China’s Clean Heating Policy and Effects on Blood Pressure in Rural Beijing Adults
9 affiliations
- 1Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Quebec H3A 0G4, Canada
- 2Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado 80523-1019, United States
- 3Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, Colorado 80523-1019, United States
- 4National Field Observation and Research Station (Beijing Yanshan) for Earth Critical Zone, University of Chinese Academy of Sciences, Beijing 100049, China
- 5College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
- 6College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
- 7Bieler School of Environment, McGill University, Montréal, Quebec H3A 0G4, Canada
- 8Department of Equity, Ethics, and Policy, McGill University, Montréal, Quebec H3A 0G4, Canada
- 9Department of Geography, McGill University, Montréal, Quebec H3A 0G4, Canada
Abstract
Large-scale residential energy transitions from solid fuel to clean energy are promising strategies to mitigate climate change and improve population health, but rigorous evaluation of their impacts is rare. China’s Clean Heating Policy (CHP) aimed to transition tens of millions of households from coal to electric and gas-based space heating. Following evidence of policy-driven improvements in indoor air pollution and indoor temperature, we evaluated the CHP’s impact on blood pressure (BP). In winter 2018–2019, we enrolled 1,003 adults aged >40 years from 50 Beijing villages not yet treated by the CHP; 20 villages were treated during follow-up (winters 2019–2020 and 2021–2022). Brachial and central BP and covariates were measured during household visits by trained staff. Policy impacts were estimated using an extended two-way fixed-effects difference-in-differences approach with village-clustered standard errors and adjustment for key BP predictors to improve precision. We found evidence of reductions (in mmHg) in brachial systolic BP (−1.4, 95% confidence interval [CI]: −3.3, 0.5), central systolic BP (−1.5, 95% CI: −3.3, 0.4), brachial diastolic BP (−1.6, 95% CI: −2.9, −0.3), and central diastolic BP (−1.6, 95% CI: −2.9, −0.3) among villages treated by the CHP compared with those untreated. Treatment effects varied by the year villages were treated by the CHP (p for homogeneity = 0.00 to 0.14) with greater BP reductions among participants in earlier-treated villages. Household energy policies like the CHP may serve as effective population-level interventions to reduce BP in China and complement high-risk cardiovascular prevention strategies.
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BibTeX
@article{sternbach2026chinas,
title = {{China’s Clean Heating Policy and Effects on Blood Pressure in Rural Beijing Adults}},
author = {Talia Sternbach and Sam Harper and Xiaoying Li and Collin Brehmer and Yuanxun Zhang and Wenlu Yuan and Shu Tao and Kaibing Xue and Kennedy Hirst and Guofeng Shen and Christopher Barrington-Leigh and Xiang Zhang and Brian Robinson and Ellison Carter and Jill Baumgartner},
journal = {Environmental Health Perspectives},
year = {2026},
month = aug,
doi = {10.1021/ehp.6c00053},
url = {https://doi.org/10.1021/ehp.6c00053},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - China’s Clean Heating Policy and Effects on Blood Pressure in Rural Beijing Adults
AU - Talia Sternbach
AU - Sam Harper
AU - Xiaoying Li
AU - Collin Brehmer
AU - Yuanxun Zhang
AU - Wenlu Yuan
AU - Shu Tao
AU - Kaibing Xue
AU - Kennedy Hirst
AU - Guofeng Shen
AU - Christopher Barrington-Leigh
AU - Xiang Zhang
AU - Brian Robinson
AU - Ellison Carter
AU - Jill Baumgartner
PY - 2026
DA - 2026/08/28
JO - Environmental Health Perspectives
DO - 10.1021/ehp.6c00053
UR - https://doi.org/10.1021/ehp.6c00053
AB - Large-scale residential energy transitions from solid fuel to clean energy are promising strategies to mitigate climate change and improve population health, but rigorous evaluation of their impacts is rare. China’s Clean Heating Policy (CHP) aimed to transition tens of millions of households from coal to electric and gas-based space heating. Following evidence of policy-driven improvements in indoor air pollution and indoor temperature, we evaluated the CHP’s impact on blood pressure (BP). In winter 2018–2019, we enrolled 1,003 adults aged >40 years from 50 Beijing villages not yet treated by the CHP; 20 villages were treated during follow-up (winters 2019–2020 and 2021–2022). Brachial and central BP and covariates were measured during household visits by trained staff. Policy impacts were estimated using an extended two-way fixed-effects difference-in-differences approach with village-clustered standard errors and adjustment for key BP predictors to improve precision. We found evidence of reductions (in mmHg) in brachial systolic BP (−1.4, 95% confidence interval [CI]: −3.3, 0.5), central systolic BP (−1.5, 95% CI: −3.3, 0.4), brachial diastolic BP (−1.6, 95% CI: −2.9, −0.3), and central diastolic BP (−1.6, 95% CI: −2.9, −0.3) among villages treated by the CHP compared with those untreated. Treatment effects varied by the year villages were treated by the CHP (p for homogeneity = 0.00 to 0.14) with greater BP reductions among participants in earlier-treated villages. Household energy policies like the CHP may serve as effective population-level interventions to reduce BP in China and complement high-risk cardiovascular prevention strategies.
SN - 0091-6765
SN - 1552-9924
ER -