Industrial Wastewater Discharge and Disease Incidence in China: A Spatial Analysis of Public Health and Sustainable Development Implications

With the continuous advancement of industrialization in China, industrial wastewater discharge has become a critical factor influencing water environmental quality, public health, and the long-term sustainability of regional development. This study systematically examines both the direct and spatial spillover effects of industrial wastewater on disease incidence. Based on panel data from 30 provincial-level regions in China over the period 2011–2020, a composite incidence index of four waterborne infectious diseases is constructed using the entropy weight method, and the Spatial Durbin Model (SDM) is employed to capture both local and cross-regional effects. The results show that industrial wastewater discharge significantly increases disease incidence and exhibits clear spatial spillover effects, suggesting that the associated health risks may extend beyond local boundaries. Moreover, the analysis suggests that the “Water Ten Plan” reduced both local effects and regional spillovers, highlighting the value of stricter discharge control and coordinated basin-level governance for sustainable regional development. Overall, this study uncovers the spatial health externalities of industrial pollution and provides empirical support for integrated policy approaches linking environmental governance with public health protection.