Last November, I had the great pleasure to attend the 2nd Global Symposium on Health Systems Research in Beijing, China. This was my third visit to Beijing – I had visited once in 2004 and again in 2009 to attend the International Health Economics Association biannual conference (which was in the same conference center!). Visiting this city every few years or so has allowed me to witness first hand the remarkable transformation this city has undergone over the past decade. For example, I still remember the sight of thousands of cars rolling along the side of the road in 2004 but by 2009 they had all but been replaced by cars.
One of the biggest changes I noticed this time around was the increase in air pollution, which I would describe as a thick toxic fog. Although visibility was terrible when I was there in 2009, this time the air literally left me feeling ill (and may have contributed to me nearly visiting the emergency room of a Chinese hospital on one of the conference days). So I was not terribly surprised, although still alarmed, when I read about reports of reports of terrible air quality being reported this week in Beijing.
Despite local Chinese reports to the contrary, air quality has been deteriorating rapidly in Beijing and across the country, as it has been in many developing countries. Two year ago, an air quality sensor on the roof of the United States Embassy in Beijing recorded an air quality reading of more than 500 on a a scale of 500 on the EPA standards. It was “Beyond Index” or simply “Crazy Bad”. This reading was 20 times beyond what the World Health Organization considers safe to breath! New York City, where I currently live, will record figures under 20. To make things worse, last weekend a reading of 758 was measured. This is not only beyond index but beyond imaginable.
How much impact can this pollution have on health? I am not expert on this stuff but based on a few papers I have seen on this, it could be a lot. A colleague, Avraham Ebenstein from Hebrew University in Israel, has a fabulous study that has looked exactly at this question in China in a still unpublished paper with a series of co-authors. Using a policy that affects one part of the country and not another, they find that increases in air pollution of about 100 μg/m3 is associated with about 3 years of lower life expectancy. In the areas that they study they find increases in air pollution of about 2 times this across their study area and the levels recorded in Beijing would be even higher suggesting very large and very real decreases in life expectancy due to air pollution. Increases in child mortality from air pollution have also been documented by economists in Mexico City, India, and even in New Jersey. An emerging finding from many of these studies is that the impact on health of very high levels of exposure might be even worse than what we would predict based on what we know about exposure in developed countries today.
And it is not just the water that appears to be causing significant poor health. Avi also has another excellent paper that looks at the impact of water pollution in digestive cancers in China. He documents a 10% increase in digestive cancers due to water pollution due to industrialization.
Is this simply the price to pay for development? Is there really anything that developing countries can do to prevent this? Well, for starters, there needs to be admission that there is in a problem. Fortunately, the international attention to the issue may have actually led to officials admitting that there is an air pollution crises in Beijing – students have even been ordered to avoid outdoor activities. Plus, even small changes can help to improve health: the India paper I cite above finds that even there stricter environmental regulations can improve health outcomes, suggesting that public policies can make a difference.
What is clear that the health impact can be enormous and if one believes that real development involves more than just increases in gross domestic product per capita, than progress towards true development will be hampered until these types of issues are properly addressed.Share on Facebook