Abstract
OBJECTIVES: As the digital wave reshapes the future of cities, smart city construction (SCC) is emerging as a key driver for improving public health and bridging social gaps through its inclusive potential. This research aims to investigate the impact of SCC on the health of middle-aged and older disabilities individuals, focusing on its dynamic trends, underlying mechanisms, unequal selection effects, and overall welfare. METHODS: Based on data from the China Health and Retirement Longitudinal Study, this paper estimates the impact of SCC on the health of middle-aged and older disabilities using the double machine learning method with the random forest algorithm, and examines the dynamic trend of the health effects using event study method. RESULTS: The results indicate that SCC significantly enhances the health of middle-aged and older disabilities, without resulting in a concomitant increase in healthcare expenditure. In the long term, the positive health effect increases year by year. Mechanism analysis reveals that SCC promotes health improvements through two key channels: enhanced accessibility of living infrastructure, including access to running water and internet, and increased household annual income. Heterogeneity analysis reveals that there are unequal selection effects in impact, the health-enhancing effects of SCC on middle-aged and older disabilities are more pronounced among non-retired individuals and those with a more extensive household composition. Finally, welfare analysis shows that SCC reduced their healthcare expenditures and improved labor market performance, with a conservatively estimated welfare benefit of US$3448.65. CONCLUSION: By unraveling the underlying mechanisms and inequality selection effects, this study provides a comprehensive analysis of the potential for digital inclusion to inform scientific understanding and guide policy aimed at promoting health equity and improving the well-being of disadvantaged populations.