Effects of a coal to clean heating policy on acute myocardial infarction in Beijing: a difference-in-differences analysis

作者：Martha Lee, Jie Chang, Qiuju Deng, Piaopiao Hu, Honor Bixby, Sam Harper, Guofeng Shen, Shu Tao, Moning Guo, Feng Lü, Jill Baumgartner, Jing Liu · 发表于：The Lancet Planetary Health · 年份：2024 · DOI：10.1016/s2542-5196(24)00243-2 · 被引用次数：12 · 研究领域：Energy and Environment Impacts、Air Quality and Health Impacts、Climate Change and Health Impacts

BACKGROUND: In 2015, the Chinese Government launched the coal to clean heating policy (CHP), designed to improve air quality and health in China. The CHP banned household coal burning and provided subsidies for clean electric or gas-powered heating for millions of peri-urban and rural households. We aimed to investigate whether the CHP affected the incidence of acute myocardial infarction in Beijing townships. METHODS: In this quasi-experimental study, we obtained township data on acute myocardial infarction hospital admissions and deaths, exposure to the CHP (yes vs no), and a range of covariates for periods before (Jan 1, 2013, to Dec 31, 2014) and after the CHP began (Jan 1, 2016, to Dec 31, 2017; and Jan 1, 2018, to Dec 31, 2019). The policy was gradually rolled out across villages, and townships in our study were considered exposed to the policy in periods when more than 50% of their villages were assigned into the CHP. We estimated the effect of the CHP on township incidence of acute myocardial infarction for all adults (aged ≥35 years) and separately for sex and older adults (aged ≥65 years) using a difference-in-differences approach that accommodates the progressive roll-out of the policy. FINDINGS: Of 307 townships in Beijing, we excluded 156 (51%) urban townships where most villages had central heating and were thus ineligible for the CHP. Of the 151 peri-urban and rural Beijing townships considered eligible for the CHP, 75 (50%) townships were exposed to the CHP by...