Effect of air pollution on morbidity in Sweden : county-level case study

Sammanfattning: Many studies on air pollution have been done on mortality, morbidity and hospital admissions. Little has been done on air pollution and selected air pollution-related morbidities. This research tried to fill this gap. In this research, I study the effect of air pollution on the number of total patients per 100K inhabitants on the 21 Swedish counties. I selected 4 air pollutants mainly: sulphur oxides, particulate matter 2.5μg/m3, particulate matter 10μg/m3 and total suspended particulate; and 11 diseases that are commonly known to be caused by air pollution on the epidemiological scientific literatures. The study is a panel data over the period 2005-2016 across Swedish counties. I use information of annual concentrations of the air pollutants at a county level. I incorporated socio-economic control variables for estimating the health effect of air pollution and employed the fixed effect static estimation model. It is observed that air pollution, specifically PM2.5 and TSP have a linear positive effect on the number of patients per 100K inhabitants in all the Swedish counties. Number of personnel per 100K inhabitants and population density are found to have positive and negative associations with the number of patients respectively. The results suggested a 1% increase in PM2.5 and TSP leads to a 0.113% and 0.177% increases in the number of patients per 100K inhabitants respectively. When breaking down all the selected disease, then SOx is positively associated with PHD, PM2.5 is positively associated with OFHD, GU and DU, and TSP is positively associated with PHD, OFHD, DAAC, OUDCS and DRS. The cost estimation indicated that the average annual per capita cost due to PM2.5 and TSP is SEK 18 558 and 18 594 respectively. The direct cost due to PM2.5 and TSP is around 0.11% of the Swedish GDP and indirect costs accounted for 0.10% of the Swedish GDP. The overall results of this thesis suggest that it is time to initiate policies that will encourage a further reduction in the emissions of PM2.5 and TSP. It is also required that the awareness of people to air pollution to be elevated so that people would have to improve their avoidance behavior which in turn could lead to a better health outcomes. Keywords: panel data, fixed effect model, health production function, SOx, PM2.5, TSP, patients per 100K inhabitants, direct costs and indirect costs.