Effects of air pollution on cardiovascular health in patients with type 2 diabetes mellitus: Evidence from a large tertiary hospital in Shandong Province, China

Air pollution has posed serious threats to human health. Based on the microdata of a large tertiary hospital in Shandong Province from 2016 to 2021, combined with the macro data such as air quality monitoring data, meteorological data, and city-level regional socio-economic data, this paper empirically tests the impact of air pollution instrumented by thermal inversions on the cardiovascular health of patients with type 2 diabetes mellitus (T2DM) and its group differences. The results show that: (1) Air pollution has a negative impact on the cardiovascular health of patients with T2DM, that is, the cardiovascular health of patients with T2DM will decline in regions with high air pollution; (2) The impact of air pollution on cardiovascular health in T2DM patients is heterogeneous, with males and older patients bearing greater air pollution health losses; (3) From the perspective of the external environment, the negative effects of environmental pollution on patients' health were significantly reduced in areas with higher environmental regulation intensity and better public health conditions, indicating the necessity of strengthening environmental governance and increasing public health expenditure.