Public behavioral compliance challenges in household medical waste management: an evolutionary game perspective on policy

Household medical waste (HMW) management faces significant challenges, including low waste recycling participation rates and gaps in policy regulatory. This study aims to promote a healthy living environment and wellbeing for all citizens by developing a tripartite evolutionary game model to examine the policy effectiveness mechanism and the strategic interactions among governments, medical waste disposal institutions and residents. Our findings are threefold. First, the analysis reveals a stable equilibrium (1, 1, 0), indicating that under loose government regulation, community residents and medical waste disposal institutions establish a code of conduct for compliant recycling practices, market-oriented cooperation is more sustainable than intensive government enforcement. This result can be explained by the peer effect: residents' non-compliant behavior generates feelings of guilt, and the increased psychological cost proves more effective than external policy intervention. This finding challengs the conventional assumptions that intensive government intervention achieves greater effectiveness. Second, through numerical analysis, we identify the thresholds at which key parameters become effective in government policy design. In particular, investment in environmental education exhibits a jump effect once it exceeds a critical threshold, enabling the system to bypass intermediate stages and move directly toward the optimal equilibrium. Third, we propose a three-phase household medical waste management strategy encompassing environmental education enhancement, institution's profitability optimization, and regulatory cost control to facilitate public smooth transition to optimal equilibrium.