{
  "abstract": "Climate policy is widely expected to yield a health dividend: cleaner air can improve health without a simultaneous expansion of defensive capacity. We distinguish exposure reduction from defensive adaptation in China's 2017 climate-adaptive city pilot, using a 2011–2022 panel of 264 cities, including 21 treated units. A difference-in-differences design examines fine particulate matter (PM2.5) exposure, while the Global Exposure Mortality Model translates exposure into modeled pollution-related health burden. Physicians, hospital beds, and employee-insurance enrolment measure selected defensive inputs. The pilot is associated with a 3.87 μg/m ³ lower PM2.5 (95% confidence interval −6.49 to −1.25; wild-bootstrap P = 0.0067). The estimate remains negative after pollution-convergence adjustments but is smaller and imprecise in the matched sample. The central accounting model implies an approximately 8.10% lower burden (conditional 95% confidence interval −11.32 to −4.76%), not an observed mortality reduction. Average capacity estimates are imprecise and cannot establish the absence of defensive adaptation. A physician-based coupling calibration admits positive and negative contributions and cannot bound the total defensive response. Among nine pre-policy capacity interactions, telecommunications intensity is positively associated with bed expansion (+4.40 per 10,000 residents; pointwise 95% confidence interval 2.47–6.32; adjusted P = 0.021), although pre-trend concerns limit causal interpretation. Other interactions remain uncertain. The main estimate is close to an illustrative detection threshold, warranting caution with non-significant findings. The results support an exposure-related health co-benefit under explicit accounting assumptions. Assessment incentives, coordination, and financing are possible explanations for uneven responses, but their roles are not identified by these estimates.",
  "abstract_shown": true,
  "affiliations": [
    "School of Economics and Management, Nanchang Vocational University"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Cun Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Hantao Gong"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/66vkj14e99rvj.bib",
  "cited_by": 0,
  "doi": "10.3389/fpubh.2026.1987084",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13717398/?tool=EBI",
  "id": "66vkj14e99rvj",
  "issns": [
    "2296-2565"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1987084/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2307|Air Quality and Health Impacts"
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  "openalex": "W7222270774",
  "pdf_url": "https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1987084/pdf",
  "pmcid": "PMC13717398",
  "pmid": "42959475",
  "published": "2026-10-14",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/66vkj14e99rvj.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:22Z",
      "native_id": "10.3389/fpubh.2026.1987084",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1987084/full"
    },
    {
      "first_seen": "2026-10-31T00:20:37Z",
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      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13717398"
    },
    {
      "first_seen": "2026-11-01T00:20:52Z",
      "native_id": "MED:42959475",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42959475"
    },
    {
      "first_seen": "2026-11-02T12:21:43Z",
      "native_id": "PMC13717398",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fpubh.2026.1987084"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2307|Air Quality and Health Impacts",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Does climate adaptation policy deliver a health dividend? Exposure, modeled health burden, and defensive capacity in China's climate-adaptive city pilots",
  "title_text": "Does climate adaptation policy deliver a health dividend? Exposure, modeled health burden, and defensive capacity in China's climate-adaptive city pilots",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:21:43Z",
  "url": "https://research.draconitic.com/paper/66vkj14e99rvj",
  "venue": "Frontiers in Public Health",
  "versions": []
}