrelations, and the influence of green finance reform overflows to surrounding areas. The research results can provide policy references for countries around the world to promote the green development of agriculture and reduce environmental pollution.
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When accounting for the social-ecological impact of an ecological restoration program, both objective environmental contexts and people's subjective perceptions are required. While this kind of environmental impact assessment lacks a comprehensive perspective. We use the difference-in-differences model to evaluate the effect of the greenness of the landscape after ecological migration in the Qilian Mountains in China; and analysis of variance and fixed effects models are used to evaluate the effects of such ecological restoration programs on local people's perceptions. The results show that the ecological migration program in the Qilian Mountains has been successful at not only significantly improving remotely sensed greenness at the landscape scale, but also at enhancing immigrants' environmental perceptions. These findings demonstrate the environmental impacts of ecological migration from a social-ecological perspective, and can provide methodological implications for landscape planning to support a better understanding of ecological restoration programs in the drylands.
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Conservação dos Recursos Naturais , China , Humanos , Ecossistema , Meio Ambiente , EcologiaRESUMO
This paper uses green innovation and environmental pollution as the mediating variables to construct a mediating effect model to investigate whether China's carbon emission trading policy can improve regional eco-efficiency by reducing regional environmental pollution and stimulating green innovation. This study is based on panel data from 30 provinces and municipalities directly under China's central government and autonomous regions from 2003 to 2019. The eco-efficiency of these provinces is measured using the super-efficiency DEA model and the difference-in-difference method (DID). The results show that (1) China's emission trading policy significantly improves regional ecological efficiency and the per capita GDP. The improvement can effectively improve regional ecological efficiency. (2) The mediating effect of green innovation and environmental pollution is significant. That is, China's carbon emission trading policy further improves regional ecological efficiency by stimulating more green innovation and reducing the synergy brought by environmental pollution. (3) There are differences in the feedback of this impact mechanism between different regions: It shows the characteristics of the western region being more significant than the eastern region. The central region has no significant effect. The research conclusion can provide a policy reference for the subsequent unified promotion of the construction of a carbon emission trading market nationwide and a theoretical basis for helping to achieve the "dual carbon" goal.
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Carbono , Poluição Ambiental , China , Política AmbientalRESUMO
In the context of increasingly severe global climate change, finding effective carbon emission reduction strategies has become key to mitigating climate change. Environmental Protection Tax (EPT), as a widely recognized method, effectively promotes climate change mitigation by encouraging emission reduction behaviors and promoting the application of clean technologies. Based on data from 282 cities in China, this paper takes the official implementation of the EPT in 2018 as the policy impact and the cities with increased tax rates for air taxable pollutants as the treatment group and uses DID model to systematically demonstrate the relationship between the implementation of the EPT and carbon intensity (CI) and further explores the possible pollutant emissions and green innovation mediating effects. The findings show that (1) the implementation of EPT can effectively reduce CI by about 4.75%, and this conclusion still holds after considering the robustness of variable selection bias, elimination of other normal effects, policy setting time bias, and self-selection bias. (2) The implementation of EPT can reduce CI by reducing pollutant emissions and improving the level of green innovation. (3) There is obvious regional heterogeneity in the carbon reduction effect of EPT, and the implementation of EPT has a more significant effect on CI in medium-tax areas, low environmental concern areas, general cities, and eastern regions. This paper not only provides a new analytical perspective for systematically understanding the carbon emission reduction effect of EPT but also provides policy insights for promoting regional green transformation and advancing carbon peak carbon neutralization.
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Carbono , Mudança Climática , Impostos , China , Poluição do Ar/prevenção & controle , Poluentes Atmosféricos , CidadesRESUMO
In the context of high-quality economic development in China, it is important to promote green innovation development by protecting intellectual property rights (IPR). Taking the pilot policy of the intellectual property courts in Beijing, Shanghai, and Guangzhou for example in a quasi-natural experiment, this article examines the effect of IPR protection on the development of corporate green innovation and its mechanisms by using a difference-in-differences model and a mediating effect model based on Chinese enterprise data from 2011 to 2019. The study found that first, IPR protection promotes enterprise green technological innovation; second, IPR protection affects green innovation through enterprise financing constraints and R&D investment; that is, increasing enterprise R&D investment and alleviating enterprise financing constraints are two important channels through which IPR protection promotes enterprise green technological innovation.
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China is currently confronted with the dilemma of achieving its green development goals while maintaining economic growth. The National Ecological Demonstration Zones (NEDZs) represent an innovative attempt by local governments to balance economic development with ecological civilisation, potentially offering a solution to this issue. This study calculated the Green Total Factor Productivity (GTFP) for 1925 districts and counties from 1999 to 2018. Using the selection of NEDZs as a quasi-natural experiment, a difference-in-differences model was employed to empirically analyse the impact of NEDZs on GTFP. The results indicated that the establishment of NEDZs led to an average increase in GTFP of 0.2175 compared to the control group. The primary mechanisms involved are innovation, structure, and enforcement. Moreover, the green development effects of the NEDZs exhibited regional heterogeneity. Compared to the western regions, the central and eastern regions showed limited green development effects. Areas with smaller populations, lower human capital, and lower administrative levels demonstrated significant improvements after the implementation of the NEDZ. Further analysis reveals a significant spatial agglomeration pattern of GTFP and the NEDZs exert a strong 'siphon effect' on the GTFP of neighbouring areas. This study provides a new perspective on the GTFP research and offers theoretical and practical evidence for assessing the impact of NEDZs.
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Desenvolvimento Econômico , Eficiência , Humanos , ChinaRESUMO
Medical service fragmentation is a common problem worldwide, and many countries have adopted integration to solve the difficulty. Contrary to developed countries, developing countries such as China must consider how to implement integration under a relatively weak medical foundation. This study aims to evaluate the effect of the "Compact Union of County and Township Health Sectors" policy on the medical service capacity of a typical integration model represented by Shanxi Province in China and determine the path the policy followed. By using Shanxi's county-level medical integration as a quasi-natural experiment, this study establishes a difference-in-differences model to investigate the effect of the policy using official data. A series of tests are conducted to verify the robustness of the result. Finally, the policy pathway is tested. The results show that the third-level surgeries and outpatient service utilization of leading hospitals and township institutions increased. Still, inpatient service utilization and fourth-level surgeries did not show a significant change in either type of institution. Moreover, the enhancement of leading hospitals' service capacity comes mainly through improving asset efficiency and personal income, while the improvement of township institutions' capacity comes primarily through increased personal income. Compact integration of county-level medical institutions can stimulate and improve service capacity by improving asset efficiency and personal income, even with a weak medical foundation. However, to achieve continuous service capacity improvement, the professional level of county-level institutions must be strengthened with a superior hospital's assistance, and personnel's enthusiasm for active innovation must be cultivated.
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Política de Saúde , China , Humanos , Prestação Integrada de Cuidados de Saúde , Formulação de Políticas , Governo LocalRESUMO
Environmental rights trading (ERT) is considered one of the crucial instruments for environmental governance in China, accelerating urban low-carbon sustainable development. This study utilized the Chinese Emissions Trading System (ETS), which has been implemented most widely, longest, and most typical, to represent ERT and examine its contribution to urban carbon emission reduction. Through a quasi-natural experiment perspective, urban panel data were collected from 2003 to 2019, and a time-varying difference-in-differences model and moderating models were developed. The study indicates that ERT can significantly reduce carbon emissions in cities, with robust results. In addition, the carbon reduction effect of ERT varies by city region, type, and size. This phenomenon is more obvious in central and western cities and resource-based cities. Finally, a framework to strengthen the carbon reduction effect of ERT was creatively constructed. The strengthening effects of green innovation, industrial structure, and clean energy are evident. This helps provide evidence for ERT layout and extension, especially in countries with high carbon reduction needs such as China. ERT affects not only policymakers but also a greener future for every organization and individual in the city.
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Conservação dos Recursos Naturais , Política Ambiental , Carbono , ChinaRESUMO
Introduction: This paper focuses on the construction of sponge cities and their effects on population health. Sponge cities in China both solve stormwater problems and are a systemic transformation in the urban construction paradigm, addressing related issues arising from high-speed urbanization. Whether sponge city construction in China can promote population health has received scant attention. Most previous studies have focused on urban environments and population health, with few exploring the potential effects on population health caused by urban environment changes due to urban policies. This study hypothesizes that sponge city construction improves the urban environment, and thus, population health. Methods: Using panel data from 119 prefecture-level cities between 2011 and 2019 and the China Labor-force Dynamics Survey (CLDS), based on China's sponge city pilot policy, a quasi-natural experiment is conducted using Difference-in-Differences (DID) model to identify the health effects of the sponge city policy. Results: The findings show that sponge city pilot policy not only reduced ecological environment pollution and promoted the quality of built environment, but also significantly improved population health by 10.4%. This mechanism is mainly due to the restorative effects of the built environment. Discussion: The health effects vary across city administrative levels, and especially among non-older adults and local populations. Compared with the cities at higher administrative level, the health effect in lower administrative level is significantly positive, indicating that there is a diminishing marginal effect of sponge city construction. This study extends the causal identification chain of the impact of urban environment on population health to urban policies and provide insights into policy objectives for sponge city construction.