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<p>Air pollution is a global environmental health crisis that profoundly impacts human health, particularly among children. In response to this challenge, China enacted the Air Pollution Prevention and Control Action Plan (APPCAP) in 2013. However, conclusive evidence regarding the specific benefits of the APPCAP on child health outcomes remains limited. This study aims to assess the effects of the APPCAP on children’s health and provide empirical support for evaluating the policy’s effectiveness. We utilized data from the China Family Panel Studies (CFPS) conducted in 2012 and 2018, including 7,506 participants aged 0 to 15&#xa0;years. Participants were assigned to intervention or control groups based on provincial fine particulate matter reduction targets. We combined propensity score matching (PSM) with difference-in-differences (DID) models with two-way fixed effects and province-clustered standard errors to estimate policy effects on illness incidence and frequency (past month), outpatient attendance (past month), and hospitalization (past year). The estimates indicate that APPCAP implementation is estimated to reduce the probability of childhood illness (β = − 0.049, SE = 0.017, <i>P</i> &lt; 0.01), decrease the frequency of illness episodes (β = − 0.085, SE = 0.033, <i>P</i> &lt; 0.05), and lower the probability of hospitalization (β = − 0.042, SE = 0.012, <i>P</i> &lt; 0.01). Notably, these health benefits were more pronounced among female children and those residing in rural areas. We conducted placebo and other sensitivity analyses, and the results remained qualitatively consistent with the main findings. In conclusion, the APPCAP plays a crucial role in safeguarding children’s health, offering a valuable reference for environmental and public health policies in other developing countries facing similar challenges.</p>

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Impact of China’s air pollution prevention and control action plan on children’s health outcomes: a population-based quasi-experimental study

  • 期刊论文

  • 发表日期：

    2026年6月3日

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  • Zhen Wang,
  • Xinyue Sun,
  • Jingyao Geng,
  • Zhaoyang Wang,
  • Ruizhe Wu,
  • Kai Meng

摘要

Air pollution is a global environmental health crisis that profoundly impacts human health, particularly among children. In response to this challenge, China enacted the Air Pollution Prevention and Control Action Plan (APPCAP) in 2013. However, conclusive evidence regarding the specific benefits of the APPCAP on child health outcomes remains limited. This study aims to assess the effects of the APPCAP on children’s health and provide empirical support for evaluating the policy’s effectiveness. We utilized data from the China Family Panel Studies (CFPS) conducted in 2012 and 2018, including 7,506 participants aged 0 to 15 years. Participants were assigned to intervention or control groups based on provincial fine particulate matter reduction targets. We combined propensity score matching (PSM) with difference-in-differences (DID) models with two-way fixed effects and province-clustered standard errors to estimate policy effects on illness incidence and frequency (past month), outpatient attendance (past month), and hospitalization (past year). The estimates indicate that APPCAP implementation is estimated to reduce the probability of childhood illness (β = − 0.049, SE = 0.017, P < 0.01), decrease the frequency of illness episodes (β = − 0.085, SE = 0.033, P < 0.05), and lower the probability of hospitalization (β = − 0.042, SE = 0.012, P < 0.01). Notably, these health benefits were more pronounced among female children and those residing in rural areas. We conducted placebo and other sensitivity analyses, and the results remained qualitatively consistent with the main findings. In conclusion, the APPCAP plays a crucial role in safeguarding children’s health, offering a valuable reference for environmental and public health policies in other developing countries facing similar challenges.