The impact of early-life air pollution on rural child stunting: evidence from China

This study examines the causal impact of early-life air pollution on stunting among children aged 0 to 5 years. Exploiting the staggered entry of coal-fired power plants as an exogenous shock, we construct a difference-in-differences model leveraging upwind and downwind county differentials, drawing on ten waves of CHNS data spanning 1989 to 2015. We find that child stunting probability increased significantly in downwind counties following power plant entry relative to upwind counties, indicating substantial adverse effects of early-life air pollution on child growth. Robustness checks support these conclusions. Mechanism analysis reveals that power plant entry elevated PM2.5, PM10, and O3 concentrations in downwind counties, raising child morbidity rates, illness duration, and medical expenditures. Children in downwind counties also experienced reduced nutritional intake, with marked declines in protein, fat, carbohydrate, and energy consumption, accompanied by weight reduction. Heterogeneity analysis indicates that while effects show no significant differences across age and gender, impacts concentrate among families with lower maternal education and household income, as well as in lower income counties and villages. Our findings demonstrate that air pollution from coal-fired power plants generates important negative externalities on rural child health during rapid industrialization, with disproportionate burdens on disadvantaged populations.