The study was conducted to evaluate impacts of perceived environmental pollution on health, which analyzed impacts of rural and urban residents’ perceived environmental pollution on health.
Perceived environmental pollution
This study highlighted the impacts of perceived environment pollution on health especially among urban residents. The study found that the rate of urban residents perceiving air pollution(35.67%), water pollution(17.96%), garbage pollution(25.05%), noise pollution(32.05%) was higher than that of rural counterparts, respectively, which means urban residents perceived more environmental pollution than rural counterparts. This was similar to the results of a local study on environmental awareness using the data from a national survey Chinese General Social Survey(CGSS) in 2010. A western study also found urban residents are assumed to be more environmentally concerned than rural counterparts. Perceived air pollution, garbage pollution and noise pollution all had a significant negative impact on urban residents’ health while none of the perceived pollution had a significant impact on rural residents’ health. China’s environmental pollution is severe in both cities and villages in recent years. In spite of measures such as limiting cars on the road to reduce exhaust emissions and the technical development of air purification in recent years, China's large-scale air pollution continues to spread from north to south. Some developed cities can use gas to protect the environment completely, while less developed cities still choose coal and gas as fuels in China. Due to the attribute of rapid spread, air pollution quickly transmitted to neighborhood cities. This has resulted in worse and worse air pollution in both cities and villages in China. In rural China, the rates of stomach and liver cancer are 50% higher than that in the major cities of the country . In part, this may be due to the lack of protection of water quality in rural areas. One of the goals published on Nov 8, 2018 by the Ministry of Ecology and the Environment and by the Ministry of Agriculture and Rural Affairs, by 2020, the utilization rate of fertilizers and pesticides in the country's major crops will reach more than 40%; the coverage rate of soil testing and formula fertilization technology will reach more than 90%; the overall utilization rate of livestock and poultry fungi will exceed 75%; the corresponding rate of equipment for sewage treatment plants in large farms will be over 95%. This further emphasizes that water pollution in Chinese rural areas has become a major hazard . Moreover, garbage collection and treatment in rural areas has not been talked about until recent years. Still little attention has been paid to noise pollution in these areas in China. Relative to the urban areas, environmental protection infrastructure, pollution supervision and environmental protection technology in rural areas have greatly lagged behind. In addition, due to the pressure of strict environmental policies in cities, some heavily polluting enterprises are transferred to the villages in order to weaken the risk of environmental protection departments ' punishment and also to reduce penalty costs . However, rural residents still perceived little about the impacts of environmental pollution on health due to inadequate policies aiming at controlling environmental pollution in rural areas.
The rate of good health among rural residents (68.08%) was higher than that of urban counterparts (66.64%). And the rate of poor health among rural residents (8.69%) was higher than that of urban residents (7.14%).
In this study, males were more likely to have a positive attitude towards their health status than females. The results are consistent with a study based on the first wave of the European Social Survey in 2003 conducted in 22 countries and in all countries men report a better health than women. The study based on CGSS in 2010 also presented the similar results among both urban and rural residents. Some studies also found women suffer from more nonfatal chronic conditions, and greater likelihood of functional limitations although they live longer than men.
Residents aged at 30 years old or above were more likely to have a positive attitude towards their health status than the younger ones, which applied to both urban and rural residents. This may because greater socioeconomic status(SES) will promote residents to take advantage of new mechanisms that protect and promote better health and reduce their mortality risk and young residents aged at 29 years old or below are more likely to be lack of SES compared with the older ones. However, a contradictory findings revealed by a local study conducted in China showed rural or urban residents aged at 30 years old or above both had a negative attitude towards health than the younger ones(29 years or below) as a great deal of evidence has suggested that young people are more energetic and do more physical exercise[25, 26].
Residents whose education level was primary school or below were more likely to have a negative attitude towards health than those with a higher education level among both urban and rural residents, which is similar to the results of local studies showed years of schooling had a positive impact on residents’ self-rated health[21, 27]. Education level is an indicator of SES, correlated with income and occupation, as well as working and living conditions. Residents with low education are more likely to be influenced by disease and have no access to medical interventions. A western study also found the education level mediates the health differences between Japanese and Chinese compared with Hawaiian and a higher level of education is positively associated with longer life and better health throughout the lifespan.
Most studies have showed married adults enjoyed better physical and mental health than the unmarried and have longer life expectancies than the divorced. In this study, compared with the widowed, never married residents are more likely to be good or poor health compared to general health. In a universal marriage system, tradition of marriage coexisted with modern culture of being single in China. Young residents enjoying the single status may have good health while others who can’t get married at marriageable age have poor health compared with individuals who ever married even they lost the spouse but they are more successful in the society based on the marriage tradition. And married or ever married residents were more likely to have a positive attitude towards their health than others.
In this study, the father’s education level had a positive impact on urban and rural residents’ good health. The father’s education level is an important factor with regard to the family’s SES. Higher father’s education level means the family’s income and occupation may be better, which creates better nutrition during the residents’ childhood and more medical resources when they face some health risks.
The study has several implications. First, more advocate on environmental pollution should be provided especially for rural residents and make them notice the seriousness of air, water, garbage and noise pollution. This helps residents build an awareness of environmental protection and participate more in their daily life. Second, more official report on the impact of environmental pollution on health in China should be published. The State of Environment(SOE) Report played an important role in acknowledging the development made in enhancing its environment by the government in China. However, so little attention has been paid to these reports by the rural residents and they still lack environmental awareness. Third, measures to increase the protection of rural environment should be given greater attention. For instance, some highly polluting enterprises should not be allowed to produce in villages. These enterprises continue to transfer to rural areas currently, which add risks and vulnerability of rural environment. This may create risk for agricultural production and make the peasants lose their livelihood. More research is needed to determine the factors that influence rural residents’ health and their environmental awareness as environmental rights inequality may create more health inequality between urban and rural residents.
First, as a cross-sectional study, it can solely exhibit a static picture that cannot thoroughly describe the changes between the actual impacts of perceived environmental pollution on residents’ health. Second, the study captured some demographic factors and environmental factors in residents’ health and could not take all the individual differences into consideration, such as nutrition, physical exercise. Third, the results of this study were based on measurement of self-rated health. This may not reflect the real status of their physical health. In the following study, some objective assessment needs to be added, such as some chronic diseases. Finally, the huge differences in awareness of environmental pollution’s impacts on health between urban and rural residents partly are due to the priority of environmental protection policies in cities. The study did not involve the impacts of environmental policies.