How do economic, environmental, social, and health factors affect health outcomes? Insights from 21 developing and emerging economies

Abstract

This study examines the impact of economic, environmental, social, and health factors on the Crude Death Rate (CDR), Infant Mortality Rate (IMR), and Life Expectancy at Birth (LEB) across 21 developing and emerging economies. Utilizing panel regression analysis and developing the Health Input Augmenting Index (HIAI) and Health Outcome Incidence Index (HOAI), the current study revealed two distinct clusters of countries, illustrating the critical influence of health inputs on outcomes. Notably, the study finds no consistent relationship between HIAI, HOAI, and Gross Domestic Product (GDP) per capita, emphasizing the prominent role of non-economic factors in shaping health outcomes. In the Association of Southeast Asian Nations (ASEAN), an increase in health expenditure as a percentage of GDP was associated with improvements in CDR and IMR. Conversely, in BRICS (Brazil, Russia, India, China, and South Africa) nations, higher health expenditure led to adverse effects on CDR, IMR, and LEB. Additionally, rising out-of-pocket expenditures as a share of total health expenditure were associated with deteriorating health outcomes in ASEAN, while in BRICS and overall datasets, it was related to a reduction in CDR. The study also highlights the role of non-health factors, showing that GDP per capita negatively influenced CDR, IMR, and LEB in BRICS countries, whereas rising incomes in ASEAN countries were linked to declining IMR. The elasticity of non-health determinants in affecting health outcomes was found to be more pronounced than that of health inputs. Robustness checks, including alternative panel regression models excluding Russia and Singapore, confirmed the validity of these findings.