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The European Journal of Health Economics
Published in: The European Journal of Health Economics 3/2023

Open Access 26-05-2022 | Original Paper

Live and let live: understanding the temporal drivers and spillovers of life expectancy in Europe for public planning

Authors: Pilar Gracia-de-Rentería, Hugo Ferrer-Pérez, Ana Isabel Sanjuán, George Philippidis

Published in: The European Journal of Health Economics | Issue 3/2023

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Abstract

The European continent has one of the longest life expectancies in the world, but still faces a significant challenge to meet the health targets set by the Sustainable Development Goals of the United Nations for 2030. To improve the understanding of the rationale that guides health outcomes in Europe, this study assesses the direction and magnitude effects of the drivers that contribute to explain life expectancy at birth across 30 European countries for the period 2008–2018 at macro-level. For this purpose, an aggregated health production function is used allowing for spatial effects. The results indicate that an increase in the income level, health expenditure, trade openness, education attainment, or urbanisation might lead to an increase in life expectancy at birth, whereas calories intake or quantity of air pollutants have a negative impact on this health indicator. This implies that health policies should look beyond economic factors and focus also on social and environmental drivers. The results also indicate the existence of significant spillover effects, highlighting the need for coordinated European policies that account for the synergies between countries. Finally, a foresight analysis is conducted to obtain projections for 2030 under different socioeconomic pathways. Results reveal significant differences on longevity projections depending on the adoption, or not, of a more sustainable model of human development and provides valuable insight on the need for anticipatory planning measures to make longer life-spans compatible with the maintenance of the welfare state.
Footnotes
1
The study has been performed using Stata 17 MP.
 
2
The Hausman’s specification test supports the use of a fixed effects model (Statistics value = 63.94 and p value = 0.000).
 
3
The 30 European countries included in this study are Austria, Belgium, Bulgaria, Croatia, Czechia, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, and the United Kingdom. All European countries with enough information to construct a balanced panel dataset were considered.
 
4
In fact, using the share of health expenditure in GDP reduces the high correlation coefficient between per capita health expenditure and per capita GDP from 0.928 to 0.425.
 
5
The statistic value for \({H}_{0}:\theta =0\) is 54.78 (p value = 0.000) and the statistic value for \({H}_{0}:\theta +\beta \rho = 0\) is 50.25 (p-value = 0.000).
 
6
See Elhorst [50, pp. 22–23, 31] for detailed calculations of direct, indirect and feedback effects.
 
7
A similar result is obtained when the model is re-estimated using the Gini coefficient instead of the Palma ratio as the inequality measure.
 
8
Specifically, SSP1 is defined as: “The world shifts gradually, but pervasively, toward a more sustainable path, emphasizing more inclusive development that respects perceived environmental boundaries. Management of the global commons slowly improves, educational and health investments accelerate the demographic transition, and the emphasis on economic growth shifts toward a broader emphasis on human well-being. Driven by an increasing commitment to achieving development goals, inequality is reduced both across and within countries. Consumption is oriented toward low material growth and lower resource and energy intensity” [62].
 
9
SSP2 is defined as: “The world follows a path in which social, economic, and technological trends do not shift markedly from historical patterns. Development and income growth proceeds unevenly, with some countries making relatively good progress while others fall short of expectations. Global and national institutions work toward but make slow progress in achieving sustainable development goals. Environmental systems experience degradation, although there are some improvements and overall the intensity of resource and energy use declines. Global population growth is moderate and levels off in the second half of the century. Income inequality persists or improves only slowly and challenges to reducing vulnerability to societal and environmental changes remain” [62].
 
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Metadata
Title
Live and let live: understanding the temporal drivers and spillovers of life expectancy in Europe for public planning
Authors
Pilar Gracia-de-Rentería
Hugo Ferrer-Pérez
Ana Isabel Sanjuán
George Philippidis
Publication date
26-05-2022
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 3/2023
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-022-01469-3

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