| Over the past 40 years of reform and opening up,thanks to the effective spatial agglomeration of economic activities,China’s economy has achieved sustained and rapid growth.Entering the new era,with the solid advancement of a series of regional development strategies such as the coordinated development of Beijing-Tianjin-Hebei,the development of the Yangtze River Economic Belt,and the construction of the Guangdong-Hong Kong-Macao Greater Bay Area,the spatial agglomeration process of China’s economic activities will be further strengthened and highlighted.After China’s economic and social development has made major achievements,the public has attached greater importance to health,safety and quality of life.In addition,the frequency of outbreaks of international epidemics such as influenza A,Ebola hemorrhagic fever,and new coronavirus pneumonia is also increasing.Public health issues have drawn great attention from all sectors of society.While economic agglomeration promotes rapid economic development through economies of scale and agglomeration,it also directly affects the public health of agglomeration areas through wealth creation,population mobility,and pollution of production and life.Therefore,conducting research on the topic of China’s economic agglomeration and public health is of great theoretical significance and practical value.The intermediary mechanism between economic agglomeration and public health is multifaceted,but starting from the source,resource mismatch is an important channel that cannot be ignored.According to traditional spatial economics theory,economic agglomeration can produce agglomeration effects and scale effects.Under the condition that human capital,scientific and technological resource,medical and health resource,which are naturally related to public health,are regarded as the input elements of public health output,economic agglomeration should be conducive to the optimal allocation and intensive utilization of these resources,thus contributing to urban public health.However,most of China’s economic agglomeration is policy-guided agglomeration.Since the government cannot grasp the complete market information required for correct decision-making,the aforementioned resources are mismatched to varying degrees in various regions.From this perspective,the influence direction of economic agglomeration on public health depends to a large extent on whether the human capital,scientific and technological resource,medical and health resource necessary for the improvement of public health have been rationally allocated.Based on the above considerations,this paper follows the logic path of "leading out problems--heoretical analysis--empirical investigation--practical guidance",focusing on the impact of economic agglomeration and resource mismatch on public health.First of all,on the basis of fully combing the relevant literature,the core concepts of this paper are defined.Then,from two dimensions of theoretical model and mechanism analysis,this paper analyzes the mechanism of economic agglomeration and resource mismatch on public health,thus constructing the theoretical analysis framework of this paper.Through the model derivation,it is found that the impact direction of economic agglomeration and resource mismatch on public health depends on the external impact coefficient of economic agglomeration and the contribution rate of each input factor,and these parameters are constrained by the specific economic development stage,which makes the impact of economic agglomeration and resource mismatch on public health present complex periodic changes.The mechanism analysis shows that:(1)There is a nonlinear effect of economic agglomeration on public health.In the initial growth stage,mature stage and stagnation stage of urban economic development,the impact of economic agglomeration on public health presents the characteristics of inhibition,promotion and inhibition respectively.(2)Resource mismatch has inhibitory effect on public health,that is to say,whether there is insufficient resource allocation or excessive resource allocation,it is not conducive to the improvement of urban public health,but the specific human capital mismatch,scientific and technological resource mismatch,medical and health resource mismatch have different effects on public health.(3)Resource mismatch has a mediating effect on the impact of economic agglomeration on public health.However,there are also significant differences in the mediating effects of human capital mismatch,science and technology resource mismatch and medical and health resource mismatch.Next,using the comprehensive evaluation method combining fixed base range entropy weight method and fixed base equal weight assignment method,Gaussian kernel density analysis and exploratory spatial data analysis methods,this paper focuses on the scientific measurement and spatiotemporal evolution analysis of China’s urban public health level.The main findings are as follows: The public health level in Chinese cities is showing a rising trend,and the differences in the public health level among cities are expanding at first and then converging slightly,and there is always a multi-level differentiation pattern.At the same time,urban public health has a significant positive spatial spillover effect and spatial "Peer Effects".Under the mutual "magnetic attraction" between this city and neighboring cities,the urban public health level tends to form a spatial agglomeration equilibrium of the same nature;In addition,the difference evolution of urban public health level in different time periods and different regions also has the "imprint" of time period characteristics and regional characteristics.Then,using the generalized spatial two-stage least square method and the mediating effect model test method,this paper makes an empirical study on the public health effects of economic agglomeration and resource mismatch,the mediating effects of economic agglomeration on public health through resource mismatch,and the heterogeneity influence characteristics in different periods,different regions,different grades of cities and different attributes of cities.The main findings are as follows.First,China’s economic agglomeration has a "U-shaped" influence on urban public health,which is firstly inhibited and then promoted.However,this influence is heterogeneous in different time periods,different regions,different grades of cities and different attributes of cities.(1)The inhibitory effect of economic agglomeration on public health was dominant from 2003 to 2012,while the promoting effect was dominant from 2013 to 2018.This shows that appropriately increasing the economic agglomeration degree at the national level and promoting changes in the quality of economic agglomeration is an effective and realistic way to improve the urban public health level.(2)The economic agglomeration in the eastern and central regions has a significant U-shaped influence on public health.The economic agglomeration in the northeast region has a significant negative monotonic effect on public health,while the economic agglomeration in the western region has a significant positive monotonic effect on public health.This shows that the path choice of economic agglomeration in different regions should fully consider the regional attributes and "suit measures to local conditions".(3)Both high-grade cities and ordinary cities present the "U-shaped" impact of economic agglomeration on public health.The difference is that after reaching the inflection point of the economic agglomeration degree,the public health promotion effect of high-grade cities is stronger.(4)Both urban agglomeration cities and non-urban agglomeration cities also show the "U-shaped" impact characteristics of economic agglomeration on public health.However,the public health promotion effect of the economic agglomeration of urban agglomeration cities is more prominent,while the public health restraint effect of non-urban agglomeration cities is more prominent.Second,regardless of the stage of the urban economy,the mismatch of human capital,scientific and technological resource,and medical and health resource will all have a significant inhibitory effect on urban public health,and the inhibitory effect caused by the medical and health resource mismatch is the most prominent.However,the negative health effects of the three types of resource mismatch are gradually being weakened.At the same time,the public health effects of resource mismatch are also heterogeneous:(1)The resources mismatch of the three types from 2003 to 2012 showed a significant inhibitory effect on urban public health,while from 2013 to 2018,only the medical and health resource mismatch had a significant inhibitory effect on public health,this shows that it should be an important breakthrough to correct resource mismatch and improve the urban public health level.(2)The resources mismatch of the three types on public health has an inhibitory effect in the four major regions.However,the eastern region has the least inhibitory effect,followed by the central region,and the northeast and western regions have the strongest inhibitory effect.Moreover,the regression coefficients of human capital mismatch and technological resource mismatch in the eastern region are not significant.This is consistent with the theoretical expectation.(3)Compared with ordinary cities,the inhibitory effect of resources mismatch of the three types on public health in high-grade cities is weaker,and even the human capital mismatch cannot constitute a significant inhibitory effect on urban public health.(4)Compared with non-urban agglomeration cities,the three types of resources mismatch has a weaker restraining effect on public health,indicating that the urban agglomeration cities have higher resource allocation efficiency,better matching of resource supply and demand,and more adequate resource utilization.Third,resource mismatch is the mediating variable of economic agglomeration affecting urban public health.China’s economic agglomeration has a inhibitory effect on urban public health by intensifying the mismatch of human capital,scientific and technological resource and medical and health resource.However,the mediating effect of resource mismatch also presents heterogeneity:(1)From 2003 to 2012,there was a mediating effect for all three types of resource mismatch,and from 2013 to2018,there was only a mediating effect for medical and health resource mismatch,and the mediating effect of medical and health resource mismatch has been the most prominent in the study period.(2)The mediating effect of human capital mismatch in the eastern region is not significant,the mediating effect of the science and technology resource mismatch in the northeast and central regions is not significant,and the mediating effect of the medical and health resource mismatch in the western region is not significant.This shows that different regions should pay different attention to promoting the quality reform of economic agglomeration and correcting the imbalance and mismatch of resources,so as to improve the urban public health level in China.(3)The mediating effects of the resources mismatch of three types of in high-grade cities and the mediating effects of the human capital mismatch in ordinary cities are linear,while the mediating effects of the scientific and technological resource mismatch and medical and health resource mismatch in ordinary cities are nonlinear.The reason for this heterogeneity lies in the differences in the stage and degree of economic agglomeration among different grades of cities.(4)The sub-sample test of urban agglomeration cities and non-urban agglomeration cities found that the economic agglomeration of urban agglomeration cities effectively corrected the public health inhibitory effect of human capital mismatch,and the mediating effect of non-urban agglomeration cities’ scientific and technological resource mismatch was not significant,while remaining test results are consistent with the whole sample regression results.Finally,based on the research conclusions and combined with China’s national conditions,targeted policy recommendations centered on "improving urban public health" are put forward.These suggestions include: Building a collaborative and efficient public health linkage mechanism,and gathering a strong force of health governance;Promoting the quality reform of economic agglomeration and fully tapping the positive externality of agglomeration economy;Persisting in deepening the reform of the market-oriented allocation of factors,and focusing on correcting resource imbalances and mismatch. |
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