Impact of media reports and environmental pollution on health and health expenditure efficiency

Over the past few decades, China’s rapid economic, energy, and industrial developments have caused serious environmental damage. However, as there are large resource, energy use, economic, and environmental damage differences across Chinese regions, the Chinese government is seeking to reduce city pollution across the country. Most previous analyses have only looked at these issues on a single level; for example, the impact of environmental pollution on health, or energy and environmental efficiency analyses, but there have been few studies that have conducted overall analyses. Further, many of the methods that have been used in previous research have employed one-stage radial or non-radial analyses without considering regional differences. Therefore, this paper developed a meta undesirable two-stage EBM DEA model to analyze the energy, environment, health, and media communication efficiencies in 31 Chinese cities, from which it was found that the productivity efficiency in most cities was better than the health treatment efficiencies, the GDP and fixed asset efficiency improvements were small, the air quality index (AQI) and CO₂ efficiencies varied widely between the cities, media report and governance inputs were generally inefficient, the birth rate efficiencies were better than the respiratory disease efficiencies, and the technical gap was best in Guangzhou, Shanghai, and Lhasa. Also, it found that high-income cities have a higher technology gap than upper middle–income cities, and media reports efficiency have a high correlation with respiratory diseases and CO₂.