| With the ever-expanding level of opening up,international trade has profoundly changed individuals’ health investment and consumption.The contribution of expanding international trade in promoting employment and raising residents’ income cannot be ignored,and the increasing income level further promote health investment and consumption.Besides,the import of high-tech medical equipment and medicines has improved the cure rate of diseases and played an irreplaceable role in protecting the health of residents.In addition,the technology spillover effect of foreign trade can help promote the green production technology innovation of mainland enterprises to reduce pollution emissions,which contributes to lowering health depreciation rate and improving the health by reducing the probability of residents’ exposure to high concentrations of pollution.Although foreign trade has a significant role in promoting health,the health risks associated with foreign trade should not be ignored.The import and export of high fat,high sugar,high salt food,and tobacco have led to the frequent occurrence of chronic human diseases,such as obesity,diabetes,and cardiovascular diseases.In addition to health level,international trade will affect the distribution of economic factors and lead to health inequality related to social and economic status.Health inequality has always been a major problem that puzzles people from all walks of life.Health inequality runs counter to the“Five Development Concepts”.In order to implement the “Healthy China Strategy” and achieve high-quality economic development,the problem of health inequality must be overcome.The effect of international trade on health is great and complex.Under the background of “Healthy China Strategy” and the new development of double circulation,how to realize high-quality international trade has become the key to improve residents’ health level and reduce health inequality.This paper comprehensively and systematically analyzes the multiple transmission mechanisms of international trade on health.Specifically,by adopting various research methods such as literature induction,theoretical and empirical analyses,qualitative and quantitative analyses,firstly,we make a deep and systematic study on the influence mechanism of international trade on health level;Then,we analyze the effect of trade structure on health level;Furthermore,other than health level,from the perspective of health inequality,we research the contribution degree of international trade on the health inequality,and whether the trade inequality or the elasticity of health to trade contribute more in the change of health inequality.This paper aims to provide recommendations from a foreign trade perspective to improve health level and meanwhile reduce health inequality,which has important theoretical and practical significance for realizing China’s high-quality opening up and implementing the “Healthy China Strategy”.This paper focuses on the following issues: First,what are the current situation and changing trend of foreign trade scale,trade structure,health level,and health inequality in China? Is there an inevitable connection between foreign trade and health level and health inequality? Second,given the controversial issue of the relationship between international trade and health level and the blank of domestic research in the field of international trade and health inequality,we consider whether to provide empirical support based on data of China.What is the channel mechanism of international trade affecting health level? How much does international trade contribute to health inequality? What is the impact of trade on the changing trend of health inequality? Third,in the existing research,the indirect impact of international trade on health level is explained only based on the single channel of income or environmental pollution.Is the medical level another channel? Does international trade affect individual health by affecting the medical level of a country or region? Fourth,based on clarifying the relationship among international trade,health level,and health inequality,what policy suggestions should be made on how to improve health level and meanwhile reduce the health inequality by promoting high-quality trade.Based on the above problems,the main contents of the article are divided into the following eight parts:In the introduction,we firstly expound the research background and significance of this paper and then sort out and summarize existing research at home and abroad to provide the new research perspective of this paper.After that,the research method,structure arrangement,technical route,innovations,and shortcomings are explained in detail.The first chapter defines the concepts of international trade,health level,and health inequality to specify research objects.Then,combining with the health demand theory,the foreign trade and income distribution theory,the foreign trade and public goods theory,the pollution haven hypothesis,the pollution halo hypothesis,and the environmental health theory,the theoretical elaboration is carried out to seek the theoretical support for this paper.The second chapter describes in detail the role of trade in the healthy evolution and current situation of trade and residents’ health.Through the rigorous selection of indicators,this paper makes an in-depth analysis of the changing trend of each indicator at different times and in different regions and reaches a preliminary understanding of the correlation between trade,health level,and health inequality.The third chapter analyzes the mechanisms of international trade on health.Firstly,from the perspectives of both the closed and international economic system,this paper analyses what can affect health.Then,focusing on the international economic system,how international trade directly and indirectly influence health.The direct impact is based on nutrition,food safety,and disease transmission.The indirect impact is based on family income,medical level,and environmental pollution.The deep analysis of the mechanism can provide theoretical support for empirical analyses later.The fourth chapter is an empirical analysis of the impact of international trade on health level.The individual-level research data is mainly based on the China Family Panel Studies(CFPS)from 2010 to 2018 and matches with the provincial-level international trade.Specifically,firstly,it is to judge the direction,magnitude,and influencing channels of the trade on the health.Then,the heterogeneity analyses are conducted to see whether the impact of international trade on health level varies among different samples by dividing the whole sample into eastern,central,and western regions,samples with different income and environmental pollution,and urban and rural samples.The fifth chapter is an empirical analysis of the impact of international trade structure on health.Individual-level health data is from the CFPS2014-2018 and the trade data at the provincial-and industrial-level published by the customs.First,we construct the index of trade structure by technology-intensive trade/(labor-intensive trade+capital-intensive trade+technology-intensive trade).Then,we further analyse the influence mechanism of trade structure on health level and the curve relationship between them.The sixth chapter is the empirical analysis of the effect of international trade on health inequality.This chapter mainly analyzes income-related health inequality.Firstly,the selfassessed health data of CFPS is used to measure the degree of health inequality and judge the changing trend of health inequality at present.Secondly,to analyze and compare the direct and indirect effects of international trade on health inequality,and the indirect channels include family income,medical level and environmental pollution to health inequality.Finally,further explore the role of international trade in the change of health inequality and the decomposition of the sources of change.In chapter seven,according to the previous theoretical analysis and empirical analysis results,the research conclusions and policy recommendations are put forward.This paper has some innovations in research perspective,research content,research methods,and research conclusions.Firstly,for the innovation of the research perspective,we explore the influencing factor of people’s health in China from international trade.The health problems include not only individual health level but also health inequality among different individuals or groups.The existing research mainly focuses on health level,while the problem of health inequality is often ignored,and the domestic research in the field of international trade and health inequality is still at a blank stage.This paper has marginal contributions by exploring the effect and mechanism of international trade on health level,as well as the contribution degree of international trade on health inequality.Secondly,in terms of research content,different from the existing research which studies the indirect impact of international trade on health only based on the intermediary mechanism of income or environmental pollution,this paper also adds another channel which is medical level.Furthermore,this paper constructs the index of trade structure and analyzes the influence mechanism of trade structure on health level and the curve relationship between them.Besides individual health level,income-related health inequality is also investigated.Thirdly,in terms of research methods,the research data merges the micro-level self-assessed health data with trade data at the provincial level.So,our research can be applied to the micro individual by using individual-level self-assessed data other than the provincial-level life expectancy and mortality data.Finally,for the research conclusions,this paper finds that the direct effect of international trade is not conducive to individual health but it indirectly increases health level by increasing income,improving medical level,and reducing pollution emissions.But international trade also contributes to health inequality.Based on the above theoretical analysis and empirical analysis,this paper draws the following conclusions:Firstly,the scale of foreign trade in China is constantly rising,and the structure of trade is constantly changing and upgrading from low value-added primary products to high valueadded industrial finished products,but the spatial distribution of international trade is extremely uneven among different regions.The whole health level is rising with heterogeneity among individuals while the degree of health inequality is expanding.Secondly,the direct of international trade on health level is negetive,however,in the indirect channels,international trade significantly improves health level by increasing per capita household income,reducing environmental pollution,and improving medical level.In the heterogeneity analyses,the direct negative effect of foreign trade on health was found in all the heterogeneous samples,but the indirect effect was significantly different.Specifically,the impact mechanism of international trade on health level varies among eastern,central,and western regions.The positive effect of income intermediary channel is only effective in the east,but not significant in the central and western regions;The positive effect of medical level intermediary channel has the greatest effect in the western region,followed by the central region,while the effect in the eastern region is not significant.The transmission path of international trade to promote health level by reducing environmental pollution is established in the eastern,central,and western regions,but the marginal positive effect in the western region is the largest,followed by the central region and eastern region.The impact of international trade on health level is also different between urban and rural areas.The effect of income on health is positive in urban and rural areas,but it is not significant.But the effect of trade on health through medical level channel is positive in urban and rural areas,and the positive effect is greater in urban areas than that in rural areas;The transmission path that international trade is beneficial to health level by reducing environmental pollution is only significant in urban areas,but not establishes in rural areas.Third,the international trade structure can significantly promote individual health level.The direct effect of trade structure is positive.For the indirect effects,the trade structure hurts health level because it is unfavorable to the increase of income,but it indirectly increases health level by improving medical level and reducing environmental pollution.What’s more,there is an inverted "N" curve relationship between trade structure and health level.There are two inflection points in the trade structure,and the positions of the two inflection points are 0.45 and 0.78 respectively.This shows that when the trade structure ratio is between 0.45 and 0.78,the technology-intensive trade should be increased relatively,while when the trade structure ratio is too small(less than 0.45)or too large(greater than0.78),the technology-intensive trade should be reduced relatively,while the labor-intensive and capital-intensive trade should be increased.Fourth,there is income-related health inequality,and foreign trade is one of the main factors contributing to health inequality.Forign trade contributes to health inequality through including income,medical level,and environmental pollution channels,and the contribution of income channel is the largest and then medical level and environmental pollution’s contribution smallest.In the dynamic change trend of health inequality,the degree of health inequality shows an expanding trend.The direct effect of foreign trade intensified the expansion trend of health inequality,while the mediating effect of income and medical level both alleviate the expansion trend of health inequality,while the mediating effect of environmental pollution had little effect on the change of health inequality. |
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