The Differential Impact of PM2.5 on the Health of Vulnerable Groups in the Context of Rapid Urbanization: An Empirical Analysis Based on Jiangsu Province (2010–2020)

The impact of PM2.5 pollution on the health inequality of vulnerable groups is a core issue in environmental justice research. However, existing studies in China mostly focus on severely polluted areas in northern China. They lack comparative cases in economically developed eastern regions. They also rarely consider changes in the impact of air pollution on residents’ health amid rapid urbanization. Based on multi-source data, this study employed spatial visualization, spatial autocorrelation analysis and spatial regression models. It investigated the impact of PM2.5 pollution on the health inequality of vulnerable elderly groups in 92 districts and counties of Jiangsu Province from 2010 to 2020. The results show that: first, the regional pattern of health inequality between PM2.5 pollution and vulnerable elderly groups in Jiangsu has continuously evolved, with a “lower in the south and higher in the north” pollution pattern and high overlap between high-pollution areas and high elderly health risk areas in northern Jiangsu. Second, the spatial coupling between PM2.5 and elderly health risks has gradually strengthened, showing significant positive spatial agglomeration in 2020, confirming obvious spatial agglomeration characteristics of air pollution’s health impact. Third, the adverse health impact of PM2.5 on vulnerable elderly groups became significant in 2020, exhibiting cumulative and lagged characteristics; urbanization and regional coordinated development have played a positive role in alleviating regional health inequality, while a lagging energy structure further exacerbates the health vulnerability of the elderly. This study fills the gap of insufficient research on economically developed eastern regions and provides targeted empirical references for urban refined governance and precise prevention and control of environmental health inequality.