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Pandemic-Associated Shifts and Spatial Inequality in Public Attention to Pulmonary Function Testing in China: A
Cai Chen1,2, Dedong Ma3,4,5, Tao Jing1
1State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, China.
Abstract:
Background/Objectives: Pulmonary function tests (PFTs), especially spirometry, are important for chronic respiratory disease diagnosis and management, but Baidu-based online search interest in PFT-related information remains insufficiently characterized. This study examined long-term Baidu search activity for a selected PFT-related keyword in China from 2011 to 2024, with attention to pandemic-period changes, provincial variation, spatial inequality, and associated socioeconomic factors. Methods: We analyzed Baidu Index data from 1 January 2011 to 31 December 2024. The selected PFT-related keyword, "pulmonary function instrument," was compared with "blood pressure monitor" and "blood glucose meter." Daily Baidu Index values were aggregated into monthly and annual series. Temporal trends, relative search-intensity ratios, interrupted time-series analysis, inequality indices, fixed-effects regression, subgroup heterogeneity, and convergence dynamics were assessed. Results: PFT-related Baidu search activity remained lower than that for blood pressure and glucose monitoring, with relative search-intensity ratios below 0.35. Descriptively, PFT-related searches increased during 2020-2022; however, the re-specified seasonality-adjusted ITSA using unsmoothed monthly observations did not provide strong statistical evidence for an immediate level change at pandemic onset or a sustained slope change. Provincial differences persisted, with higher values generally observed in several eastern coastal provinces. Inequality indices were lower on average during 2020-2022 but fluctuated over time, and beta-convergence analyses provided limited statistical evidence of systematic catch-up among initially low-index provinces. Urbanization, per capita GDP, and population aging were positively associated with PFT-related Baidu Index values, while subgroup findings were interpreted as exploratory ecological associations. Conclusions: PFT-related Baidu search activity in China remained lower than search activity for blood pressure and glucose monitoring and showed persistent provincial variation. These findings suggest lower visibility of PFT-related information within the Baidu-based online environment.