Martha Lee PhD , Jie Chang PhD , Qiuju Deng PhD , Piaopiao Hu PhD , Honor Bixby PhD , Prof Sam Harper PhD , Guofeng Shen PhD , Prof Shu Tao PhD , Moning Guo MD , Feng Lu PhD , Prof Jill Baumgartner PhD , Prof Jing Liu PhD
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We aimed to investigate whether the CHP affected the incidence of acute myocardial infarction in Beijing townships.</div></div><div><h3>Methods</h3><div>In this quasi-experimental study, we obtained township data on acute myocardial infarction hospital admissions and deaths, exposure to the CHP (yes <em>vs</em> 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.</div></div><div><h3>Findings</h3><div>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 the end of 2017 and 92 (61%) by the end of 2019. We estimated an overall reduction of 6·6% (95% CI –12·3 to –0·8) in the incidence of acute myocardial infarction from before to after roll-out of the CHP in exposed townships relative to those not exposed to the policy, with some evidence of larger effects in women (–11·7% [–19·0 to –4·1%]), older adults (–10·7% [–17·4 to –3·6%]), and in townships exposed for longer (–3·5% [–9·5 to 2·8%] after <2 years and –9·7% [–18·3 to –0·5%] after 2–4 years).</div></div><div><h3>Interpretation</h3><div>Our results provide among the first empirical evidence of possible cardiovascular benefits from a household clean energy policy, and support efforts to implement and assess such policies in China and globally.</div></div><div><h3>Funding</h3><div>Wellcome Trust, the Canadian Institutes for Health Research, and the National Natural Science Foundation of China.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":null,"pages":null},"PeriodicalIF":24.1000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of a coal to clean heating policy on acute myocardial infarction in Beijing: a difference-in-differences analysis\",\"authors\":\"Martha Lee PhD , Jie Chang PhD , Qiuju Deng PhD , Piaopiao Hu PhD , Honor Bixby PhD , Prof Sam Harper PhD , Guofeng Shen PhD , Prof Shu Tao PhD , Moning Guo MD , Feng Lu PhD , Prof Jill Baumgartner PhD , Prof Jing Liu PhD\",\"doi\":\"10.1016/S2542-5196(24)00243-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>In 2015, the Chinese Government launched the coal to clean heating policy (CHP), designed to improve air quality and health in China. 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Effects of a coal to clean heating policy on acute myocardial infarction in Beijing: a difference-in-differences analysis
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 the end of 2017 and 92 (61%) by the end of 2019. We estimated an overall reduction of 6·6% (95% CI –12·3 to –0·8) in the incidence of acute myocardial infarction from before to after roll-out of the CHP in exposed townships relative to those not exposed to the policy, with some evidence of larger effects in women (–11·7% [–19·0 to –4·1%]), older adults (–10·7% [–17·4 to –3·6%]), and in townships exposed for longer (–3·5% [–9·5 to 2·8%] after <2 years and –9·7% [–18·3 to –0·5%] after 2–4 years).
Interpretation
Our results provide among the first empirical evidence of possible cardiovascular benefits from a household clean energy policy, and support efforts to implement and assess such policies in China and globally.
Funding
Wellcome Trust, the Canadian Institutes for Health Research, and the National Natural Science Foundation of China.
期刊介绍：
The Lancet Planetary Health is a gold Open Access journal dedicated to investigating and addressing the multifaceted determinants of healthy human civilizations and their impact on natural systems. Positioned as a key player in sustainable development, the journal covers a broad, interdisciplinary scope, encompassing areas such as poverty, nutrition, gender equity, water and sanitation, energy, economic growth, industrialization, inequality, urbanization, human consumption and production, climate change, ocean health, land use, peace, and justice.
With a commitment to publishing high-quality research, comment, and correspondence, it aims to be the leading journal for sustainable development in the face of unprecedented dangers and threats.
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