The impact of China’s low-carbon city pilot policy on public health expenditure

ObjectiveIn driving a transition in environmental governance, China’s low-carbon city pilot (LCCP) policy has exerted a dichotomous impact on public health expenditure that is characterized by both a decline in relative proportion and expansion of absolute scale. Research to date is insufficient for understanding the transmission mechanisms and policy coordination pathways underlying this contradiction, which has hindered the sustainable realization of environmental health benefits. This study thus investigates the impact of China’s LCCP policy on public health expenditure and the underlying mechanisms involved.MethodsBased on panel data of 285 Chinese cities at the prefecture level and above from 2003 to 2019, a quasi-natural experiment was conducted using China’s LCCP policy. The time-varying difference-in-differences simulation method and hierarchical regression method were used to analyze the effect and mechanism of the LCCP policy on China’s public health expenditure.ResultsThe results demonstrate the inherently paradoxical nature of the effects of the LCCP policy on public health expenditure: although the LCCP policy produces a significant relative reduction in public health