Does Urbanization Increase the Risk of Emerging Infectious Diseases in China? A Spatial Econometric Analysis

The current COVID-19 pandemic has inspired more and more discussion about the relationship between urbanization and emerging infectious diseases (EID). This paper aims to examine the spatial effect of urbanization on EID incidence, such as hepatitis, syphilis and gonorrhea in China. Taking into account geographical and economic factors, the estimation results of the Spatial Error Model (SEM) show that urbanization has increased the risks of EID transmission from 2003 to 2019 in China. The spatial effects of urbanization are slightly different due to different types of infectious diseases, with a larger effect on syphilis comparing with hepatitis and gonorrhea. The regional heterogeneity test shows that the impact of urbanization on EID in eastern China is stronger than that in the Midwest especially when considering spatial correlation. Policy implications that include health must be integrated into urban planning, attaching more importance to ecological construction, improving regional joint prevention and control mechanisms, and more attention being paid to vulnerable groups. Considering the frequent occurrence of COVID-19 among cities in China, we emphasize the importance of enhancing the coordinated anti-crisis capacity of urban clusters and highlight the leading role of central cities.