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Xuanwei City (formerly known as Xuanwei County) locates in the northeastern of Yunnan Province and is rich in coal, iron, copper and other mines, especially the smoky (bituminous) coal. Unfortunately, the lung cancer morbidity and mortality rates in this region are among China's highest, with a clear upward trend from the mid-1970s to mid-2000s. In 2004-2005, the crude death rate of lung cancer was 91.3 per 100,000 in the whole Xuanwei City, while that for Laibin Town in this city was 241.14 per 100,000. The epidemiologic distribution (clustering patterns by population, time, and space) of lung cancer in Xuanwei has some special features, e.g., high incidence in rural areas, high incidence in females, and an early age peak in lung cancer deaths. The main factor that associates with a high rate of lung cancer incidence was found to be indoor air pollution caused by the indoor burning of smoky coal. To a certain extent, genetic defects are also associated with the high incidence of lung cancer in Xuanwei. Taken together, lung cancer in this smoky coal combustion region is a unique model for environmental factor-related human cancer, and the current studies indicate that abandoning the use of smoky coal is the key to diminish lung cancer morbidity and mortality.

The accessibility of hospital facilities is of great importance not only for maintaining social stability, but also for protecting the basic human right to health care. Traditional accessibility research often lacks consideration of the dynamic changes in transport costs and does not reflect the actual travel time of urban residents, which is critical to time-sensitive hospital services. To avoid these defects, this study considered the city of Kaifeng, China, as an empirical case, and directly acquired travel time data for two travel modes to the hospital in different time periods through web mapping API (Application Program Interface). Further, based on travel time calculations, we compared five baseline indicators. For the last indicator, we used the optimal weighted accessibility model to measure hospital accessibility for each residential area. The study discovered significant differences in the frequency and spatial distribution of hospital accessibility using public transit and self-driving modes of transportation. In addition, there is an imbalance between accessibility travel times in the study area and the number of arrivals at hospitals. In particular, different modes of transportation and different travel periods also have a certain impact on accessibility of medical treatment. The research results shed new light on the accessibility of urban public facilities and provide a scientific basis with which local governments can optimize the spatial structure of hospital resources.

Environmental pollution damages public health and affects economic development. Environmental regulation is the main way for the government to solve environmental pollution. So what type of environmental regulation works better for public health and economic development? Can environmental regulation have an influence on economic development through public health? To solve these problems, this research uses China’s provincial panel data from 2013 to 2017 to divide environmental regulation into command-control policy tools and economic incentive policy tools and uses the mediating effect model to examine the relationship among environmental regulation, public health and economic development. The results show that: (1) There is a positive correlation between economic incentive policy tools and economic development; while no significant relationship between command-control policy tools and economic development is founded; (2) The relationship between command-control policy tools and public health is not significant, while the relationship between economic incentive policy tools and public health is positive; (3) Public health does not play a mediating role between command-control policy tools and economic development but plays a partial mediating role between economic incentive policy tools and economic development. Therefore, the government should strengthen the use of economic incentive policy tools to promote public health and sustainable economic development.

Dietary change presents an opportunity to meet the dual challenges of non-communicable diseases and the effects of climate change in China. Based on a food survey and reviewed data sets, we linked nutrient composition and carbon footprint data by aggregating 1950 types of foods into 28 groups. Nine dietary scenarios for both men and women were modeled based on the current diet and latest National Program for Food and Nutrition. Linear uncertainty optimization was used to produce diets meeting the Chinese Dietary Reference Intakes for adults aged 18-50years while minimizing carbon footprints. The theoretical optimal diet reduced daily footprints by 46%, but this diet was unrealistic due to limited food diversity. Constrained by acceptability, the optimal diet reduced the daily carbon footprints by 7-28%, from 3495 to 2517-3252g CO2e, for men and by 5-26%, from 3075 to 2280-2917g CO2e, for women. Dietary changes for adults are capable of benefiting China in terms of the considerable footprint reduction of 53-222Mt.CO2eyear-1, when magnified based on the Chinese population, which is the largest worldwide. Seven of eight scenarios showed that reductions in meat consumption resulted in greater reductions in greenhouse gas emissions. However, dramatic reductions in meat consumption may produce smaller reductions in emissions, as the consumption of other ingredients increases to compensate for the nutrients in meat. A trade-off between poultry and other meats (beef, pork, and lamb) is usually observed, and rice, which is a popular food in China, was the largest contributor to carbon footprint reductions. Our findings suggest that changing diets for climate change mitigation and human health is possible in China, though the per capital mitigation potential is slight lower than that in developed economies of France, Spain, Sweden, and New Zealand.

An individual’s sense of place has a motivational impetus on how s/he relates to the place. Thus, environmentally sustainable behaviors are deemed as products of a person’s sense of place. However, little is known about the extent to which geospatial thinking conditions a person’s sense of place. Accordingly, this study builds a theoretical model that examines the influence of geospatial thinking on a person’s sense of place. Further, it investigates the mediating role of creativity. A survey data from 1037 senior high school students in western China was utilized to test the theoretical model. The findings indicate that students’ geospatial thinking has a positive relationship with their creative behaviors and sense of place. Students’ creativity was found to facilitate their sense of place. Moreover, students’ creativity was discovered to mediate the relationship between geospatial thinking and sense of place. These results provide useful implication for the cultivation of students’ sense of place. In this regard, geography education has the critical role in improving students’ geospatial thinking skills to stimulate creative behaviors for a better sense of place.

Spatiotemporal monitoring of urban CO2 emissions is crucial for developing strategies and actions to mitigate climate change. However, most spatiotemporal inventories do not adopt urban form data and have a coarse resolution of over 1 km, which limits their implications in intra-city planning. This study aims to model the spatiotemporal carbon emissions of the two largest mega-urban regions in China, the Yangtze River Delta and the Pearl River Delta, using urban form data from the Local Climate Zone scheme and landscape metrics, nighttime light images, and a year-fixed effects model at a fine resolution from 2012 to 2016. The panel data model has an R2 value of 0.98. This study identifies an overall fall in carbon emissions in both regions since 2012 and a slight elevation of emissions from 2015 to 2016. In addition, urban compaction and integrated natural landscapes are found to be related to low emissions, whereas scattered low-rise buildings are associated with rising carbon emissions. Furthermore, this study more accurately extracts urban areas and can more clearly identify intra-urban variations in carbon emissions than other datasets. The open data supported methodology, regression models, and results can provide accurate and quantifiable evidence at the community level for achieving a carbon-neutral built environment.

Birth defects are a leading cause of infant death. Pregnant women spend a large amount of time indoors, and little research from population-based studies has investigated the association between indoor air pollution and birth defects. We aimed to examine whether using coal, biomass, or electromagnetic stoves for cooking is associated with risk of birth defects compared to using gas stoves.A birth cohort study was conducted from 2010 to 2012 in Lanzhou, China. Cases (n = 264) were singleton births with birth defects, which were defined as abnormalities of structure or function, including metabolism, presented at birth based on the International Classification of Diseases (ICD)-10 codes. Controls (n = 9926) were defined as singleton live births without birth defects. Unconditional logistic regression models were employed to estimate the association adjusting for confounding variables.Compared to gas stoves for cooking, biomass (OR = 2.66, 95%CI: 1.38-5.13), and electromagnetic stove (OR = 1.90, 95%CI: 1.26-2.88) for cooking were associated with an increased risk of birth defects. The significant associations remained among non-congenital heart disease (CHD) defects but not CHDs.Using biomass or electromagnetic stoves for cooking during pregnancy was associated with an increased risk of birth defects. Additional studies are warranted to confirm these novel findings. Studies with larger sample size or greater statistical power are also warranted to better estimate the associations for individual birth defects.

In recent years, the health conditions of the elderly (the middle-aged and the old, which for this study means people over 50 years of age) have deteriorated along with the aggravation of air pollution, which led to the change of medical insurance costs. This phenomenon is particularly prominent in developing countries, such as China. A total of 15,892 research subjects from 56 prefecture-level cities in 23 provinces were collected from the database of China Health and Retirement Longitudinal Survey (CHARLS). We investigated the effects of air pollution, physical health, and medical insurance costs among three mechanisms using logistics and Ordinary Least Squares (OLS) hybrid cross-sectional regression, and we conducted a robust test. Overall, two pollutants, namely, PM10 and NO2, respectively showed an “inverted U-shaped” and “positive U-shaped” influencing path to health. In addition, when we studied the mechanism of air pollution affecting medical insurance costs, we found that air pollution can affect medical insurance costs through affecting self-rated health, and that the impact path is related to different diseases to some extent. At the same time, there was a certain negative correlation between air pollution and medical insurance: The higher the degree of air pollution, the worse the self-rated health, and the fewer opportunities there are to purchase medical insurance. It can be seen that air pollution affects the physical health of middle-aged and elderly people, thus indirectly and negatively affecting the medical insurance cost. Further research also found that the types of air pollutants in southern and northern China showed some differences. Specifically, NO2 and SO2 were the pollutants that harm the health of the elderly in the south and north, respectively.