The battle of health with environmental evils of Asian countries: promises to keep

Examining the dynamic impact of carbon emissions, renewable energy and economic growth on healthcare expenditure in Asian countries

This study aims to examine the impact of renewable energy, carbon emissions, and economic growth on healthcare spending in 36 Asian countries during 2000-2019. Fully Modified Ordinary Least Square (FMOLS) and Dynamic Ordinary Least Square (DOLS) models have been applied to the panel data for 36 Asian countries. The study's findings show that CO2 emissions in Asia increased due to public and private health spending, with the commercial health sector having a larger negative influence on CO2 emissions than the public sector. According to FMOLS and DOLS findings, carbon emissions and GDP are positively related to health spending, indicating that high economic growth through energy-intensive production processes leads to increased carbon emissions, but on the contrary, renewable energy consumption has decreased healthcare expenditure. This study advocates new policies to reduce carbon emissions and hospitalisation without jeopardising national economic growth. In order to achieve sustainable health services and an environmentally friendly future in Asia, health administrators must raise state and private healthcare spending while implementing an effective cost-service and energy-efficient management plan.

How does economic complexity improve energy efficiency? Mechanism discussion and empirical test

Energy efficiency represents one of the best productive strategies to lessen the effects of global warming and climate change. Similarly, the manufacturing and export of a wide variety of high-tech, knowledge-based items like chemicals and machinery have significant effects on both economic growth and the environment. The main goal of this study is to examine the long-run effects of economic complexity on energy efficiency in 93 countries over the period from 1995 to 2015. The empirical outcomes reveal that economic complexity improves energy efficiency. Specifically, countries that produce and export a wide range of sophisticated products tend to enjoy higher levels of energy efficiency compared to their counterparts who export a limited range of simple products. Moreover, empirical findings suggest that economic growth and population density increase energy efficiency, while trade impedes it. Further empirical investigations from a mediation analysis revealed that about 63% and 38% of the effects of economic complexity on energy efficiency mediate through income inequality reduction and human capital accumulation, respectively. Based on these results, political leaders and governments are provided with solid reasons to pay more attention to improving their productive structures in order to promote energy efficiency and a green future.

Access to sustainable healthcare infrastructure: a review of industrial emissions, coal fires, and particulate matter

Environmental health is critical for the economy's social welfare and environmental sustainability. Using time series data from 1975 to 2020, the research examines the short- and long-run relationship between environmental pollutants and healthcare costs in the context of Pakistan. The study's results reveal that short-term and long-term efforts towards cleaner development in terms of carbon emissions, coal combustion, nitrous oxide (N₂O) emissions, and industrial value-added have resulted in significant reductions in healthcare expenses due to improved management of industrial emissions. However, in the long run, particulate matter (PM_2.5) has a detrimental effect on a country's sustainable healthcare agenda, leading to increased healthcare costs. Furthermore, the increased use of coal-fired power plants that release polycyclic aromatic hydrocarbons (PAH) and revenue generated by contaminated production lead to higher out-of-pocket healthcare costs, increasing a country's risk of morbidity and mortality. The study's Granger causality estimations demonstrate that carbon emissions are responsible for emissions-driven healthcare expenses in a nation. Additionally, economic growth leads to increased carbon emissions and industrial toxins, which are also emission-led. Through variance decomposition analysis (VDA), the study finds that carbon emissions have the highest variance shock of 32.702% on healthcare expenditures in the next ten years. This is followed by polluted income and continued economic growth, which have a variance shock of 13.243% and 8.858%, respectively, over the same period. The findings indicate that the maximum healthcare benefits may be acquired by mitigating environmental pollutants via stringent environmental regulations, reducing industrial toxins through solid waste management techniques, and minimizing coal combustion reliance through renewable fuels. Environmental research is still required to provide more sustainable solutions to the sustainability of the global healthcare agenda.

Does environment quality affect the health care spending? Nexus among CO2 emissions, non-renewable energy production, financial development, and health care spending

This study investigates the dynamic associations among carbon dioxide (CO₂) emissions, non-renewable energy production from petroleum derivatives, financial development, and healthcare expenditures to improve environmental quality. This research has employed the balanced annual panel of thirty (30) Organizations for Economic Co-operation and Development (OECD) countries' data set and applied panel vector autoregression (VAR) method depending on the generalized method of moments (GMM). Furthermore, the empirical findings reveal that health spending and CO₂ emissions have a favorable bidirectional link, but there is no indication that health spending promotes power generation. The results demonstrate that increased energy consumption and productions affect pollution, and higher CO₂ emissions increase healthcare costs. Whereas, energy consumption, financial development, and healthcare expenditures have a positive toward environmental quality.

Nexus between non-renewable energy production, CO2 emissions, and healthcare spending in OECD economies

The present study investigates the dynamic relationships between non-renewable energy production from fossil resources, healthcare expenditures, and carbon dioxide (CO₂) emissions in the OECD region. This study has used the balanced panel of 38 OECD countries spanning from 2008 to 2018. This study is employing panel vector auto-regression econometric approach based on generalized method of moment. The study reveals the following interesting outcomes: The response of energy production from fossil resources to healthcare expenditures is positive; energy production has a positive unidirectional causal relationship with CO₂ emissions, whereas CO₂ emissions have insignificant relation with energy production. There is a positive bidirectional relationship between healthcare spending and CO₂ emissions, but there is no evidence that healthcare spending causes energy production. Furthermore, the outcomes present the essential policy consequences.

Association between residential green cover and direct healthcare costs in Northern California: An individual level analysis of 5 million persons

BACKGROUND AND OBJECTIVE

Prior studies have shown higher green cover levels are associated with beneficial health outcomes. We sought to determine if residential green cover was also associated with direct healthcare costs.

METHODS

We linked residential Normalized Difference Vegetation Index (NDVI) satellite data for 5,189,303 members of Kaiser Permanente Northern California (KPNC) to direct individual healthcare costs for 2003-2015. Using generalized linear regression to adjust for confounding, we examined the association between direct healthcare costs and green cover within250, 500, and 1000 meters (m) of an individual's residence. Costs were determined from an internal cost accounting system that captures administrative and patient care costs for each clinical encounter. Sensitivity analyses included adjustments for comorbidity and an alternative measure of green cover, tree canopy.

RESULTS

We observed a significant inverse association between higher levels of residential green cover and lower direct healthcare costs. The relative rate of total cost for the highest compared to the lowest decile of NDVI was 0.92 (95% CI 0.90-0.93) for the 500 m buffer. The association was robust to adjustment from a broad array of confounders, found at each buffer size, and largely driven by hospitalization, and emergency department visits. Individuals in the top decile of residential green cover had adjusted healthcare costs of $374.04 (95% CI $307.31-$439.41) per person per year less than individuals living in the bottom or least green decile. Sensitivity analyses including tree canopy cover as the green space measure yielded similar findings. Analyses that included adjustment for comorbidity were consistent with the hypothesis that green cover reduces healthcare costs by improving health status.

CONCLUSION

Green cover was associated with lower direct healthcare costs, raising the possibility that residential greening can have a significant healthcare cost impact across the population.

Impact of Environment, Life Expectancy and Real GDP per Capita on Health Expenditures: Evidence from the EU Member States

This research explores the impact of environment, life expectancy, and real GDP per capita on health expenditures in a sample of 27 EU member states over the 2000-2018 period through causality and cointegration analyses. The causality analysis revealed a significant unilateral causality from variables of greenhouse gas emissions, life expectancy, and real GDP per capita to health expenditures. In other words, greenhouse gas emissions, life expectancy, and real GDP per capita had a significant impact on health expenditures in the short run. The cointegration analysis indicated that life expectancy and real GDP per capita had a significant positive impact on health expenditures at the overall panel. On the other side, the country level cointegration coefficients revealed that life expectancy had a considerable positive impact on health expenditures, real GDP per capita had a moderate positive impact on the health expenditures in most of the countries in the panel, but the environment proxied by greenhouse gas emissions had a low positive or negative impact on the health expenditures in a limited number of countries.

Analysis of Pedestrians’ Perceptions about the Design Aspects of Crossing Facilities: A Case in Nizwa, Oman

This study aims to identify the key factors in pedestrians’ intentions when using crossing facilities. For this purpose, a comprehensive questionnaire was designed and conducted at selected locations in Nizwa city. The main investigated variables are linked to personal characteristics, opinions on the main reasons for accidents, and how hard it is for pedestrians to cross roads at different locations in Nizwa city. Statements were also designed on the safety and health aspects of pedestrian crossings, as well as the physical and design aspects of pedestrian crossing facilities. Suitable locations were selected for the survey to assess the main concerns of pedestrian facilities. A total of 280 usable samples were collected from the selected locations. The analysis results revealed that young pedestrians do not find it difficult to use pedestrian bridges and underpasses when crossing roads. Pedestrians’ prioritization of safety when crossing, pedestrians’ health conditions, the proper cleaning and lighting of facilities, and the good design of facilities are significant determinants of pedestrians’ intentions when using crossing facilities. Crossing facilities need to be maintained properly, for example, through the cleaning and lighting of facilities. Proper awareness among pedestrians and vehicle drivers is required for the safety of pedestrians.

The roles of economic growth and health expenditure on CO2 emissions in selected Asian countries: a quantile regression model approach

Continuous economic growth and the rise in energy consumption are linked with environmental pollution. Demand for health care expenditure increased after the COVID-19 pandemic. This study is interesting in modeling the nexus between public and private health expenditure, carbon dioxide emissions, and economic growth. To this end, the present study analyzed the nexus between public and private health care expenditure, economic growth, and environmental pollution for 36 Asian countries for the period 1991-2017. FMOLS, GMM, and quantile regression analysis confirm the EKC hypothesis in Asia. Besides, FMOLS and quantile regressions reached the reducing effects of government and private health expenditures on CO₂ emissions. While quantile regression results show that public and private health expenditures can mitigate CO₂ emissions; however, these results differ for various levels of CO₂. Findings of quantile regression show a significant impact of both public and private health expenditures in reducing CO₂ at the 50^th and 75^th quantiles but results are insignificant for the 25^th quantile. Overall, the paper concludes that both government and private health sectors' expenditures caused CO₂ emissions to decrease in Asia and that the negative impact of the private health sector on CO₂ emissions is greater than that of the government health sector. The concluding remark is that the higher the health spending, the higher the environmental quality will be in Asia. Hence, the health administrators need to increase public and private health expenditures with an effective cost-service and energy-efficient management approach to reach sustainable health services and a sustainable environment in Asia.

Efficiency in reducing air pollutants and healthcare expenditure in the Seoul Metropolitan City of South Korea

This study analyzes efficiency in the reduction of air pollutants and the associated healthcare costs using a stochastic frontier cost function panel data approach. For the empirical analysis, we use monthly data covering 25 districts in the Seoul metropolitan city of South Korea observed over the period January 2010 to December 2017. Our results show large variations in air pollution and healthcare costs across districts and over time and their efficiency in reducing air pollutants. The study concludes that efforts are needed to apply the World Health Organization's air quality standards for designing and implementing location-specific customized policies for improving the level of air quality and its equal distribution, provision of health services, and improved efficiency in improving air quality standards. The study identifies a number of determinants of air pollutants and efficiency enhancement which provide useful pointers for policymakers for addressing the current environmental problems in South Korea.

Association between health expenditures, economic growth and environmental pollution: Long-run and causality analysis from Asian economies

This study examines the association between health expenditures, economic growth (EG) and environmental pollution in Asia both at panel and country level. The separate impact of EG and environmental pollution on public and private health expenditures (PRHEs) are also examined. In doing so the panel cointegration tests with the level break, common correlated effects mean group and heterogeneous panel causality test are employed. The study covers 20 Asian economies and time-period from 1995 to 2017. The results provide evidence in support of a long run association between selected variables. The results explain that EG and environmental pollution are positively associated with total health expenditures as well as with public and PRHEs in all countries. However, the magnitude of environmental pollution coefficient is greater from EG coefficient, thus indicate that environmental pollution is the key determinant in increasing national health expenditures. Causality results demonstrate the existence of two-way causality between health expenditures and EG and unidirectional causality flowing from environmental pollution to health expenditures in Asian economies. Findings of this study have provided some important suggestions to policy makers which can be used to minimize the risk of environmental pollution on health in Asian economies.

Health care expenditure and environmental pollution: a cross-country comparison across different income groups

This paper investigates the long-run dynamics between health care expenditure and environmental pollution across four global income groups. The analysis uses data from 178 countries, spanning the period 1995-2017. Panel estimations are employed with unobserved heterogeneity, temporal persistence, and cross-sectional dependence using a model with common correlated effects. The findings document that the health care expenditure is a necessity for all sub-groups. We established that a 1% increase in national income increased health expenditure by 7.2% in the full sample, and 9.3%, 8.6%, 6.8% and 2.9% for low, low-middle, upper-middle and high-income groups, respectively, while a 1% increase in CO₂ emissions increased health expenditure by 2.5% in the full sample, and 2.9%, 1.2%, 2.3% and 2.6% across these four income groups. We recommend that coordinated approach is needed in setting policy goals both in energy and health sectors in mitigating the negative effects of pollution. Our findings indicate that low-carbon emissions and energy efficient health care services will significantly reduce future health care expenses.

Modeling Work Practices under Socio-Technical Systems for Sustainable Manufacturing Performance

In light of the overwhelming consumption of resources by the manufacturing sector, this paper examined three key subsystems that are critical in greening the sector. Whereas the extant literature has focused on technological development to reduce environmental damage, it has not analyzed profoundly how manufacturing processes can be greened effectively. Hence, using carefully gathered data of 299 respondents and structural equation modeling, this paper sought to investigate the mediating effect of social, environmental, and technical subsystems on the relationship between management support and sustainable manufacturing performance. The results show that management support has a positive relationship with sustainable manufacturing performance (p < 0.005), while social, environmental, and technical subsystems partially mediate this relationship. Hence, efforts must be taken to encourage management of manufacturing firms to support sustainable management performance, while at the same time supporting them to introduce innovative social, environmental, and technical practices.

Socio-economic and environmental factors influenced the United Nations healthcare sustainable agenda: evidence from a panel of selected Asian and African countries

The objective of the study is to evaluate socio-economic and environmental factors that influenced the United Nations healthcare sustainable agenda in a panel of 21 Asian and African countries. The results show that changes in price level (0.0062, p < 0.000), life risks of maternal death (4.579, p < 0.000), and under-5 mortality rate (0.374, p < 0.000) substantially increases out-of-pocket health expenditures, while CO₂ emissions (5.681, p < 0.003), prevalence of undernourishment (15.184, p < 0.000), PM_2.5 particulate emission (1557, p < 0.000), unemployment, and private health expenditures (30.729, p < 0000) are associated with high mortality rate across countries. Healthcare reforms affected by low healthcare spending, unsustainable environment, and ease of environmental regulations that ultimately increases mortality rate across countries. The Granger causality estimates confirmed the different causal mechanisms between socio-economic and environmental factors, which is directly linked with the country's healthcare agenda, i.e., the causality running from (i) CO₂ emissions to life risks of maternal death and under-5 mortality rate, (ii) from depth of food deficit to incidence of tuberculosis and unemployment, (iii) from PM_2.5 emissions to infant mortality rate, (iv) from foreign direct investment (FDI) inflows to PM_2.5 emissions, (v) from trade openness to greenhouse gas (GHG) emissions, and (vi) from mortality indicators to per capita income, while there is a feedback relationship between health expenditures and per capita income across countries. The variance decomposition analysis shows that (i) under-5 mortality rate will increase out-of-pocket health expenditures, (ii) unemployment rate will increase mortality indicators, and (iii) health expenditures will increase economic well-being in a panel of selected countries, for the next 10 years.

Food-beverage-tobacco consumption, smoking prevalence, and high-technology exports influenced healthcare sustainability agenda across the globe

The objective of the study is to analyze the long-run, causal, and inter-temporal relationships between food-beverage-tobacco consumption, smoking prevalence in male and females, and high-technology exports and their resulting impact on global healthcare sustainability agenda in a panel of 19 European, North American, and Asian countries during a period of 1990-2016. The results show that the sample countries are largely affected by high mass consumption of food, beverages, and tobacco, due to which the health spending is very high in their economies that increase healthcare costs and mortality rates accordingly. The relationship between death rate and per capita income is found negative in a panel of selected countries, where high death rates substantially decrease country's per capita income. The Granger causality estimates confirm the unidirectional causality running from (i) high-technology exports to CO₂ emissions, (ii) smoking prevalence of male and female to health expenditures, (iii) industrial value added to mortality, (iv) health expenditures to per capita income, (v) per capita income to death rates, and (vi) food, beverages, and tobacco consumption to mortality indicators, whereas, the inter-temporal causation confirmed that lifetime risk of maternal death will largely influence health expenditures in a panel of selected countries for the next 10-year time period.

On the nexus of air pollution and health expenditures: new empirical evidence

OBJECTIVE

To analyse the impact of per capita income and environmental air quality variables on health expenditure determinants.

METHOD

In this study, we analyse the relationship between air pollution and health expenditure in 29 OECD countries over the period 1995-2014. In addition, we test whether our findings differ between countries with higher or lower incomes.

RESULTS

The econometric results show that per capita income has a positive effect on health expenditure, but is not as statistically significant as expected when lag-time is incorporated. In addition, an anchorage effect is observed, which implies that about 80%-90% of previous expenditure explain current expenditure. Our empirical results are quite consistent between groups and when compared with the full sample. Nevertheless, there appear to be some differences when broken down by financing scheme (total, public, and private).

CONCLUSIONS

Overall, our findings could be used to clarify the appropriate health expenditure level or to obtain better environmental quality and social well-being. That is, empirical support is provided on how health management and policy makers should include more considerations for the use of cleaner fuels in developed countries.

On the causal links between health indicator, output, combustible renewables and waste consumption, rail transport, and CO2 emissions: the case of Tunisia

This study employs the autoregressive distributed lag (ARDL) approach and Granger causality test to investigate the short- and long-run relationships between health indicator, real GDP, combustible renewables and waste consumption, rail transport, and carbon dioxide (CO2) emissions for the case of Tunisia, spanning the period of 1990-2011. The empirical findings suggest that the Fisher statistic of the Wald test confirm the existence of a long-run relationship between the variables. Moreover, the long-run estimated elasticities of the ARDL model provide that output and combustible renewables and waste consumption have a positive and statistically significant impact on health situation, while CO2 emissions and rail transport both contribute to the decrease of health indicator. Granger causality results affirm that, in the short-run, there is a unidirectional causality running from real GDP to health, a unidirectional causality from health to combustible renewables and waste consumption, and a unidirectional causality from all variables to CO2 emissions. In the long-run, all the computed error correction terms are significant and confirm the existence of long-run association among the variables. Our recommendations for the Tunisian policymakers are as follows: (i) exploiting wastes and renewable fuels can be a good strategy to eliminate pollution caused by emissions and subsequently improve health quality, (ii) the use of renewable energy as a main source for national rail transport is an effective strategy for public health, (iii) renewable energy investment projects are beneficial plans for the country as this contributes to the growth of its own economy and reduce energy dependence, and (iii) more renewable energy consumption leads not only to decrease pollution but also to stimulate health situation because of the increase of doctors and nurses numbers.