Pollution, health and inequality: escape from the environment-health-poverty trap

QI Yu1 LU Hongyou 2

(1.College of Finance and Taxation in Zhongnan University of Economics and Law )
(2.Department of Finance, College of Economic and Management in Wuhan University)

【Abstract】An overlapping generations model was constructed in this study to explore the relationship among environment, health and inequality. Then the Chinese General Social Survey (CGSS) data (2006) about individuals’ features and data of city-level pollution were used in a hierarchical generalized linear model and it was found that pollution is an important transmission mechanism influencing health inequality. Since people with different socioeconomic status vary in the ability of avoiding environmental risks, differentiated exposure levels and health effects caused by environment pollution will become a new source triggering health and social inequality. Hence this study adopted the epidemiological method calculating the health burden of pollution to estimate the health and economic burdens of air pollution and their regional distribution as well as contribution to inter-regional inequality in 112 major cities in China from 2003 to 2010. The results show that the more backward the economy, the heavier the pollution’s health and economic burdens. Moreover, a clear regressive distribution was found. In addition, it was also found that pollution’s health burdens caused an increase of 1.33% to 9.919% in inter-regional real economic inequality. Using simultaneous equations and the panel data from 1998 to 2011, this study further verified and explained that pollution could influence intra-regional and urban-rural inequality through affecting health. Given pollution’s close connection with poverty and the grim pollution situation, China should be alert to the environment-health-poverty trap in the process of industrialization and urbanization.

【Keywords】 environmental quality ; citizens’ health; inequality; the environment-health-poverty trap ;


【Funds】 Supported by National Social Science Foundation (11&ZD041) Project of the Young Scholar Award of the Education Ministry for Doctoral Candidates (505201205001)

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    [1]. 1Including the reports of the 18th National Congress of the Communist Party of China, the Twelfth Five-Year Plan for national environment protection, speech made by President Xi Jinping during the collective learning of ecological civilization health arranged by the Political Bureau of the Central Committee, etc. [^Back]

    [2]. 2"Incidence of environment group events in China in recent years increasing with an average annual 29% ", http://money.163.com/12/1027/02/8EPP4IHP00253B0H.html [^Back]

    [3]. 3http://news.xinhuanet.com/yzyd/health/20130402/c_115245288.htm [^Back]

    [4]. 4UN’s 2013 Human Development Report warns that if no emergency measures are taken to deal with environment threats, the number of people under extreme poverty will increase to 3 billion until 2050. http://env.people.com.cn/n/2013/0321/c1010-20870996.html [^Back]

    [5]. 5Duraiappah (1998) had made detailed comments on the relationship between poverty and environment deterioration in early days. [^Back]

    [6]. 6The main reason is that when there is only a small number of sample individuals at level 2, the regression estimation based on these samples is unstable. For example, there are only several sample individuals in one region while there are abundant samples in other regions. Under such a situation, the estimation conducted based on those two types of samples will be comprehensively weighted, getting a final estimation in the hierarchical linear model. At the two levels, two types of estimations will be carried out: one is OLS (Ordinary Least Square) at level 1, which is more adopted when the sample number is larger; the other is the WLS (Weighted Least Square) at level 2 or between regions, which is more relied on when the sample number is small. [^Back]

    [7]. 7Announcement of the State Council of China on printing and distributing the National Twelfth Five-Year plan of environment protection, http://www.gov.cn/zwgk/2011-12/20/content_2024895.htm [^Back]

    [8]. 8PM10, SO2 and NO2 are current important pollutants recognized by WHO and each country, see WHO Air Quality Guidelines for Particulate Matter, Ozone, Nitrogen Dioxide and Sulfur Dioxide (Global Update 2005), Ambient Air Quality Standard in People's Republic of China (GB 3095-2012). [^Back]

    [9]. 9Meta-analysis is a statistic method to analyze and summarize collected research materials, which hence offers quantitative average effects to study exposure-response function (Aunan & Pan, 2004). [^Back]

    [10]. 10In cohort studies, sample individuals will be divided into different sub-groups according to their exposure degrees to pollution and their activities and situation will be traced until final results are acquired. Then, the frequency differences between sub-groups will be compared in order to investigate whether exposure factors have casual relations with health results and the degree of the correlation. [^Back]

    [11]. 11Values of β are 0.0012 (cough), 0.0048 (bronchitis (acute)), 0.001882 (asthma) and 0.0003668 (emergency cases). [^Back]

    [12]. 12In western developed countries, methods similar to WTP and VSL are adopted to conduct evaluation. [^Back]

    [13]. 13According to 2011 Statistical Bulletin of National Health and Family Planning, the proportion of personal health expenditure in total national health expenditure kept falling from 2008 to 2011 but the proportion was still as high as 34.8%. Government health expenditure only accounted for 30.7% and social one was 34.6%. In the 2012 Statistical Bulletin of National Health and Family Planning, the proportion of personal one was 33.4%, which is still very high. [^Back]

    [14]. 14Details see annually published air quality data of main cities. [^Back]

    [15]. 15Li Keqiang: Basic Environmental quality, the Public Service Shall Guaranteed By Government, http://www.chinanews.com/gn/2011/12-21/3546661.shtml [^Back]


    [1] Sen, A. Development as Freedom, Ren, Z. & Yu, Z. (trans.), Beijing: China Renmin University Press, (2012).

    [2] Cai, F. Economic Perspectives (经济学动态), (12) (2012).

    [3] Guo, X. Environmental Health Science (环境健康学). Beijing: Peking University Medical Press, (2006).

    [4] Hu, Y. Population and Development (人口与发展), (2) (2010).

    [5] Lu, H. & Qi, Y. Journal of Finance and Economics (财经研究), ((6) (2013).

    [6] Lou, J. Comparative Studies (比较), (6) (2010).

    [7] Lu, H. Process Report of Basic Public Services' Equalization in China (中国基本公共服务均等化进程报告). Beijing: People's Publishing House, (2012).

    [8] Miao, Y. & Chen, W. The Journal of World Economy (世界经济), (6) (2010).

    [9] Niu, J. Social Science in China (中国社会科学), (2) (2013).

    [10] Qi, Y. & Lu, H. Economic Management (经济管理), (9) (2013).

    [11] Qi, Y., Lu, H. & Du, Y. Economic Perspectives (经济学动态), (3) (2014).

    [12] Qi, L. & Li, Z. Economic Research Journal (经济研究), (9) (2011).

    [13] Qi, L. Economic Research Journal (经济研究), (11) (2006).

    [14] Wang, T. & Cui, X. Social Science in China (中国社会科学), (5) (2010).

    [15] Xie, E. Economic Research Journal (经济研究), (2) (2009).

    [16] Yu, F., Guo, X., Zhang, Y. & et.al. Journal of Environment and Health (环境与健康杂志), (12) (2007).

    [17] Yang, J. & Zhang, E. Social Science in China (中国社会科学), (8) (2013).

    [18] Asian Development Bank. Toward an Environmental Sustainable Future: Country Environmental Analysis of the People's Republic of China (迈向环境可持续的未来--中华人民共和国国家环境分析). Beijing: Chinese financial & Economic Publishing House, (2012).

    [19] Yang, J., Xu, J. & Wu, X. Economic Research Journal (经济研究), (12) (2013).

    [20] Zhang, L. Application of Hierarchical Linear Models (多层线性模型应用). Beijing: Educational Science Publishing House, (2003).

    [21] China Council for International Cooperation on Environment and Development. A Summary Report of the Research Group of China Council for International Cooperation on Environment and Development (中国环境保护与社会发展课题组摘要报告), (2013).

    [22] Zheng, B. Chinese Journal of Population Science (中国人口科学), (1) (2011).

    [23] Zhang, D. Economic Research Journal (经济研究), (9) (2013).

    (24)Aldy J. E.,2006,“Per Capita Carbon Dioxide Emissions: Convergence or Divergence?”, Environmental Resource Economics, Vol. 33, No. 4,pp. 533-555.

    (25)Amit K. Biswas, 2012,“Pollution, Shadow Economy and Corruption: Theory and Evidence”, Ecological Economics, Vol. 75,pp. 114-125.

    (26)Aunan K. and Pan X. C., 2004, “Exposure-response Functions for Fealth Effects of Ambient Air Pollution Applicable for China: A Meta Analysis”, Science of the Total Environment, Vol. 329, pp. 3-16.

    (27)Barassi M. R. and Cole M. A.,Elliot R. J. R., 2008, “Stochastic Divergence or Convergence of Per Capita Carbon Dioxide Emissions: Re-examining the Evidence”, Environmental Resource Economics, Vol. 40, No. 1, pp. 121-137.

    (28)Baron and Reuben M.; Kenny, 1986, David A. Journal of Personality and Social Psychology, Vol. 51, No. 6, pp. 1173-1182.

    (29)Been, V. and Gupta, F., 1997, “Coming to The Nuisance or Going to the Barrios? A Longitudinal Analysis of Environmental Justice Claims”, Ecological Law Quarterly, Vol. 24, pp. 1-56.

    (30)Becker G. S., 2007 "Health as Human Capital: Synthesis and Extensions”,Oxford Economic Papers, Vol. 59, pp. 379-410.

    (31)Brock W. A. and Taylor M. S.,2010,“The Green Solow Model”, Journal of Economic Growth,Vol. 15, No. 2, pp. 127-153.

    (32)Buxton, M. J. and S. D. Sullivan,L. F. Andersson,C. J. Lamm, B. Liljas,W. W. Busse,S. Pedersen and K. B. Weiss, 2004,“Country-specific Cost-effectiveness of Early Intervention with Budesonide in Mild Asthma”, European Respiratory Journal, Vol. 24, pp. 568-574.

    (33)Coneus, K. and C. Katharina Spieb, 2012, “Pollution Exposure and Child Health: Evidence for Infants and Toddlers in Germany”, Journal of Health Economics, Vol. 31, pp. 180-196.

    (34)Currie J. and Neidell M.,2005,“Air Pollution and Infant Health: What Can We Learn from California's Recent Experience?”,Quarterly Journal of Economics,Vol. 120, No. 3, pp. 1003-1030.

    (35)Currie J., 2011,“Inequality at Birth: Some Causes and Consequences”, NBER Working Paper, No. 16798.

    (36)Currie J., Neidell, Johannes F. Schmieder,2009, “Air Pollution and Infant h Health: Lessons From New Jersey”, Journal of Health Economics,Vol. 28, No. 3,pp. 688-703.

    (37)Daniels G. and Friedman S.,1999,“Spatial in Equality and the Distribution of Industrial Toxic Releases: Evidence from the 1990 TRI”, Social Science Quarterly,Vol. 80,No. 2, pp. 244-261.

    (38)Davidson,P. and Anderton,D. L.,2000. “Demographics of Dumping II:A National Environmental Equity Survey and the Distribution of Hazardous Materials Handlers”,Demography,Vol. 37,No. 4,pp. 461-466.

    (39)Deaton,A.,2003,“Health,Inequality and Economic Development”,Journal of Economic Literature,Vol.4,pp.113-158.

    (40)Downey,L.and Dubois,S.,Hawkins,B.,Walker,M.,2008,“Environmental Inequality Inmetropolitan America,Organ”,American Journal of Sociology,Vol. 21,pp. 270-295.

    (41)Duraiappah,1998,“Poverty and Environmental Degradation: A Review and Analysis of the Nexus”,World Development,Vol. 26,No. 12,pp. 2169-2179.

    (42)D’Alessandro S.,Luzzati T.,Morroni M.,2010,“Energy Transition Towards Economic and Environmental Sustainability: Feasible Paths and Policy Mmplications”,Journal of Cleaner Production,Vol. 18,pp. 291-298.

    (43)Ethan D. Schoolman,Chunbo Ma,2012,“Migration,Class and Environmental Inequality: Exposure to Pollution in China's Jiangsu Province”,Ecological Economics,Vol. 75,pp. 140-151.

    (44)Efron,B .and R. J. Tibshirani,1993,An Introduction to the Bootstrap,New York: Chapman and Hall.

    (45)Forastiere et al.,2007,“Socioeconomic Status,Particulate Air Pollution and Daily Mortality: Differential Exposure or Differential Susceptibility”,American Journal of Industrial Medicine,Vol.50,No.3,pp.208-216.

    (46)Guo,X.,2006,“The Economic Value of Air-pollution-related Health Risks in China”,Ph.D. thesis,Graduate School,Ohio State University,Columbus,OH.

    (47)Graff and Neidell,2013,“Environment,Health and Human Capital”,Journal of Economic Literature,Vol.51,No.3,pp.24-75.

    (48)Hammitt,J. K. and Y. Zhou,2006,“The Economic Value of Air-Pollution-Related Health Risks in China: A Contingent Valuation Study”,Environmental and Resource Economics,Vol.33,pp.399-423.

    (49)Hamilton and James T.,2005,Regulation Through Revelation:The Origin,Politics and Impacts of the Toxics Release Inventory Program,Cambridge University Press.

    (50)Ikefuji and Horii,2007,“Wealth Heterogeneity and Escape from the Poverty-Environment Trap”,Journal of Public Economic Theory,Vol.9,No.6,pp.10411068.

    (51)John A.and Pecchenino R.,1994,“An Overlapping Generations Model of Growth and the Environment”,The Economic Journal,Vol.104,pp.1393-1410.

    (52)Jennifer Holdaway,2010,“Environmental and Health in China:An Introduction to an Emerging Research Field”,Journal of Contemporary Chin,Vol.63,No.19,pp.394-423.

    (53)Keng,Shao-Hsun,Sheu,Sheng-Jang,2013,“The Effect of National Health Insurance on Mortality and the Ses-Health Gradient: Evidence from the Elderly in Taiwan”,Health Economics,Vol.22,No.1,pp.52-72.

    (54)Lai,C. K. W.,Y.-Y.Kim,S.-H. Kuo,M.Spencer and A.E.,2006,“Williams on Behalf of the Asthma Insights and Reality in Asia Pacific Steering Committee(2006),‘Cost of asthma in the Asia-Pacific region”,European Respiratory Review,Vol.15,pp.10-16.

    (55)Mitchell D.Wong,Tomoko Tagawa,Hsin-Ju Hsieh,Martin F.Shapiro,W.John Boscardin and Susan L.Ettner,2005,“Differences in Cause-Specific Mortality between Latino and White Adults”,Medical Care,Vol.43,No.10,pp.1058-1062.

    (56)Mithas S.,2007,“Designing Websites for Customer Loyalty Across Business Domains:A Multilevel Analysis”,Journal of Management Infornation Systems,Vol.23,No.3,pp.97-127.

    (57)Mohai,P.and Saha,R.,2006,“Reassessing Racial and Socioeconomic Disparities in Environmental Justice Research”,Demography,Vol.43,No.2,pp.383-399.

    (58)Mohai and Saha,2007,“Racial Inequality in the Distribution of Hazardous Waste:A National-Level Reassessment”,Social Problems,Vol.54,No.3,pp.343-370.

    (59)Morello-Frosch and Jesdale,2006,“The Environmental ‘Riskscape’ and Social Inequality: Implications for Explaining Maternal and Child Health Disparities”,Environmental Health Perspect,Vol. 14,No. 8,pp. 1150-1153.

    (60)Naimzada A. and Sodini M.,2010,“Multiple Attractors and Nonlinear Dynamics in an Overlapping Generations Model With Environment”,Discrete Dynamics in Nature and Society,Article ID 503695,11 pages.

    (61)Nguyen-Van P.,2005,“Distribution dynamics of CO2emissions”,Environmental Resource Economics,Vol. 32,pp. 495-508.

    (62)Ordás Criado C. and Valente S.,Stengos T.,2011,“Growth and Pollution Convergence:Theory and Evidence”,Journal of Environmental Economics and Management,Vol. 62,No. 2,pp. 199-214.

    (63)Rana C. and Leslie I. B.,2008,“Does Income Inequality Modify the Association Between Air Pollution and Health?”Environmental Research,Vol. 106,No. 1,pp. 81-88.

    (64)Romero-Avila D.,2008,“Convergence in Carbon Dioxide Emissions among Industrialized Countries Revisited”,Energy Economics,Vol. 30,No. 5,pp. 2265-2282.

    (65)Strazicich M. and List J. A.,2003,“Are CO2 Emissions Levels Converging among Industrial Countries?”,Environmental Resource Economics,Vol. 24, 263-271.

    (66)Thomas Bassetti and Nikos Benos,Stelios Karagiannis,2013,“CO2Emissions and Income Dynamics: What Does the Global Evidence Tell Us?”,Environmental Resource Economics,Vol.54,pp.101-125.

    (67)Tonne, S. Beevers1,B. Armstrong,F. Kelly,P .Wilkinson, 2008,“Air Pollution and Mortality Benefits of the London Congestion Charge: Spatial and Socioeconomic Inequalities”, Occupation&Environmental Medicine, Vol. 65, pp. 620-627.

    (68)Victor Brajer, Robert W. Mead and Feng Xiao,2010, “Adjusting Chinese Income Inequality for Environmental Equity”, Environment and Development Economics, Vol. 15, pp. 341-362.

    (69)Wang,H. and J. Mullahy, 2006,“Willingness to Pay for Reducing Fatal Risk by Improving Air Quality: A Contingent Valuation Study in Chongqing, China”,Science of the Total Environment,Vol. 367,pp. 50-57.

    (70)World Bank,2007,“Cost of Pollution in China: Economic Assessment of Physical Damage”,Washington,DC: The World Bank.

    (71)WHO, 2004, "The World Health Report 2004: Changing History", Geneva: World Health Organization.

    (72)Westerlund J., Basher S. A., 2008, “Testing for Convergence in Carbon Dioxide Emissions Using a Century of Panel Data”, Environmental Resource Economics, Vol. 40,No. 1,pp. 109-120.

    (73)Xepapadeas A., 1997,“Economic Development and Environmental Pollution: Traps and Growth”, Structural Change and Economic Dynamics, Vol. 8, pp. 327-350.

    (74)Xinshu Zhao John G.Lynch Qimei Chen, 2010, “Reconsidering Baron and Kenny:Myths and Truths about Mediation Analysis”, Journal of Consumer Research, Vol. 37, No. 2, pp. 197-206.

    (75)Yang, Z. and L. Xu, 2004, “Valuing Health Effects from the Industrial Air Pollution in Rural Tianjin, China”, Journal of Environmental Sciences, Vol. 16, pp. 157-160.

    (76)Yuyu Chen, Avraham Ebenstein, Michael Greenstone, Hongbin Li, 2013, “Evidence on the Impact of Sustained Exposure to Air Pollution on Life Expectancy from China’s Huai River policy”, PNAS, Vol. 110,No. 32,pp. 1-6.

    (77)Zhang, J. J., W. Hu, F. Wei, G. Wu, L. R. Korn and R. S. Chapman, 2002, “Children’s Respiratory Morbidity Prevalence in Relation to Air Pollution in Four Chinese Cities”, Environmental Health Perspectives, Vol. 110, pp. 961-967.

This Article


CN: 11-1235/F

Vol , No. 09, Pages 32-51

September 2015


Article Outline



  • 1 Introduction
  • 2 Literature review and theoretical analysis
  • 3 Environmental pollution, socioeconomic status and health inequality
  • 4 Evaluation of health damage caused by the environment and inter-regional inequality: 2003–2010
  • 5 Health burdens and intra-regional inequality (between rural and urban areas)
  • 6 Further discussion
  • 7 Basic conclusion
  • Footnote