Promoting or inhibiting? The impact of sports industry investment on regional health equity

Abstract Addressing regional health equity (RHE) is a pivotal challenge for sustainable development. The innovative and rapidly expanding sports industry investment (SII) presents a potential avenue to mitigate these disparities. Based on a panel dataset of 287 Chinese prefecture-level cities from 2003 to 2023, we systematically investigate this relationship using fixed effects, mediation models, and a spatial Durbin model. Our findings show that SII significantly enhances RHE, with the effects being more pronounced in economically advanced regions, cities with net capital inflows, and sports-derivative sectors. We identify three key mechanisms driving this effect: boosts in resident income, industrial structure upgrades, and advancements in health-related technology. Notably, we uncover substantial positive spatial spillovers, demonstrating that investments in one locality generate health equity benefits in neighboring regions. These indirect spillovers constitute the primary component of the total effect. To our knowledge, this is the first study to empirically map the comprehensive pathway - including both direct mechanisms and spatial spillovers - through which SII influences RHE. Our findings offer crucial policy implications for the synergistic formulation of industrial and public health strategies.