【作者】 刘斌；

【导师】 杜两省；

【作者基本信息】 东北财经大学 ， 西方经济学， 2018， 硕士

【摘要】 中国城镇化进程带来了经济上的飞跃,人民生活水平日益提高,但随之而来的环境污染问题削弱了居民的公共福利,特别是大气污染问题,更是严重的威胁居民身体健康。习近平总书记在十九大报告中提出实施健康中国战略,说明保障国民健康已经上升到国家战略高度,研究大气污染的健康效应具有很强的现实意义。为了全面衡量大气污染对公众健康的影响,本文以环境经济学和健康经济学理论为基础,从短期和长期两个方面识别大气污染对公众健康的影响机制。首先,本文选取2015年作为研究基年,选取流行病学中普遍采用的泊松回归模型对北京2015年全年日均PM2.5浓度进行危险度健康评价。其次,为了对大气污染的健康危害进行识别,本文选取2002-2016年中国30个省市区数据,以围产儿死亡率作为公众健康的代理指标,采用空间自滞后模型(SLX)分析大气污染的长期健康影响。最后,以本地区经济发展水平作为门槛变量构建面板门槛模型,分析大气污染滞后项对公众健康的异质性影响,捕捉其非线性特征。短期健康评价结果显示:如果2015年北京地区PM2.524小时均浓度达到国标情景75μg/m3,则可以避免呼吸系统疾病住院约57755例,心血管疾病约34606例,儿科约473754例,内科约1163606例,急性支气管炎约277621例,哮喘约325370例;按照世界卫生组织情景,如果PM2.524小时均浓度达到25μg/m3,则可以避免呼吸系统疾病住院约83661例,心血管疾病约51137例,儿科约705168例,内科约1739962例,急性支气管炎约371195例,哮喘约457518例。大气污染的长期健康效应研究结果显示:大气污染具有显著的空间关联特征,呈现出高-高和低-低的空间集聚现象。大气污染浓度的增加是显著增加围产儿死亡的主要因素之一,但邻近地区的大气污染浓度增加并未对本地区围产儿死亡产生不利影响;经济发展水平的提高有利于降低围产儿死亡,经济发展的背后带来的是对物质生活的满足,继而是对更高的精神和自身健康的追求,因此提高经济发展水平居民健康的有力保障;医疗支出占消费比重的增加会降低围产儿死亡率,医疗支出的占比增加说明居民对自身健康关注度提高,居民会提前预防疾病,降低围产儿的死亡率;人口密度的增加并没有增加围产儿死亡;受教育程度虽然会提高居民的保护意识,但教育的转化并非一朝一夕,所以其系数并不显著;每千人医疗卫生人员的增加反而提高了围产儿死亡率,这一结论说明国家医疗投入并没有有效的转化为居民所需,医疗资源的集中使得居民看不起病的情况依然存在。面板门槛模型结果显示,临近地区大气污染浓度会根据本地区经济发展水平的不同对本地区围产儿健康显现出不同的健康效果,具体表现为随着经济发展水平的提高,临近地区大气污染浓度对本地区的围产儿死亡率的抑制作用越来越强。进一步讨论发现:接收到临近地区高浓度大气污染信息之后,“警示作用”的存在使本地政府和居民会预先采取措施保障自己健康,且随着经济发展水平的提高,这种作用愈加显著,这使得临近地区大气污染对本地区的围产儿死亡产生抑制作用。综上,本文提出以下几点建议。①必须进一步落实国家发布的《大气十条》计划和各项节能减排工作,争取早日达到国际标准,建设健康中国;②在治理大气污染时必须同时考虑地理因素和经济因素,单方面的实行治理策略不会达到预期效果,应加强实行区域间联防联控政策,这才是建立绿色中国的必然选择;③作为市场运行的监管者,政府需要对每个行业按照其边际污染处理成本进行差别征税,以此弥补其排污行为导致的负外部性成本,并将税所得投入到绿化环境和医疗事业之中,直接和间接的保障居民健康;④政府应该提高孕妇群体的社会福利,比如定期免费对孕产妇群体进行身体及胎儿检测等;⑤要加大健康教育宣传,建立层层宣传机制,从政府部门到基层社区形成有效的学习途径,定期进行安全教育讲座学习,最大限度减少大气污染造成的健康损失。本文的主要贡献体现在:首先,在样本选择角度,本文选取2002-2016年中国大陆30个省市区年均PM2.5浓度较能全面的反映真实空气污染情况;其次,在研究方法上,本文以10米高风速作为大气污染浓度的有效工具变量处理模型可能存在的内生性问题;最后,在研究内容上,本文采用空间自滞后模型识别大气污染的空间溢出效应,并运用面板门槛模型解释大气污染和公众健康之间的非线性关系。更多还原

【Abstract】 China’s urbanization process has brought about an economic leap,and people’s living standards have been increasing,but at the same time it has also lead to serious environmental pollution problems.These problems have weakened residents’ public welfare in anotherr way,especially air pollution,which is seriously threatening the health of the residents.In the report of China’s 19th National Congress,General Secretary Xi Jinping pointed out that we would carry out the Healthy China Strategy,which means that the protection of public health has risen to the national strategic level.Therefore,it is of great practical significance to study the health effects of air pollution.In order to comprehensively measure the impact of air pollution on public health,we identified it from both short-term and long-term perspectives based on the environmental economics and health economics theory.Firstly,we selected 2015 as the research base year,and apply the Poisson regression model commonly used in epidemiology to assess the public health impacts of Beijing’s annual average PM2.5 concentration in 2015.Secomdly,in order to identify the health hazards of air pollution,using perinatal mortality as a proxy for public health,we used the spatial lag of X model(SLX)to analyze the long-term public health effects of the PM2.5 concentration based on the data from 30 provinces and municipalities in China from 2002 to 2016.Finally,taknig the level of economic development as the threshold variable,we constructed the panel threshold model to solve the nonlinear characteristics of air pollution for perinatal death.The short-term health assessment results showed that if the average concentration of PM2.5 in 24 hour in Beijing decreased to 75μg/m3 in the national standard scenario,that would avoid about 57,755 cases of respiratory diseases,34,606 cases of cardiovascular disease,473,754 cases of pediatrics,1,163,606 cases of internal medicine,about 277,621 cases of acute bronchitis,and about 325,370 of asthma.According to the World Health Organization scenario,25μg/m3,that would avoid about 86,361 cases of respiratory diseases,about 51,137 cases of cardiovascular disease,705,168 cases of pediatrics,1,739,962 cases of internal medicine,371,195 cases of acute bronchus and about 457,518 cases of asthma.The results of long-term health effects of air pollution showed that air pollution had significant spatial correlation characteristics,showing high-high and low-low agglomeration.The increase of atmospheric pollution concentration was one of the main factors that significantly increase the death of perinatal infants.However,the increase of atmospheric pollution concentration in adjacent areas had not adversely affected the perinatal death in this area,and the concentration coefficient of air pollution in the adjacent area was not in line with expectations.It could be known from the coefficients of other variables that the improvement of economic development was conducive to reducing the death of perinatal children.When our material life is satisfied,we will pursuit the spirit needs and self-health,thus improving the level of economic development and meeting the basic needs of residents are the necessary protection of residents’ health;the increase of medical expenditure in the proportion of consumption would reduce the perinatal mortality rate,and people’s attention to their own health would lead to an increase in medical expenditure,which would prevent disease from happening in advance,so it would reduce the mortality rate of perinatal children;the increase of population density didn’t increase perinatal death;although the education level would improve the protection awareness of residents,the education level needs to be transformed for a long time,so the coefficient was not significant;the increase in health workers per thousand people has increased the perinatal mortality rate.This conclusion indicated that the national medical investment had not been transformed to the needs of the residents,and the concentration of medical resources had made the situation that residents couldn’t afford their medical expenses still happen.The results of the panel threshold model showed that the concentration of air pollution in the adjacent areas would show different effects depending on the economy.And it was showed that the concentration of air pollution in neighboring areas would stronger inhibit the perinatal mortality in this area,as the level of economic development increases.Further discussion,we found that after receiving high-level air pollution information in neighboring areas,the existence of "warning effect" would enable local governments and residents to take measures to protect their health in advance,and this effect would become more and more significant along with the growth of the economy.Those reasons has caused air pollution in neighboring areas to inhibit perinatal deaths in the region.Above all,we give some suggestions.Firstly,the related enterprises are supposed to further implement the Action Plan and various energy conservation and emission reduction work,and strive to reach international standards as soon as possible,and finally we can build a healthy China.Secondly,when dealing with atmospheric pollution,the government should consider both geographical and economic factors.Otherwise,the unilateral implementation of the governance strategy would not achieve the expected results.The implementation of the inter-regional joint prevention and control policy should be strengthened.This is the inevitable choice for establishing a green China.Thirdly,as a regulator of market operations,the government needs to differentially tax each industry according to its marginal pollution treatment costs,so as to compensate for the negative external costs caused by its pollution discharge,and put the tax revenue into the green environment and medical invests to directly and indirectly protec the residents’ health.Forthly,the government should improve the social welfare of pregnant women,such as a regular free physical and fetal testing of maternal groups.Finally,it is necessary to increase health education propaganda,establish a layer of publicity mechanism,form the effective learning channels from government departments to grassroots communities,and regularly conduct safety education lectures to minimize the health losses caused by air pollution.The main contributions of this paper can be summarized in three aspects.First,from the perspective of sample selection,we selected the average annual PM2.5 concentration of 30 provinces and municipalities in 2002-2016 to reflect the true atmospheric pollution concentration.Second,in terms of research methods,the 10m-high wind speed was used as an effective instrumental variable for air pollution concentration to deal with the endogenous problem of the model.Furthermore,in the research content,we uses the spatial self-lag model to capture the spatial spillover effect of air pollution,and uses the panel threshold model to explain the nonlinear relationship between air pollution and public health.更多还原