How residential environment governance improves residents' health and well-being-evidence from a quasi-natural...

Improvement in urban-rural residential environment is not only vital to national health and well-being, but also an important pillar for safeguarding global public health security and promoting the sustainable development of human health.

Taking China's pilot program of the Ecological Restoration and Urban Renovation (ERUR) as a quasi-natural experiment, this study matches five waves of the China Health and Retirement Longitudinal Study (CHARLS) dataset from 2011 to 2020, constructs a difference-in-differences (DID) model to examine the impact and channel of residential environment governance on residents' health and well-being.

The results show that residential environment governance significantly improves residents' health status, and this effect is more pronounced among urban residents, individuals with low education levels, and those living in highly livable regions and areas with inadequate medical resources. Channel analysis reveals that residential environment governance enhances residents' health through three channels: ecological environment restoration, infrastructure upgrading and health awareness improvement. Further analysis indicates that residential environment governance does not directly reduce medical expenditure burden; instead, it moderately increases residents' utilization of medical services and self-medication expenditure. This phenomenon essentially reflects the improved awareness of health management and the optimized structure of health demand, rather than an irrational expansion of overall medical demand.

The research findings provide a pragmatic foundation for establishing a developmental framework that fosters reciprocal enhancement between environmental sustainability and public health.