IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v224y2019icp37-44.html

Economic development and health outcomes: Evidence from cardiovascular disease mortality in Europe

Author

Listed:
  • Spiteri, Jonathan
  • von Brockdorff, Philip

Abstract

The impact of economic growth on health outcomes has generated various conflicting results in recent years, particularly with the emergence of cardiovascular disease as one of the most salient global health issues. This paper looks at the relationship between economic development and health outcomes. We first estimate an empirical model using data on annual cardiovascular disease mortality in a panel of 27 European countries, over the period 2003 to 2014, together with per capita GDP levels in each country. We also include a number of additional determinants of health outcomes as prescribed by the literature, including various socio-economic, lifestyle and contextual variables. The results show that there is a statistically-significant inverted U-shaped relationship, whereby as income increases mortality rates first rise, before declining at subsequent levels of development. This trajectory persists even after the inclusion of the other determinants of health, as well as other robustness checks. We then seek to explain the persistence of the inverted U-shaped income-mortality relationship using a microeconomic model of consumer choice, with our findings suggesting that this relationship is consistent with a scenario of increasing returns to scale from healthcare investment. The results emphasise the importance of investment in the latest healthcare technologies and continued improvements to public healthcare systems, particularly within developing countries, in conjunction with efforts to boost economic growth.

Suggested Citation

  • Spiteri, Jonathan & von Brockdorff, Philip, 2019. "Economic development and health outcomes: Evidence from cardiovascular disease mortality in Europe," Social Science & Medicine, Elsevier, vol. 224(C), pages 37-44.
    • Handle: RePEc:eee:socmed:v:224:y:2019:i:c:p:37-44
    DOI: 10.1016/j.socscimed.2019.01.050
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953619300565
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2019.01.050?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. James Thornton, 2002. "Estimating a health production function for the US: some new evidence," Applied Economics, Taylor & Francis Journals, vol. 34(1), pages 59-62.
    2. Robert C. Feenstra & Robert Inklaar & Marcel P. Timmer, 2015. "The Next Generation of the Penn World Table," American Economic Review, American Economic Association, vol. 105(10), pages 3150-3182, October.
    3. Donald S. Kenkel, 1995. "Should you eat breakfast? Estimates from health production functions," Health Economics, John Wiley & Sons, Ltd., vol. 4(1), pages 15-29, January.
    4. Stern, David I., 2004. "The Rise and Fall of the Environmental Kuznets Curve," World Development, Elsevier, vol. 32(8), pages 1419-1439, August.
    5. Anca M. Grecu & Kurt W. Rotthoff, 2015. "Economic growth and obesity: findings of an Obesity Kuznets curve," Applied Economics Letters, Taylor & Francis Journals, vol. 22(7), pages 539-543, May.
    6. David N. Well, 2007. "Accounting for the Effect Of Health on Economic Growth," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(3), pages 1265-1306.
    7. Ehrlich, Isaac & Lui, Francis T, 1991. "Intergenerational Trade, Longevity, and Economic Growth," Journal of Political Economy, University of Chicago Press, vol. 99(5), pages 1029-1059, October.
    8. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    9. Sherry Glied & Adriana Lleras-Muney, 2008. "Technological innovation and inequality in health," Demography, Springer;Population Association of America (PAA), vol. 45(3), pages 741-761, August.
    10. Bloom, David E. & Canning, David & Sevilla, Jaypee, 2004. "The Effect of Health on Economic Growth: A Production Function Approach," World Development, Elsevier, vol. 32(1), pages 1-13, January.
    11. World Bank, 2016. "World Development Indicators 2016," World Bank Publications - Books, The World Bank Group, number 23969, April.
    12. Joseph J. Doyle, 2011. "Returns to Local-Area Health Care Spending: Evidence from Health Shocks to Patients Far from Home," American Economic Journal: Applied Economics, American Economic Association, vol. 3(3), pages 221-243, July.
    13. Babones, Salvatore J., 2008. "Income inequality and population health: Correlation and causality," Social Science & Medicine, Elsevier, vol. 66(7), pages 1614-1626, April.
    14. Barro, Robert J. & Lee, Jong Wha, 2013. "A new data set of educational attainment in the world, 1950–2010," Journal of Development Economics, Elsevier, vol. 104(C), pages 184-198.
    15. Psacharopoulos, George, 1994. "Returns to investment in education: A global update," World Development, Elsevier, vol. 22(9), pages 1325-1343, September.
    16. Grossman, G.M & Krueger, A.B., 1991. "Environmental Impacts of a North American Free Trade Agreement," Papers 158, Princeton, Woodrow Wilson School - Public and International Affairs.
    17. Lant Pritchett & Lawrence H. Summers, 1996. "Wealthier is Healthier," Journal of Human Resources, University of Wisconsin Press, vol. 31(4), pages 841-868.
    18. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, January-J.
    19. Andreoni, James & Levinson, Arik, 2001. "The simple analytics of the environmental Kuznets curve," Journal of Public Economics, Elsevier, vol. 80(2), pages 269-286, May.
    20. Kenneth Y. Chay & Michael Greenstone, 2003. "The Impact of Air Pollution on Infant Mortality: Evidence from Geographic Variation in Pollution Shocks Induced by a Recession," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 118(3), pages 1121-1167.
    21. Tapia Granados, José A., 2012. "Economic growth and health progress in England and Wales: 160 years of a changing relation," Social Science & Medicine, Elsevier, vol. 74(5), pages 688-695.
    22. Clark, Rob, 2011. "World health inequality: Convergence, divergence, and development," Social Science & Medicine, Elsevier, vol. 72(4), pages 617-624, February.
    23. World Bank, 2014. "World Development Indicators 2014," World Bank Publications - Books, The World Bank Group, number 18237, April.
    24. World Bank, 2003. "World Development Indicators 2003," World Bank Publications - Books, The World Bank Group, number 13920, April.
    25. Tapia Granados, José A. & Ionides, Edward L., 2008. "The reversal of the relation between economic growth and health progress: Sweden in the 19th and 20th centuries," Journal of Health Economics, Elsevier, vol. 27(3), pages 544-563, May.
    26. Biggs, Brian & King, Lawrence & Basu, Sanjay & Stuckler, David, 2010. "Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America," Social Science & Medicine, Elsevier, vol. 71(2), pages 266-273, July.
    27. Rosenzweig, Mark R & Schultz, T Paul, 1983. "Estimating a Household Production Function: Heterogeneity, the Demand for Health Inputs, and Their Effects on Birth Weight," Journal of Political Economy, University of Chicago Press, vol. 91(5), pages 723-746, October.
    28. Alok Bhargava & Dean T. Jamison & Lawrence J. Lau & Christopher J. L. Murray, 2006. "Modeling the effects of health on economic growth," World Scientific Book Chapters, in: Econometrics, Statistics And Computational Approaches In Food And Health Sciences, chapter 20, pages 269-286, World Scientific Publishing Co. Pte. Ltd..
    29. Stephan Klasen, 2008. "Poverty, undernutrition, and child mortality: Some inter-regional puzzles and their implicationsfor research and policy," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 6(1), pages 89-115, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Tomasz Rokicki & Aleksandra Perkowska & Marcin Ratajczak, 2020. "Differentiation in Healthcare Financing in EU Countries," Sustainability, MDPI, vol. 13(1), pages 1-17, December.
    2. Ayfer Ozyilmaz & Yuksel Bayraktar & Esme Isik & Metin Toprak & Mehmet Bilal Er & Furkan Besel & Serdar Aydin & Mehmet Firat Olgun & Sandra Collins, 2022. "The Relationship between Health Expenditures and Economic Growth in EU Countries: Empirical Evidence Using Panel Fourier Toda–Yamamoto Causality Test and Regression Models," IJERPH, MDPI, vol. 19(22), pages 1-17, November.
    3. Wen, Jun & Deng, Peidong & Fu, Qiang & Chang, Chun-Ping, 2022. "Does health innovation relieve disease burden? The comprehensive evidence," Technological Forecasting and Social Change, Elsevier, vol. 174(C).
    4. Antonio Fernando Boing & S. V. Subramanian & Alexandra Crispim Boing, 2019. "Reducing socioeconomic inequalities in life expectancy among municipalities: the Brazilian experience," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(5), pages 713-720, June.
    5. Ebeh, Joy Eleojo & Awe, Abel, Ariyo, 2021. "Does Poverty Matters in Maternal Health and Output Growth Nexus in sub-Saharan African Countries? A Panel ARDL Approach," Noble International Journal of Economics and Financial Research, Noble Academic Publsiher, vol. 6(6), pages 119-130, December.
    6. Ye Fan & Ming Fang & Xin Zhang & Yongda Yu, 2023. "Will the economic growth benefit public health? Health vulnerability, urbanization and COVID-19 in the USA," The Annals of Regional Science, Springer;Western Regional Science Association, vol. 70(1), pages 81-99, February.
    7. Forshaw, Rachel & Kharadi, Natalya & McLaughlin, Eoin, 2023. "Cardiovascular Disease Mortality and Non-Particulate Air Pollution: Evidence from the 20th Century," Accountancy, Economics, and Finance Working Papers 2023-01, Heriot-Watt University, Department of Accountancy, Economics, and Finance.
    8. Guozhen Gao & Jinmiao Hu & Yuanyuan Wang & Guofeng Wang, 2022. "Regional Inequalities and Influencing Factors of Residents’ Health in China: Analysis from the Perspective of Opening-Up," IJERPH, MDPI, vol. 19(19), pages 1-17, September.
    9. Ichiro Kawachi & Ilias Kyriopoulos & Sotiris Vandoros, 2023. "Economic uncertainty and cardiovascular disease mortality," Health Economics, John Wiley & Sons, Ltd., vol. 32(7), pages 1550-1560, July.
    10. Yemin Ding & Lee Chin & Fangyan Li & Peidong Deng, 2022. "How Does Government Efficiency Affect Health Outcomes? The Empirical Evidence from 156 Countries," IJERPH, MDPI, vol. 19(15), pages 1-18, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bloom, David E. & Canning, David & Kotschy, Rainer & Prettner, Klaus & Schünemann, Johannes, 2024. "Health and economic growth: Reconciling the micro and macro evidence," World Development, Elsevier, vol. 178(C).
    2. Husain, Muhammad Jami, 2009. "Contribution of health to economic development: a survey and overview," Economics Discussion Papers 2009-40, Kiel Institute for the World Economy (IfW Kiel).
    3. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    4. Husain, Muhammad Jami, 2010. "Contribution of health to economic development: A survey and overview," Economics - The Open-Access, Open-Assessment E-Journal (2007-2020), Kiel Institute for the World Economy (IfW Kiel), vol. 4, pages 1-52.
    5. Rob Clark & Kara Snawder, 2020. "A Cross-National Analysis of Lifespan Inequality, 1950–2015: Examining the Distribution of Mortality Within Countries," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 148(3), pages 705-732, April.
    6. Declan French, 2012. "Causation between health and income: a need to panic," Empirical Economics, Springer, vol. 42(2), pages 583-601, April.
    7. Gehringer, Agnieszka & Prettner, Klaus, 2019. "Longevity And Technological Change," Macroeconomic Dynamics, Cambridge University Press, vol. 23(4), pages 1471-1503, June.
    8. Prettner, Klaus & Bloom, David E. & Strulik, Holger, 2013. "Declining fertility and economic well-being: Do education and health ride to the rescue?," Labour Economics, Elsevier, vol. 22(C), pages 70-79.
    9. Liu, Gordon G. & Dow, William H. & Fu, Alex Z. & Akin, John & Lance, Peter, 2008. "Income productivity in China: On the role of health," Journal of Health Economics, Elsevier, vol. 27(1), pages 27-44, January.
    10. Francesco Ricci & Marios Zachariadis, 2006. "Determinants of Public Health Outcomes: A Macroeconomic Perspective," Computing in Economics and Finance 2006 107, Society for Computational Economics.
    11. Arminen, Heli & Menegaki, Angeliki N., 2019. "Corruption, climate and the energy-environment-growth nexus," Energy Economics, Elsevier, vol. 80(C), pages 621-634.
    12. Francesco Ricci & Marios Zachariadis, 2013. "Education Externalities on Longevity," Economica, London School of Economics and Political Science, vol. 80(319), pages 404-440, July.
    13. Nolazco Cama, Jose Luis & Bravo-Ortega, Claudio, 2015. "Instituciones, Recursos Naturales Y Sus Efectos En El Crecimiento Economico: Un Sistema De Ecuaciones Simultáneas En Panel De Datos [Institutions, Natural Resources And Its Impact On Economic Growt," MPRA Paper 74421, University Library of Munich, Germany.
    14. Wang, Qingfeng & Sun, Xu, 2016. "The Role of Socio-political and Economic Factors in Fertility Decline: A Cross-country Analysis," World Development, Elsevier, vol. 87(C), pages 360-370.
    15. Isreal, Akingba Idowu Opeoluwa & Kaliappan, Shivee & Hamzah, Hanny Zurina, 2019. "Impact of Health Capital on Total Factor Productivity in Singapore," Jurnal Ekonomi Malaysia, Faculty of Economics and Business, Universiti Kebangsaan Malaysia, vol. 53(2), pages 83-98.
    16. Jochen Hartwig, 2008. "Has Health Capital Formation Cured 'Baumol's Disease'? - Panel Granger Causality Evidence for OECD Countries," KOF Working papers 08-206, KOF Swiss Economic Institute, ETH Zurich.
    17. Nicolli, Francesco & Gilli, Marianna & Vona, Francesco, 2025. "Inequality and climate change: Two problems, one solution?," Energy Economics, Elsevier, vol. 145(C).
    18. Martine AUDIBERT & Pascale COMBES MOTEL & Alassane DRABO, 2010. "Global Burden of Disease and Economic Growth," Working Papers 201036, CERDI.
    19. Martine Audibert & Pascale Combes Motel & Alassane Drabo, 2013. "Health capital depreciation effects on development: theory and measurement," CERDI Working papers halshs-00832877, HAL.
    20. Baldacci, Emanuele & Clements, Benedict & Gupta, Sanjeev & Cui, Qiang, 2008. "Social Spending, Human Capital, and Growth in Developing Countries," World Development, Elsevier, vol. 36(8), pages 1317-1341, August.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:224:y:2019:i:c:p:37-44. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.