Effects of Household Clean Fuel Combustion on the Physical and Mental Health of the Elderly in Rural China

Against the backdrop of the construction of an ecological civilization and the "Healthy China 2030" initiative, access to clean fuels is crucial for achieving optimal health and wellbeing, as well as sustainable social development. The purpose of this study is to investigate the effect of household clean fuel combustion (HCFC) on multiple dimensions of health among older adults while shedding light on the potential mechanisms. We performed a cross-sectional study of the data from the 2018 China Health and Retirement Longitudinal Survey, and we surmounted the underlying issues of endogeneity with the application of propensity score matching and the instrumental variable strategy. The results revealed that HCFC has positive effects on the health of older adults, particularly by improving their psychological wellbeing. The adoption of clean fuels among the elderly was associated with a significant increase in SRH by 3.06% to 3.42% and a decrease in CES-D by 7.96% to 8.28%. These positive environmental health effects became stronger among the elderly under the age of 75, as well as among those who were educated and had chronic diseases. Moreover, the results demonstrated that HCFC significantly alleviated chronic pain and increased social interaction among older adults, highlighting two potential pathways for promoting their wellbeing. Given that a significant number of rural households in China rely on polluting fuels, targeted strategies are crucial for promoting the use of clean fuels, particularly for vulnerable populations.