Background: The impact of air pollution on residents' happiness remains unclear and the underlying mechanism remains unknown. We aimed to examine the direct effect of air pollution on residents' happiness and indirect effect through mediating their health. Methods: Based on the 2017 China Comprehensive Social Survey Data (CGSS), data on happiness were retrieved from 11,997 residents in 28 provinces in China. An ordered-probit model was used to examine the effect of air pollution on residents' happiness and health, respectively. A stepwise regression was used to derive the direct effect of air pollution on residents' happiness and indirect effect from health impairment attributable to air pollution. Results: Air pollution was associated with lower levels of health (coef. -0.190, 95% CI -0.212, -0.167, p < 0.001), while health was positively associated with happiness (coef. 0.215, 95% CI 0.196, 0.234, p < 0.001). Mediation analysis methods showed that air pollution impacted residents' happiness directly and indirectly: the percent of total effect that was mediated through health was 36.97%, and the ratio of indirect to direct effect was 0.5864. Conclusions: Health plays a major mediating role in the relation between air pollution and residents' happiness. In order to alleviate the impact of air pollution on residents' happiness, future strategies should focus on health promotion besides reducing air pollutant emission.
Keywords: air pollution; health; mediating effect; residents’ happiness.