Effect of agricultural carbon emissions on farmers’ health expenditure of China: evidence from the educational threshold effect

Environmental pollution, especially agricultural carbon emissions (ACE), has led to public health problems to rural areas in China and accompanied by a heavy medical economic burden. However, most studies on carbon dioxide emissions and healthcare expenditures focused on the industrial sector, and the effect of ACE was overlooked. Therefore, studying the effect of ACE on rural residents’ healthcare expenditures (NHCE) is not only conducive to accelerating the low-carbon transformation of agriculture but also has important implications for reducing healthcare expenditures. In addition, the effect of ACE on NHCE in different areas might be complex and nonlinear due to differences in years of schooling (EDU) leading to different awareness of environmental protection and health among farmers. Therefore, this paper used the Bayesian quantile regression (BQR) model and the panel threshold model to explore the effect of ACE on NHCE in different areas, based on the panel data of 31 provinces in China from 2007 to 2019. The results showed that ACE and NHCE experienced similar spatial distribution from 2007 to 2019. The BQR estimation results found that ACE had a significant positive effect on NHCE at different quantile levels during the sample period, public health concern, and thereby increasing the medical and economic burden of rural households. Meanwhile, ACE had a positive effect on NHCE with a significant single threshold effect from EDU. Specifically, farmers gradually realize the harm of environmental pollution to health with the continuous improvement of education level, and then ACE aggravated the improvement of NHCE after exceeding the threshold. EDU was more essential for farmers in contiguous poverty (CP) areas than in relatively developed (RD) areas and played an important role between ACE and NHCE. Furthermore, demographic structure, economic development, and public services were also positive driving factors for NHCE. The results of analysis provide a valuable reference for understanding the factors influencing NHCE and enable formulation of ACE emission reduction policies according to local conditions.