Impact of clean energy use on the health of rural residents in China: The mediating role of leisure activities and household cleanliness

• Clean energy use improves rural health, reducing asthma, discomfort, and depression. • Greater benefits for women, low-income households, and Midwestern residents. • Mechanisms: Promotes leisure activities and enhances household cleanliness. • Policy recommendations for clean energy adoption and health outcomes. Against the backdrop of global sustainable development goals and Healthy China Initiative, investigating the health impacts of clean energy adoption in rural areas is critical for improving rural well-being and advancing sustainable social development. Using data from 6,535 China Family Panel Studies, this study employs a multiple ordered probit model and mediation effect model to examine the health effects of clean energy use. Descriptive statistics reveal that 62.3% of rural residents report good, very good, or excellent health, while 61.6% use clean energy. Despite these encouraging trends, both health outcomes and clean energy adoption rates still leave room for improvement. Empirical results demonstrate that clean energy use significantly improves rural health outcomes by reducing asthma incidence, physical discomfort, and depressive symptoms. Notably, the health benefits are more pronounced among women, low-income households, and residents in central-western regions. Mechanistic analysis identifies two indirect pathways: clean energy adoption improves health outcomes through increased leisure activities and enhanced household cleanliness. Consequently, the government needs to enhance the production and promotion of clean energy, implement awareness campaigns for it, foster a conducive atmosphere for its utilization, and bolster the establishment of public cultural and recreational facilities in rural regions.