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Is the health-led growth hypothesis valid in the Sub-saharan African countries? Fresh evidence from newly developed panel causality tests

Author

Listed:
  • Sinan Erdogan

    (Hatay Mustafa Kemal University
    Azerbaijan State University of Economics (UNEC) Clinic of Economics
    Western Caspian University)

  • Eyup Serdar Erdogan

    (Social Security Institution of Türkiye, EU and Foreign Relations Department)

Abstract

Having insights into the validity of the health-led growth hypothesis in the Sub-Saharan African Countries is crucial for forming sustainable, inclusive health and economic growth policies and achieving Sustainable Development Goals in the region. However, less attention has been paid to this research topic. Therefore, this paper uses various health expenditure indicators and recently proposed panel causality methods to provide new insights into whether the health-led growth hypothesis can be valid in 43 Sub-Saharan African countries from 2000 to 2019. Empirical findings unveil that (i) there is a bidirectional causality nexus between the current health expenditures-economic growth and governmental health expenditures-economic growth, (ii) there is a unidirectional causal effect running from economic growth to non-governmental health expenditures, (iii) there is a bidirectional causality nexus between the democracy-economic growth and control of corruption economic growth, (iv) there is a unidirectional causal impact running from political stability to economic growth. Moreover, robustness checks have confirmed that the empirical results are robust. A significant part of the empirical findings reveals that the health-led growth hypothesis could be valid in 43 SSA countries, and institutional factors, which determine cultural/political framework and inequalities in accessing health services, have causal impacts on economic growth.

Suggested Citation

  • Sinan Erdogan & Eyup Serdar Erdogan, 2025. "Is the health-led growth hypothesis valid in the Sub-saharan African countries? Fresh evidence from newly developed panel causality tests," Quality & Quantity: International Journal of Methodology, Springer, vol. 59(1), pages 497-521, February.
  • Handle: RePEc:spr:qualqt:v:59:y:2025:i:1:d:10.1007_s11135-024-01941-7
    DOI: 10.1007/s11135-024-01941-7
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    as
    1. Romer, Paul M, 1986. "Increasing Returns and Long-run Growth," Journal of Political Economy, University of Chicago Press, vol. 94(5), pages 1002-1037, October.
    2. Jiaqi Xiao & Artūras Juodis & Yiannis Karavias & Vasilis Sarafidis & Jan Ditzen, 2023. "Improved tests for Granger noncausality in panel data," Stata Journal, StataCorp LLC, vol. 23(1), pages 230-242, March.
    3. Shahbaz, Muhammad & Haouas, Ilham & SBIA, Rashid & Ozturk, Ilhan, 2018. "Financial Development-Environmental Degradation Nexus in the United Arab Emirates: The Importance of Growth, Globalization and Structural Breaks," MPRA Paper 87365, University Library of Munich, Germany, revised 11 Jun 2018.
    4. Michael Kremer, 1993. "The O-Ring Theory of Economic Development," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 108(3), pages 551-575.
    5. Vyas, Vishal & Mehta, Kiran & Sharma, Renuka, 2023. "The nexus between toxic-air pollution, health expenditure, and economic growth: An empirical study using ARDL," International Review of Economics & Finance, Elsevier, vol. 84(C), pages 154-166.
    6. Sen, Amartya, 1988. "The concept of development," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 1, chapter 1, pages 9-26, Elsevier.
    7. Xiaoxuan Yang, 2020. "Health expenditure, human capital, and economic growth: an empirical study of developing countries," International Journal of Health Economics and Management, Springer, vol. 20(2), pages 163-176, June.
    8. Nazlioglu, Saban & Gormus, N. Alper & Soytas, Uğur, 2016. "Oil prices and real estate investment trusts (REITs): Gradual-shift causality and volatility transmission analysis," Energy Economics, Elsevier, vol. 60(C), pages 168-175.
    9. Pierre-Richard Agénor, 2015. "Public capital, health persistence and poverty traps," Journal of Economics, Springer, vol. 115(2), pages 103-131, June.
    10. Bebonchu Atems, 2019. "Public health expenditures, taxation, and growth," Health Economics, John Wiley & Sons, Ltd., vol. 28(9), pages 1146-1150, September.
    11. Dumitrescu, Elena-Ivona & Hurlin, Christophe, 2012. "Testing for Granger non-causality in heterogeneous panels," Economic Modelling, Elsevier, vol. 29(4), pages 1450-1460.
    12. Odhiambo, Nicholas M, 2021. "Health expenditure and economic growth in Sub-Saharan Africa: An empirical investigation," Working Papers 28863, University of South Africa, Department of Economics.
    13. Wang, Kuan-Min, 2011. "Health care expenditure and economic growth: Quantile panel-type analysis," Economic Modelling, Elsevier, vol. 28(4), pages 1536-1549, July.
    14. Im, Kyung So & Pesaran, M. Hashem & Shin, Yongcheol, 2003. "Testing for unit roots in heterogeneous panels," Journal of Econometrics, Elsevier, vol. 115(1), pages 53-74, July.
    15. Serge Mandiefe Piabuo & Julius Chupezi Tieguhong, 2017. "Health expenditure and economic growth - a review of the literature and an analysis between the economic community for central African states (CEMAC) and selected African countries," Health Economics Review, Springer, vol. 7(1), pages 1-13, December.
    16. Narayan Sethi & Saileja Mohanty & Aurolipsa Das & Malayaranjan Sahoo, 2024. "Health Expenditure and Economic Growth Nexus: Empirical Evidence from South Asian Countries," Global Business Review, International Management Institute, vol. 25(2_suppl), pages 229-243, April.
    17. Rezwanul Hasan Rana & Khorshed Alam & Jeff Gow, 2020. "Health expenditure and gross domestic product: causality analysis by income level," International Journal of Health Economics and Management, Springer, vol. 20(1), pages 55-77, March.
    18. Robert J. Barro, 2013. "Health and Economic Growth," Annals of Economics and Finance, Society for AEF, vol. 14(2), pages 329-366, November.
    19. Butkiewicz, James L. & Yanikkaya, Halit, 2006. "Institutional quality and economic growth: Maintenance of the rule of law or democratic institutions, or both?," Economic Modelling, Elsevier, vol. 23(4), pages 648-661, July.
    20. Tang, Chor Foon, 2011. "Multivariate Granger Causality and the Dynamic Relationship between Health Care Spending, Income and Relative Price of Health Care in Malaysia," Hitotsubashi Journal of Economics, Hitotsubashi University, vol. 52(2), pages 199-214, December.
    21. Edmond Kamanda & Yang Lanpin & Brima Sesay, 2022. "Causal nexus between health expenditure, health outcome and economic growth: Empirical evidence from Sub‐Saharan Africa countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(4), pages 2284-2302, July.
    22. Amber Hsiao & Verena Vogt & Wilm Quentin, 2019. "Effect of corruption on perceived difficulties in healthcare access in sub-Saharan Africa," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-12, August.
    23. Sinan Erdogan & Ali Acaravci, 2022. "On the Nexus Between Institutions and Economic Development: An Empirical Analysis for Sub-Saharan African Countries," The European Journal of Development Research, Palgrave Macmillan;European Association of Development Research and Training Institutes (EADI), vol. 34(4), pages 1857-1892, August.
    24. Josep Lluís Carrion-i-Silvestre & Tomás del Barrio-Castro & Enrique López-Bazo, 2005. "Breaking the panels: An application to the GDP per capita," Econometrics Journal, Royal Economic Society, vol. 8(2), pages 159-175, July.
    25. Emirmahmutoglu, Furkan & Kose, Nezir, 2011. "Testing for Granger causality in heterogeneous mixed panels," Economic Modelling, Elsevier, vol. 28(3), pages 870-876, May.
    26. M. Hashem Pesaran, 2007. "A simple panel unit root test in the presence of cross-section dependence," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 22(2), pages 265-312.
    27. Yingzhu Yang & Rong Zheng & Lexiang Zhao, 2021. "Population Aging, Health Investment and Economic Growth: Based on a Cross-Country Panel Data Analysis," IJERPH, MDPI, vol. 18(4), pages 1-16, February.
    28. Tiwari, Aviral Kumar & Kyophilavong, Phouphet & Albulescu, Claudiu Tiberiu, 2016. "Testing the stationarity of CO2 emissions series in Sub-Saharan African countries by incorporating nonlinearity and smooth breaks," Research in International Business and Finance, Elsevier, vol. 37(C), pages 527-540.
    29. Ruwan Jayathilaka & Rishani Rathnayake & Bhakthi Jayathilake & Thanuja Dharmasena & Dananja Bodinayake & Deumi Kathriarachchi, 2023. "Exploring the growth direction: the impact of exchange rate and purchasing managers index on economic growth in Sri Lanka," Quality & Quantity: International Journal of Methodology, Springer, vol. 57(3), pages 2687-2703, June.
    30. Rao, B. Bhaskara & Cooray, Arusha, 2008. "Growth literature and policies for the developing countries," MPRA Paper 10951, University Library of Munich, Germany.
    31. Lucas, Robert Jr., 1988. "On the mechanics of economic development," Journal of Monetary Economics, Elsevier, vol. 22(1), pages 3-42, July.
    32. Ahn, Sang-Jin, 2017. "Institutional basis for research boom: From catch-up development to advanced economy," Technological Forecasting and Social Change, Elsevier, vol. 119(C), pages 237-245.
    33. Artūras Juodis & Yiannis Karavias & Vasilis Sarafidis, 2021. "A homogeneous approach to testing for Granger non-causality in heterogeneous panels," Empirical Economics, Springer, vol. 60(1), pages 93-112, January.
    34. Serdar Ozturk & Ebru Topcu, 2014. "Health Expendıtures and Economıc Growth: Evıdence from G8 Countries," International Journal of Economics and Empirical Research (IJEER), The Economics and Social Development Organization (TESDO), vol. 2(6), pages 256-261, June.
    35. Chang, Koyin & Ying, Yung-Hsiang, 2006. "Economic growth, human capital investment, and health expenditure : a study of OECD countries," Hitotsubashi Journal of Economics, Hitotsubashi University, vol. 47(1), pages 1-16, June.
    36. Perron, Pierre, 1989. "The Great Crash, the Oil Price Shock, and the Unit Root Hypothesis," Econometrica, Econometric Society, vol. 57(6), pages 1361-1401, November.
    37. William Easterly, 2006. "Reliving the 1950s: the big push, poverty traps, and takeoffs in economic development," Journal of Economic Growth, Springer, vol. 11(4), pages 289-318, December.
    38. Masako Ikegami & Zijian Wang, 2023. "Does military expenditure crowd out health-care spending? Cross-country empirics," Quality & Quantity: International Journal of Methodology, Springer, vol. 57(2), pages 1657-1672, April.
    39. Muller, Edward N. & Seligson, Mitchell A., 1994. "Civic Culture and Democracy: The Question of Causal Relationships," American Political Science Review, Cambridge University Press, vol. 88(3), pages 635-652, September.
    40. Eric Arthur & Hassan E. Oaikhenan, 2017. "The Effects of Health Expenditure on Health Outcomes in Sub-Saharan Africa (SSA)," African Development Review, African Development Bank, vol. 29(3), pages 524-536, September.
    41. Sharif, Arshian & Raza, Syed Ali & Ozturk, Ilhan & Afshan, Sahar, 2019. "The dynamic relationship of renewable and nonrenewable energy consumption with carbon emission: A global study with the application of heterogeneous panel estimations," Renewable Energy, Elsevier, vol. 133(C), pages 685-691.
    42. Sinan Erdogan & Samuel Asumadu Sarkodie & Festus Fatai Adedoyin & Festus Victor Bekun & Phebe Asantewaa Owusu, 2024. "Analyzing transport demand and environmental degradation: the case of G-7 countries," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 26(1), pages 711-734, January.
    43. Pedro Pita Barros, 1998. "The black box of health care expenditure growth determinants," Health Economics, John Wiley & Sons, Ltd., vol. 7(6), pages 533-544, September.
    44. Tolga Omay & Muhammad Shahbaz & Chris Stewart, 2021. "Is there really hysteresis in the OECD unemployment rates? New evidence using a Fourier panel unit root test," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 48(4), pages 875-901, November.
    45. Simon Appleton & John Hoddinott & John MacKinnon, 1996. "Education and health in sub-Saharan Africa," Journal of International Development, John Wiley & Sons, Ltd., vol. 8(3), pages 307-339.
    46. Amber Hsiao & Verena Vogt & Wilm Quentin, 2019. "Correction: Effect of corruption on perceived difficulties in healthcare access in sub-Saharan Africa," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-1, November.
    47. Mujaheed Shaikh & Afschin Gandjour, 2019. "Pharmaceutical expenditure and gross domestic product: Evidence of simultaneous effects using a two‐step instrumental variables strategy," Health Economics, John Wiley & Sons, Ltd., vol. 28(1), pages 101-122, January.
    48. Jude Eggoh & Hilaire Houeninvo & Gilles-Armand Sossou, 2015. "Education, Health And Economic Growth In African Countries," Journal of Economic Development, Chung-Ang Unviersity, Department of Economics, vol. 40(1), pages 93-111, March.
    49. Omay, Tolga & Shahbaz, Muhammad & Stewart, Chris, 2021. "Is There Really Hysteresis in OECD Countries’ Unemployment Rates? New Evidence Using a Fourier Panel Unit Root Test," MPRA Paper 107691, University Library of Munich, Germany, revised 10 May 2021.
    50. Brahim Gaies, 2022. "Reassessing the impact of health expenditure on income growth in the face of the global sanitary crisis: the case of developing countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(9), pages 1415-1436, December.
    51. Arusha Cooray, 2009. "Government Expenditure, Governance and Economic Growth," Comparative Economic Studies, Palgrave Macmillan;Association for Comparative Economic Studies, vol. 51(3), pages 401-418, September.
    52. Gyimah-Brempong, Kwabena & Wilson, Mark, 2004. "Health human capital and economic growth in Sub-Saharan African and OECD countries," The Quarterly Review of Economics and Finance, Elsevier, vol. 44(2), pages 296-320, May.
    53. Hong Xie & Aviral Kumar Tiwari & Tsangyao Chang, 2018. "Investigating stationarity in tourist arrivals to India using panel KPSS with sharp drifts and smooth breaks," Applied Economics, Taylor & Francis Journals, vol. 50(46), pages 4985-4998, October.
    54. Author-Name: Jeffrey D. Sachs & John W. McArthur & Guido Schmidt-Traub & Margaret Kruk & Chandrika Bahadur & Michael Faye & Gordon McCord, 2004. "Ending Africa's Poverty Trap," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 35(1), pages 117-240.
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