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Fulltext Uptake and determinants of private health insurance enrollment in a country with heavily subsidised public healthcare: A cross-sectional survey in East Coast Malaysia

Abd Khalim MA, Sukeri S

PLoS One, 2023;18(1):e0278404.
PMID: 36649258 DOI: 10.1371/journal.pone.0278404

Malaysia's subsidised public healthcare system is heavily reliant on government funding. Increasing the uptake of private health insurance (PHI) would alleviate the financial burden on public healthcare facilities caused by high patient loads. The study aimed to determine the uptake of PHI and its associated factors among the East Coast Malaysian populations. A cross-sectional online survey was conducted between February and June 2021. Proportionate stratified sampling was applied to select 1138 participants, and logistic regression was performed to determine the factors associated with PHI uptake. The proportion of the study samples that purchased PHI was 54.3%. Enrolment of private health insurance was associated with working in the public sector (aOR: 6.06, 95% CI: 2.65, 13.88) and private sector (aOR: 6.27, 95% CI: 2.65, 14.85), being self-employed (aOR: 9.23, 95% CI: (3.59, 23.70), being in the middle 40% household income percentile (aOR: 2.74, 95% CI: 1.95, 3.85) and top 20% household income percentile (aOR: 4.42, 95% CI: 2.87, 6.80), and living in urban areas (aOR: 1.31, 95% CI: 1.01, 1.70). Even in the presence of subsidised public healthcare, the high proportion of PHI uptake reflects a demand for private health insurance. The study suggests that PHI should be promoted among those who are employed or self-employed, the middle- and high-income groups, and urban residents. The findings may be beneficial for the government and insurance companies to improve strategies to enhance PHI uptake among these population.

Matched MeSH terms: Income*
Cost-effectiveness analysis of clinical smoking cessation interventions in Thailand

Tosanguan J, Chaiyakunapruk N

Addiction, 2016 Feb;111(2):340-50.
PMID: 26360507 DOI: 10.1111/add.13166

AIMS: Clinical smoking cessation interventions have been found typically to be highly cost-effective in many high-income countries. There is a need to extend this to low- and middle-income countries and undertake comparative analyses. This study aimed to estimate the incremental cost-effectiveness ratio of a range of clinical smoking cessation interventions available in Thailand.
METHODS: Using a Markov model, cost-effectiveness, in terms of cost per quality-adjusted life years (QALY) gained, from a range of interventions was estimated from a societal perspective for males and females aged 40 years who smoke at least 10 cigarettes per day. Interventions considered were: counselling in hospital, phone counselling (Quitline) and counselling plus nicotine gum, nicotine patch, bupropion, nortriptyline or varenicline. An annual discounting rate of 3% was used. Probabilistic sensitivity analyses were conducted and a cost-effectiveness acceptability curve (CEAC) plotted. Comparisons between interventions were conducted involving application of a 'decision rule' process.
RESULTS: Counselling with varenicline and counselling with nortriptyline were found to be cost-effective. Hospital counselling only, nicotine patch and bupropion were dominated by Quitline, nortriptyline and varenicline, respectively, according to the decision rule. When compared with unassisted cessation, probabilistic sensitivity analysis revealed that all interventions have very high probabilities (95%) of being cost-saving except for nicotine replacement therapy (NRT) patch (74%).
CONCLUSION: In middle-income countries such as Thailand, nortriptyline and varenicline appear to provide cost-effective clinical options for supporting smokers to quit.

Matched MeSH terms: Income
Fulltext A comparative drug utilisation study of the treatment of diabetes in Malaysia and Australia

Hasan SS, Clavarino AM, Mamun AA, Kairuz T

Australas Med J, 2015;8(6):179-88.
PMID: 26213581 DOI: 10.4066/AMJ.2015.2330

Once a disease of developed countries, type 2 diabetes mellitus (T2DM) has become widespread worldwide. For people with T2DM, achievement of therapeutic outcomes demands the rational and quality use of medicine.

Matched MeSH terms: Income
Effectiveness of Quality Improvement Processes, Interventions, and Structure in Trauma Systems in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis

Jin J, Akau'ola S, Yip CH, Nthumba P, Ameh EA, de Jonge S, et al.

World J Surg, 2021 07;45(7):1982-1998.
PMID: 33835217 DOI: 10.1007/s00268-021-06065-9

BACKGROUND: Trauma mortality in low- and middle-income countries (LMICs) remains high compared to high-income countries. Quality improvement processes, interventions, and structure are essential in the effort to decrease trauma mortality.
METHODS: A systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country trauma systems was conducted from November 1989 to August 2020 according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were conducted in an LMIC population according to World Bank Income Classification, occurred in a trauma setting, and measured the effect of implementation and its impact. The primary outcome was trauma mortality.
RESULTS: Of 37,575 search results, 30 studies were included from 15 LMICs covering five WHO regions in a qualitative synthesis. Twenty-seven articles were included in a meta-analysis. Implementing a pre-hospital trauma system reduced overall trauma mortality by 45% (risk ratio (RR) 0.55, 95% CI 0.4 to 0.75). Training first responders resulted in an overall decrease in mortality (RR 0.47, 95% CI 0.28 to 0.78). In-hospital trauma training with certified courses resulted in a reduction of mortality (RR 0.71, 95% CI 0.62 to 0.78). Trauma audits and trauma protocols resulted in varying improvements in trauma mortality.
CONCLUSION: There is evidence that quality improvement processes, interventions, and structure can improve mortality in the trauma systems in LMICs.

Matched MeSH terms: Income
Fulltext Agreement Technologies for Energy Optimization at Home

González-Briones A, Chamoso P, De La Prieta F, Demazeau Y, Corchado JM

Sensors (Basel), 2018 May 19;18(5).
PMID: 29783768 DOI: 10.3390/s18051633

Nowadays, it is becoming increasingly common to deploy sensors in public buildings or homes with the aim of obtaining data from the environment and taking decisions that help to save energy. Many of the current state-of-the-art systems make decisions considering solely the environmental factors that cause the consumption of energy. These systems are successful at optimizing energy consumption; however, they do not adapt to the preferences of users and their comfort. Any system that is to be used by end-users should consider factors that affect their wellbeing. Thus, this article proposes an energy-saving system, which apart from considering the environmental conditions also adapts to the preferences of inhabitants. The architecture is based on a Multi-Agent System (MAS), its agents use Agreement Technologies (AT) to perform a negotiation process between the comfort preferences of the users and the degree of optimization that the system can achieve according to these preferences. A case study was conducted in an office building, showing that the proposed system achieved average energy savings of 17.15%.

Matched MeSH terms: Income
Fulltext Interlinked motivation model to use mobile Crowdsourcing platforms among low-income citizens

Mahmod, M., Na’in, N., Ahmad, R., Chit, S.C., Habbal, A.

Pertanika Journal of Science & Technology, 2017;25(110):99-108.
MyJurnal

Crowdsourcing is an initiative implemented by the Malaysian government to support its National Key Result Area (NKRA) agenda to improve the lives of citizens with low household income in the B40 group. Crowdsourcing activities are done on mobile crowdsourcing platforms that enable workers to perform micro tasks at any time for a fixed payment. However, without active and constant participation from the crowd, this initiative might not be successful. This paper describes a preliminary study in identifying motivation factors for participating in mobile crowdsourcing platforms. This study identified intrinsic and extrinsic motivation factors that can attract crowds to participate in mobile crowdsourcing platforms. Technology efficacy factors that interlink with motivation factors were also identified in this study. The preliminary study employed the qualitative method where in-depth interviews were conducted among 30 crowdsourcing participants in Peninsular Malaysia. The findings of this study are the basis for a motivation model that can attract crowdworkers from among the B40 group of household-income earners to participate in crowdsourcing to procure and perform available micro-tasks. The findings will also help improvise mobile platforms for crowdsourcing.

Matched MeSH terms: Income
Integrated models for shipping a vendor’s final production batch to a single buyer under linearly decreasing demand for consignment policy

Omar M, Supadi S

Sains Malaysiana, 2012;41:367-370.

This paper considers the problem of a vendor or manufacturer supplying a final production batch to a single buyer under linearly decreasing demand for a finite time horizon. The vendor manufactures the product at a finite rate and ships the output to the buyer. In this model we considered the case where the holding cost at the vendor is greater than the buyer and propose a consignment model. The objective was to minimize the total cost of stock transfer from vendor to buyer and stock holding at the vendor and the buyer. We derived the structure of the optimal solution and illustrate the proposed models with numerical examples.

Matched MeSH terms: Income
Fulltext Survey dataset of Malaysian perception on rising cost of living

Che Sulaiman NF, Sanusi NA, Muhamad S

Data Brief, 2020 Feb;28:104910.
PMID: 31890781 DOI: 10.1016/j.dib.2019.104910

The introduction of good and services tax (GST) that has replaced the sales and services tax (SST) had contributed to the rising cost of living in Malaysia. The focus of this research was to present a data article on the response and perception of Malaysian households about the increasing cost of living. A descriptive research design was adopted in this study. Data were obtained from randomly selected 751 respondents of households across Malaysia. The data were collected through a structured questionnaire. Data analysis was carried out using tables and percentages. The findings show the negative perceptions of Malaysian households on the increase in the cost of living. There are various causes of the rising cost of living and can be inferred based on the perspective of income changes, price changes and patterns household consumption expenditure.

Matched MeSH terms: Income
Malaysian household income distribution: a fractal point of view

Fatimah Abdul Razak, Faridatulazna Ahmad Shahabuddin

Sains Malaysiana, 2018;47:2187-2194.

Malaysian Household Income Survey data provided by the Malaysian Department of Statistics is used to provide evidence
that the upper tails of the household income distribution follows a fractal based distribution known as power-law.
Inequality measures are then applied to ascertain the levels of inequality based on this distribution. In addition to that,
we analyzed the data in terms of different classes of occupation, obtained power-law exponents for each class and then
highlighted the inequality between these classes.

Matched MeSH terms: Income
Feasibility study on small cars as an alternative to conventional fleets due to low occupancy: case study in Indonesia

Setiyo M, Widodo EM, Rosyidi MI, Waluyo B, Pambuko ZB, Tamaldin N

Heliyon, 2020 Jan;6(1):e03318.
PMID: 32051877 DOI: 10.1016/j.heliyon.2020.e03318

Consumer interest in privately managed urban transport services in Indonesia are showing a declining trend. On the other hand, the presence of Transportation on Demand (ToD) based on Internet of Things (IoT) has attracted the majority of conventional fleet customers which contribute to the declining trend of occupancy. Therefore, this study aims to present a feasibility study of a small car RE60 Three Passenger and One Driver (3P+1D) four-wheeler as an alternative to replace conventional fleets. The Break-Even Point (BEP), Net Present Value (NPV), Internal Rate of Return (IRR), and Payback Period (PP) are analyzed based on vehicle operating data. The analysis shows that there is an additional monthly income flow of IDR 1,533,122 and IDR 2,536,946 from RE60 operations compared to the high and low consumption of fuel from existing fleets, respectively. In conclusion, it is feasible to invest in small car RE60 as a replacement for the existing fleets since the fundamental indicators (BEP, NPV, IRR, and PP) showed positive results before the specified instalment period. Sensitivity analysis also shows good results, NPV shows positive results (>0) although the input conditions are made pessimistic to -30% from NPV base case. The BEP of RE60 will cut distance travelled at 190,670 km and 115,225 km, respectively. NPV of IDR 33,088,000 and IDR 80,841,000 will be obtained at the 60th month after the operation and IRR also enabled good scores, at 2.24% and 4.17%.

Matched MeSH terms: Income
Economic Evaluation of Type 2 Diabetes Mellitus Interventions in Low- and Middle-Income Countries: A Systematic Review of the Literature

Lum KY, Oppong R, Kigozi J

Asia Pac J Public Health, 2022 Nov;34(8):752-760.
PMID: 36039503 DOI: 10.1177/10105395221122643

The primary aim of this study is to assess the evidence on the cost-effectiveness of type 2 diabetes mellitus (T2DM) interventions with a focus on diabetes education, lifestyle modifications, surgical intervention, and pharmacological therapy in low- and middle-income countries (LMICs). A systematic review was conducted to identify economic evaluations of T2DM interventions published in LMICs for the period 2009-2019. A total of 25 studies were identified, with more than half of the studies being decision analytic models. Critical appraisal of the identified studies showed they were of good quality. Overall, the reported interventions in this review were very heterogeneous, which made them difficult to compare. However, there was strong evidence suggesting that diabetes education was a very cost-effective strategy in LMICs. Further evidence on affordability and budget impact of bariatric surgery is required before adopting the intervention. Metformin-based therapy showed promising evidence on cost-effectiveness and thus should be offered to T2DM patients in LMICs. On the contrary, the cost-effectiveness of lifestyle modifications remains understudied in LMICs. The findings in this review can inform policy guidance toward the inclusion of T2DM interventions in the benefit packages for Universal Health Coverage in LMICs.

Matched MeSH terms: Income
Fulltext Watershed Horizontal Ecological Compensation Policy and Green Ecological City Development: Spatial and Mechanism Assessment

Lin X, Baskaran A, Zhang Y

Int J Environ Res Public Health, 2023 Feb 02;20(3).
PMID: 36768047 DOI: 10.3390/ijerph20032679

Green ecological development has become an inevitable choice to achieve sustainable urban development and carbon neutrality. This paper evaluates the level of green ecological city development in the Xin'an watershed as measured by green total factor productivity (GTFP), analyzes the direct and spatial effects of the Watershed Horizontal Ecological Compensation policy on GTFP, and further examines the moderating effect of the Research and Development (R&D) incentives, industrial structure, and income gap. This paper conducts difference-in-differences (DID) and spatial regression analysis on 27 cities from 2007 to 2019. The results show that GTFP progresses to varying degrees across cities over time, especially in the pilot cities. Crucially, the Watershed Horizontal Ecological Compensation policy significantly improved GTFP, although the effect was slight. Interestingly, the increase in GTFP in pilot cities that implemented the policy spatially suppressed the increase in GTFP in cities that did not implement the policy. Our evidence also shows that the positive effect of the policy is higher in regions with higher R&D incentives and industrial structure upgrading, which indicates that R&D incentives and industrial upgrading are crucial. In comparison, the income gap has not made the expected negative adjustment effect under the Chinese government's poverty alleviation policy. However, the positive policy effect is heterogeneous in the downstream and upstream pilot cities. The "forcing effect" of the policy on the downstream cities is more favorable than the "compensating effect" on the upstream cities. Therefore, policymakers should pay more attention to ensuring the effectiveness of the Watershed Horizontal Ecological Compensation policy in enhancing GTFP as a long-term strategy to guarantee the sustainability of green ecological development in Chinese cities.

Matched MeSH terms: Income
Fulltext Disparities in Prevalence and Barriers to Hypertension Control: A Systematic Review

Elnaem MH, Mosaad M, Abdelaziz DH, Mansour NO, Usman A, Elrggal ME, et al.

Int J Environ Res Public Health, 2022 Nov 06;19(21).
PMID: 36361453 DOI: 10.3390/ijerph192114571

Controlling hypertension (HTN) remains a challenge, as it is affected by various factors in different settings. This study aimed to describe the disparities in the prevalence and barriers to hypertension control across countries of various income categories. Three scholarly databases-ScienceDirect, PubMed, and Google Scholar-were systematically examined using predefined search terms to identify potentially relevant studies. Original research articles published in English between 2011 and 2022 that reported the prevalence and barriers to HTN control were included. A total of 33 studies were included in this systematic review. Twenty-three studies were conducted in low and middle-income countries (LMIC), and ten studies were from high-income countries (HIC). The prevalence of hypertension control in the LMIC and HIC studies ranged from (3.8% to 50.4%) to (36.3% to 69.6%), respectively. Concerning barriers to hypertension control, patient-related barriers were the most frequently reported (n = 20), followed by medication adherence barriers (n = 10), lifestyle-related barriers (n = 8), barriers related to the affordability and accessibility of care (n = 8), awareness-related barriers (n = 7), and, finally, barriers related to prescribed pharmacotherapy (n = 6). A combination of more than one category of barriers was frequently encountered, with 59 barriers reported overall across the 33 studies. This work reported disparities in hypertension control and barriers across studies conducted in LMIC and HIC. Recognizing the multifactorial nature of the barriers to hypertension control, particularly in LMIC, is crucial in designing and implementing customized interventions.

Matched MeSH terms: Income
Fulltext Analysing the Predictors of Financial Stress and Financial Well-Being among the Bottom 40 Percent (B40) Households in Malaysia

Mansor M, Sabri MF, Mansur M, Ithnin M, Magli AS, Husniyah AR, et al.

Int J Environ Res Public Health, 2022 Sep 30;19(19).
PMID: 36231802 DOI: 10.3390/ijerph191912490

This paper aims to analyse factors affecting financial stress among the Bottom 40 Percent (B40) group of Malaysian households, reflecting overall financial well-being. Data were collected through questionnaires from 1008 respondents across five major regions in Malaysia. The data were analysed using Exploratory Factor Analysis (EFA) and Partial Least Squares-Structural Equation Modelling (PLS-SEM). This study provides evidence that financial behaviour, financial vulnerability (debt and income), and locus of control (luck and self-confidence) significantly affect financial stress among B40 households. The results show a significantly positive relationship between financial stress with financial vulnerability (debt and income) and locus of control (self-confidence). On the contrary, financial behaviour and locus of control (luck) show a significant negative relationship with financial stress. The result also indicates that financial stress affects financial well-being. Overall, the findings indicate that policy-makers should invent more effective and substantial stimulus packages or other measures to reduce the financial burden on B40 households. The findings could eventually provide insights for future research to delve into the social impact of financial stress. This study also has established a valid and reliable instrument to measure financial stress involving B40 households in Malaysia that eventually reflects the financial well-being of this group of people.

Matched MeSH terms: Income
Stochastic convergence in carbon emissions based on a new Fourier-based wavelet unit root test

Erdogan S, Solarin SA

Environ Sci Pollut Res Int, 2021 May;28(17):21887-21899.
PMID: 33410083 DOI: 10.1007/s11356-020-12033-y

Most of the existing studies on stochastic convergence of emission have not adequately considered smooth structural changes. The primary purpose of this paper is to examine the validity of stochastic convergence at different income levels by recently proposed Fourier-based wavelet augmented Dickey-Fuller test with smooth shifts. Empirical results can be summed up as follows: (i) carbon emission per capita follows the stationarity process in 35 high-income countries, while carbon emission per capita follows the stationarity process in 27 upper-middle-income countries; (ii) besides, carbon emission per capita follows stationarity process in 30 lower-middle-income countries, while carbon emission per capita follows stationarity process in 13 low-income countries; (iii) in light of these findings, it can be said that stochastic convergence among different income groups is valid. The implications of the empirical findings for environmental planning and management are discussed in the body of the paper.

Matched MeSH terms: Income
The control of corruption and energy efficiency relationship: an empirical note

Ozturk I, Al-Mulali U, Solarin SA

Environ Sci Pollut Res Int, 2019 Jun;26(17):17277-17283.
PMID: 31012074 DOI: 10.1007/s11356-019-05016-1

This study aims at exploring the impact of corruption control on energy efficiency in 60 countries categorized by income: lower middle (LMI), upper middle (UMI), and high (HI). Panel methodology was utilized taking the period of 2000-2017. As cross-sectional dependence is confirmed among the tested equations, the Pesaran (J Appl Econ 22(2):265-312, 2007) unit root test and the augmented mean group estimator proposed by Eberhardt and Teal (2010) were utilized to overcome this matter. The results in general indicate that the lower the corruption is, the more the energy efficiency for all income group economies. Moreover, renewable energy reduces energy efficiency in lower-middle income and high-income economies while its effect is positive in middle-income economies. In addition, the environmental Kuznets curve (EKC) found to be present in all income group economies. Lastly, causality relationships among energy efficiency, corruption, and GDP were present mostly in upper-middle income and high-income economies. From the results, it was recommended that the countries from all income groups should increase their corruption control for the purpose of enhancing energy efficiency.

Matched MeSH terms: Income
Effects of energy consumption, economic growth, and financial development on carbon emissions: evidence from heterogeneous income groups

Ehigiamusoe KU, Lean HH

Environ Sci Pollut Res Int, 2019 Aug;26(22):22611-22624.
PMID: 31165972 DOI: 10.1007/s11356-019-05309-5

This paper examines the effects of energy consumption, economic growth, and financial development on carbon emissions in a panel of 122 countries. We employ both first-generation and second-generation cointegration and estimation procedures in order to address diverse economic and econometric issues such as heterogeneity, endogeneity, and cross-sectional dependence. We find a cointegration relationship between the variables. Energy consumption, economic growth, and financial development have detrimental effects on carbon emissions in the full sample. When the sample is split into different income groups, we reveal that economic growth and financial development mitigate carbon emissions in high-income group but have the opposite effects in low-income and middle-income groups. The implication of the findings is that energy consumption increases carbon emissions. While high levels of income and financial development decrease carbon emissions, low levels of income and financial development intensify it. Based on the findings, the paper makes some policy recommendations.

Matched MeSH terms: Income
The impact of democracy and income on CO2 emissions in MINT countries: evidence from quantile regression model

Agbede EA, Bani Y, Naseem NAM, Azman-Saini WNW

Environ Sci Pollut Res Int, 2023 Apr;30(18):52762-52783.
PMID: 36847946 DOI: 10.1007/s11356-023-25805-z

This study analyses the relationship between democracy and environmental pollution in the MINT countries using a panel data spanning 1971-2016. It also investigates the interactive effect of income and democracy on CO2 emissions. We used various estimation techniques for the analysis, ranging from the quantile regression, OLS-fixed effect and GLS-random effect regressions with Driscoll-Kraay standard errors to control for cross-sectional dependence while a panel threshold regression is used for robustness check. The results showed existence of long-run relationship between CO2 emissions and the explanatory variables. The quantile regression results for interaction model indicate that economic growth, democracy and trade openness promote environmental pollution via their positive effects on CO2 emissions. Primary energy however reduces pollution across the lower and middle quantiles but enhances it in higher quantiles. The interaction effect is negative and statistically significant across all quantiles. This implies that democracy has a significant role in moderating the impact of income on CO2 emission in the MINT countries. It thus follows that if the MINT countries radically strengthen democracy and enhance income, it would be possible for them to achieve greater economic development and reduce CO2. In addition, a single threshold model is used to identify the asymmetry in response to CO2 emissions at lower and upper levels of democratic regimes. The results showed that once the degree of democracy is above the threshold level, an increase in income would reduce CO2 emissions but once it is below the threshold level, the effect of income becomes insignificant. Based on these results, the MINT countries need to strengthen democracy, enhance income level and relax trade barriers.

Matched MeSH terms: Income
Fulltext Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension

Schutte AE, Jafar TH, Poulter NR, Damasceno A, Khan NA, Nilsson PM, et al.

Cardiovasc Res, 2023 Mar 31;119(2):381-409.
PMID: 36219457 DOI: 10.1093/cvr/cvac130

Raised blood pressure (BP) is the leading cause of preventable death in the world. Yet, its global prevalence is increasing, and it remains poorly detected, treated, and controlled in both high- and low-resource settings. From the perspective of members of the International Society of Hypertension based in all regions, we reflect on the past, present, and future of hypertension care, highlighting key challenges and opportunities, which are often region-specific. We report that most countries failed to show sufficient improvements in BP control rates over the past three decades, with greater improvements mainly seen in some high-income countries, also reflected in substantial reductions in the burden of cardiovascular disease and deaths. Globally, there are significant inequities and disparities based on resources, sociodemographic environment, and race with subsequent disproportionate hypertension-related outcomes. Additional unique challenges in specific regions include conflict, wars, migration, unemployment, rapid urbanization, extremely limited funding, pollution, COVID-19-related restrictions and inequalities, obesity, and excessive salt and alcohol intake. Immediate action is needed to address suboptimal hypertension care and related disparities on a global scale. We propose a Global Hypertension Care Taskforce including multiple stakeholders and societies to identify and implement actions in reducing inequities, addressing social, commercial, and environmental determinants, and strengthening health systems implement a well-designed customized quality-of-care improvement framework.

Matched MeSH terms: Income
Does China Overseas Economic and Trade cooperation Zone affect CO2 emissions in host countries? Evidence from a quasi-natural experimental of countries along the "Belt and Road"

Jiang Y, Chen Y

Environ Sci Pollut Res Int, 2023 Sep;30(41):94276-94289.
PMID: 37531059 DOI: 10.1007/s11356-023-29081-9

China Overseas Economic and Trade Cooperation Zone (COCZs) which as a platform for China's foreign investment and trade has a potential impact on CO2 emissions, while strengthening bilateral investment and trade between China and the host countries. Since most of the COCZs are located in countries along the "Belt and Road," the purpose of this paper is to investigate the impact of COCZs on CO2 emissions of the countries along the "Belt and Road" and the mechanism of this impact. We constructed a panel data of 63 countries along the "Belt and Road" from 2000 to 2020, and conducted an empirical study using the difference-in-difference (DID) model. Our research result show that COCZs can significantly increase the CO2 emissions of the countries along the "Belt and Road." Then, we conduct a series of robustness tests and endogeneity test on the estimation results of the baseline model, and the results of the tests all support the conclusion reached by the baseline model. Our heterogeneity analysis reveals that the effect of COCZs on CO2 emissions is more significant in Asian countries with lower national income or industrialization and higher country risk. Finally, we analyzed industrial value added and energy depletion as possible impact mechanisms, the results of mechanism model shows that COCZs can increase the industrial value added and then significantly increase CO2 emissions, but energy depletion was not an efficient mechanism. Our paper provides a new insight into the impact of bilateral economic and trade cooperation zones on CO2 emissions in host countries.

Matched MeSH terms: Income

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