Air pollution control and health economic burdens: Evidence from a megacity in China from 2014 through 2022

The Guangdong-Hong Kong-Macao Greater Bay Area (GBA) stands as China's foremost region in air pollution control. Shenzhen, as a model city, was selected to quantify the health-economic gains brought about by pollution control efforts. The paper showcased the exemplary practices of GBA in safeguarding the blue sky, providing a template for other regions. We assessed the variation of health impacts and economic burdens in Shenzhen from 2014 to 2022 using the proportional hazards model based on Poisson regression, along with the value of a statistical life, the cost of illness, and the willingness-to-pay approach. The results showed that only the premature mortality and economic burdens attributable to PM_2.5 exhibited improvement prior to the COVID-19, with a total reduction of 9846.65 (95%Cl: 9846.65-9846.65) premature deaths and a cost saving of 63.93 (95%Cl: 63.93-63.93) million dollars. Short-term public health policies may affect the outcomes of air quality management, most types of health impacts and economic burdens showed a cliff decline during the pandemic. In addition, the study revealed that cardiovascular health economic burdens outweighed respiratory ones at the premature mortality level, while the opposite scenario was observed at the hospitalization level. This paper advocated for the strengthening of pollution control efforts, especially focusing on industrial emission reduction and intelligent transportation. The theoretical study of O₃ and the synergistic management of O₃ and PM_2.5 should be advanced. Additionally, health education should be emphasized, and residents should be encouraged to cultivate personal hygiene habits.