Analysis of the association between economic growth, environmental quality and health standards in the Gulf Cooperation Council during 1980-2012

This paper aimed to examine the validity of the environmental Kuznets curve (EKC) hypothesis and study the causality relationship using time series data for the period 1990–2014. These examinations included three main variables, which are carbon dioxide (CO2) emissions, energy consumption, and gross domestic product (GDP) per capita among the Gulf Cooperation Council (GCC) countries. This paper used a Granger causality and vector auto-regression (VAR) test to detect the direction of causality within the three variables. There was a repeated unidirectional causality going from GDP per capita—representing the economic growth—to energy consumption over the six GCC countries. On the other hand, the UAE was the only country that holds the inverted U-shaped curve of the EKC hypothesis among the GCC countries when using the vector error correction model (VECM). The suggested recommendations are to set energy policies to reduce energy consumption and control CO2 emissions. These can be adopted by GCC countries without much concern about their effects on economic growth.KeywordsGCCEnergy consumptionCausality testEnvironmental Kuznets curve

Interpreting mortality trends in the GCC countries: The healthy migrant effect

Purpose: The purpose of this study was twofold: to examine the correlation between CO2 emissions and economic development in the Gulf Cooperation Council (GCC) countries and to compare the contributions of the oil, gas, and cement sectors to the CO2 emission in each GCC country.Study design/methodology/approach: The research design used was descriptive, and cross-sectional independence, panel autoregressive distributed lag, pooled ordinary least squares and ordinary least squares methods were used to analyze data.Sample and data: The study used secondary data on CO2 emissions and gross domestic product (GDP) growth rates from 1981 to 2021 and on the specific contributions of the oil, gas, and cement sectors from 1985 to 2022.Results: The study found a long-term cointegration between CO2 emissions and the GDP growth rate in the GCC countries. However, in short term, economic growth did not have a significant impact on CO2 emissions. The major contributor to the CO2 emissions in Oman, Kuwait, Saudi Arabia, and Qatar was the oil sector, whereas that in the United Arab Emirates was the cement sector. CO2 emissions in Bahrain were significantly affected by the gas sector.Originality/value: The work is original and innovative, offering new insights through sector-specific comparisons across the GCC countries. It emphasizes the urgent need to cultivate renewable energy sources to protect the environment.Research limitations/implications: The study excludes the transportation, manufacturing, and agriculture sectors, although these also significantly contribute to CO2 emissions. The study suggests the need for targeted policies to mitigate emissions and promote sustainable development in the GCC countries.

Oil and gas are key energy sources in the Gulf Cooperation Council (GCC) region. The present study examines the asymmetrical environmental effects of these energy sources and also tests the environmental Kuznets curve (EKC) from 1975 to 2019. In the long run, the EKC is corroborated in Kuwait and Saudi Arabia. But the EKC is not validated in the GCC Panel. Increasing oil consumption raises carbon dioxide (CO2) emissions in all investigated GCC countries, and decreasing oil consumption reduces CO2 emissions in Kuwait, Oman, Saudi Arabia, and the United Arab Emirates (UAE). The effect of oil consumption is found asymmetrical in Qatar and symmetrical in the rest of GCC countries. Increasing natural gas consumption (NGC) carries a positive effect in all investigated GCC countries, and decreasing NGC reduces emissions in Oman, Qatar, and the UAE. Moreover, NGC's effects are asymmetrically in all GCC countries except Qatar. In the panel estimates, both increasing and decreasing oil and NGC have positive effects on CO2 emissions. The long-run effect of oil consumption on CO2 emissions is larger than the effect of NGC in most GCC economies and panel results. In the short run, increasing and decreasing oil consumption and NGC have a positive effect on emissions in all investigated economies except Saudi Arabia. In the long run, coefficients of decreasing oil consumption are found significantly greater than coefficients of increasing NGC in Kuwait, Oman, Saudi Arabia, the UAE, and the whole GCC. This finding corroborates that increasing CO2 emissions with increasing NGC is lower than decreasing CO2 emissions with decreasing oil consumption. Hence, we recommend these countries switch from oil consumption to NGC to reduce overall CO2 emissions.

CO2 emissions, energy consumption, economic growth, and financial development in GCC countries: Dynamic simultaneous equation models

This study explores the relations between Oil Prices (OP) and Gross Domestic Product (GDP) per capita in Gulf Cooperation Council (GCC) countries using the asymmetric causality test for the period of 1996-2018. The results of the standard bootstrap causality test reveal bidirectional causality between the OP and the GDP per capita in Qatar and Saudi Arabia. The results of asymmetric causality tests are different for some countries, which demonstrate the unidirectional causality running from OP+ to GDP+ in Oman and Saudi Arabia. Whereas, the bidirectional causality exists between the GDP- and OP- in Kuwait and Oman and unidirectional causality exists between the OP- and the GDP- per capita in Bahrain, Qatar, and UAE. The results support the Real Business Cycle Theory (RBC Theory), which states that external positive or negative shocks have significant impact on GDP per capita through consumption and investment channels. GCC countries should channelize the huge revenues towards other private sectors, which will create more prospects for the GDP and will provide substitution in case of arising any crisis. In addition, the GCC countries must diversify their economic activities since the OP are quite volatile and uncertain and the revenues of these countries are dependent on the OP to a large extent. Sustainable development can be achieved through a balanced path between government expenditures and future savings.

The economic development and environmental sustainability nexus have long been a fiercely debated issue. Researchers have widely acknowledged the environmental Kuznets curve (EKC) hypothesis when evaluating this relationship. Recently, an emerging strand of research examined the EKC through the lens of the Economic Complexity Index (ECoI) as a broader measure of economic development. However, empirical evidence of the index’s environmental impact is still limited. Despite its growing prominence, no prior research has been conducted in the Gulf Cooperation Council (GCC) using the ECoI, particularly in the EKC context. Furthermore, research comparing the ECoI differentiated impacts on Ecological Footprint and Carbon Dioxide (CO2) emissions is largely lacking. Extending on this line of research, our investigation intends to ascertain the influence of ECoI, income, globalization as well as non-renewable energy consumption on two dominant environmental pressure metrics: CO2 emissions and ecological footprint per capita (EFpc) within the EKC hypothesis context in six GCC countries during 1995–2018. To this end, Pedroni’s cointegration approach was conducted to examine the long-term association between variables; cointegration coefficients were analyzed using Dynamic and Fully modified OLS. Our investigation indicates the emergence of an inverted U-shaped link between ECoI and environmental sustainability in the GCC region for both CO2 emissions and EFpc. Furthermore, according to the individual country analysis, our findings demonstrate that the EKC hypothesis is sensitive to both the environmental degradation indicator used and the country analyzed; such that the quadratic link incorporating ECoI is confirmed for Saudi Arabia, Bahrain, United Arab Emirates, and Kuwait when EFpc is employed. In comparison, it holds for Kuwait, Oman, and Qatar when CO2 emissions are used. Moreover, the findings show that income per capita and non-renewables consumption significantly harm environmental sustainability, however, in terms of EFpc only. In contrast, through its three sub-dimensions, globalization contributes to the environmental burden by increasing both EFpc and CO2 emissions. These conclusions emphasize the economic complexity’s dominant role in mitigating environmental pollution in GCC beyond a certain threshold. Finally, the paper reaches a concise set of implications. Among the foremost, the GCC nations could enhance their environmental sustainability by diversifying their energy sources and increasing reliance on renewable sources, encouraging investment in carbon-reduction technologies, converting their economy from energy-intensive to technology-intensive, as well as imposing strict environmental laws to enable globalization to improve environmental quality.

PurposeThis paper aims to assess and empirically analyze the impact of marine production manufacturing on gross domestic product (GDP) indicators as a comparative study in Gulf Cooperation Council (GCC) countries.Design/methodology/approachThis study used analytical quantitative approaches to assess the impact of marine production manufacturing on GDP between GCC countries over the period from 2007 to 2015. The data were collected from Global Competitiveness Reports during 2006-2016 and from Food and Agriculture Organization of the United Nations, FAO 2015 reports.FindingsThe results show that Saudi Arabia country has the highest production of marine while Bahrain country is the lowest in GCC. The results of ordinary least squares test show that marine production has a statistical significance on GDP indicators as Pearson correlation matrix shows a strong relationship between all variables.Practical implicationsThe main conclusion is that GCC countries must adopt a regional strategy to support maritime activities, especially in the light of green environmental fluctuations. Integrated management plans are also needed to protect vital coastal ecosystems while allowing economic growth and ensuring a better quality of life for all coastal populations. Comprehensive and collaborative leadership provides effective long-term management of coastal ecosystems in the GCC. In addition, GCC countries have high competition with each other for their market share in the global export-based marine production manufacturing.Originality/valueThis paper is the first to present most wealthy GCC countries in terms of marine production manufacturing. Marine production manufacturing introduces to create a new competitive market that generates distinctive internal capabilities for survival and growth in international markets.

To analyze the fertility rate trends in the GCC countries and their association with socioeconomic factors so that policymakers may use the study findings for future healthcare plans. Total population, crude death rate, life expectancy, literacy rate, human development index (HDI), female employment, unemployment rate, urbanisation, gross domestic product (GDP) per capita and inflation were chosen as possible predictors of TFR trends. The data were collected for the Global Burden of Disease 2021 study and other official databases such as the World Bank, the United Nations Development Program and Our World in Data for the 6 Gulf Cooperation Council (GCC) countries. Mean with standard deviation and percentage change was calculated to assess trends of TFR and all other variables from 1980-2021. The fertility rate declined in all 6 countries in 2021 compared to 1980. The highest decline was found in the United Arab Emirates (75.5%), while the lowest was in Kuwait (60.9%). From 1980-2021, total population, life expectancy, HDI, literacy rate, GDP, urbanisation, and female labor force increased in all GCC countries. The total population, life expectancy, urbanisation, female labor force, GDP and HDI were negatively and significantly correlated with TFR (p<0.01). The literacy rate showed a negative and significant correlation with TFR in Bahrain, Kuwait, Saudi Arabia, and Qatar. The TFR is declining in GCC countries. The plausible causes include the inclination towards postponement of marriages and excessive costs of living. These trends and associations need to be evaluated by policymakers so that they identify priority areas for interventions, allocate resources and formulate developmental plans accordingly to ensure strategic progress of the region.

Research performance of the GCC countries: A comparative analysis of quantity and quality

The prospective observational Dialysis Outcomes and Practice Patterns Study (DOPPS) was initiated in late 2012 in national samples of hemodialysis (HD) units (n = 41 study sites) in all six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates). For many years, guidelines have recommended single pool Kt/V ≥1.2 as the minimum adequate dose for chronic HD patients. Here, we report initial DOPPS results regarding HD practices related to dialysis dose achievement in the GCC. A total of 928 adult HD patients were included in this analysis from 41 centers representing all six GCC countries. Baseline descriptive statistics (e.g., mean, standard deviation, median, interquartile range, or percentage) were calculated for the study sample. Results were weighted according to the fraction of HD patients sampled within each participating study site. Mean age varied between 51 years in Bahrain, Oman, and Saudi Arabia, 55 years in the United Arab Emirates (UAE) and Kuwait, and 62 years in Qatar. Mean body mass index (BMI) was the lowest in Oman patients (23.9 kg/m 2 , but the remaining GCC countries had mean BMIs of 25.7-28.9 kg/m 2 and substantial fractions of overweight patients. Median dialysis vintage ranged from 1.52 years in Kuwait to 3.52 years in Oman. Mean treatment time per session varied from 202 min in Saudi Arabia to 230 min in Qatar while mean blood flow rate (BFR) ranged between 267 mL/min in Oman and 310 mL/min in Saudi Arabia. Interdialytic weight gain varied considerably among GCC countries between 3.1 and 4.0 kg. Central venous catheter use was high among GCC countries, ranging from 29% in Oman to 56% in Kuwait, with other countries averaging 30-40% catheter use. Data were available only for 50-76% of patients in four GCC countries (Kuwait, Qatar, Saudi Arabia, and UAE) for calculating single pool Kt/V to indicate dialysis adequacy. When calculated for patients with vintage >1 year and dialyzing three times per week, mean single pool Kt/V was highest in Qatar and the UAE (1.50-1.51), intermediate in Kuwait (1.35), and lowest in Saudi Arabia (1.29). A higher risk of mortality was observed for patients having a single pool Kt/V <1.2 (vs. ≥1.2) [hazard ratio (HR) = 1.71, 95% confidence interval [CI]: 1.01-2.92]. Achievement of Kt/V in the GCC, although lower than in other DOPPS regions such as Europe/ANZ and North America, was similar to that in Japan. Japan and the GCC also share the practice of having a lower blood volume filtered per HD session per kg body weight. These findings suggest that increasing mean BFR and treatment time in the GCC, along with reducing catheter use, would substantially increase overall achievement of Kt/V >1.2 in the GCC, and hence, may improve survival. These mortality findings will need to be confirmed with up-coming GCC-DOPPS 6 analysis.

The prospective cohort Dialysis Outcomes and Practice Patterns Study (DOPPS) initiated data collection in national samples of hemodialysis (HD) units (total of 41 study sites) in all six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) in late 2012. Here, we report initial results regarding mineral bone disorders (MBDs) and its management in the GCC countries. Forty-one randomly selected HD facilities, treating >23 HD patients each, were sampled and represent care for >95% of GCC HD patients. Descriptive results for the GCC countries based on a random sample of 20-30 HD patients in each study facility. Initial results for the GCC are from 931 HD patients treated at 41 dialysis units (ranging from 1 unit in Bahrain to 21 in Saudi Arabia). Results are presented as weighted estimates, accounting for the sampling fraction in each unit. Baseline descriptive statistics (e.g., mean, median, or percentage), weighted by facility sampling fraction were calculated for the study sample. For analyses examining the percent of facility patients having (a) serum phosphorus >6.0 mg/dL or (b) parathyroid hormone (PTH) >600 pg/mL, analyses were restricted to facilities having at least 10 HD patients with a reported serum phosphorus or PTH measurement, respectively. Logistic regression analyses of the indicated binary outcomes were based on the use of generalized estimating equations and were adjusted for GCC country, patient age category (<45 years, 45-65 years, and >65 years old), sex, and whether the patient was diagnosed with diabetes mellitus. Logistic models accounted for clustering of patients within facilities, assuming an exchangeable working correlation matrix. Mean age of HD patients in the GCC countries was 53 years vs. 61-64 years in the three other DOPPS regions. MBD markers showed slightly lower mean serum Calcium in the GCC countries, similar mean serum phosphorus, and intermediate median PTH levels compared with the three other DOPPS regions. Among GCC countries, the country mean value of MBD markers ranged from 8.6-9.0 mg/dL for serum calcium, 4.4-5.4 mg/dL for serum phosphorus, whereas median PTH ranged from 163-389 pg/mL. Similar to other DOPPS regions, PTH was higher among patients who were younger or without diabetes, and serum phosphorus was lower with older age (P <0.001 for each). History of parathyroidectomy was lower in the GCC countries versus other regions but did not differ when adjusted for age and dialysis vintage. Among treatments used for managing MBD, the GCC countries showed one of the highest uses of cinacalcet (24%) and phosphorus binder use (81%), whereas intravenous Vitamin D use (24%) was slightly higher than that in EURANZ. A much larger fraction of HD patients in the GCC countries had a dialysate calcium bath ≥3.5 mEq/L (43%) versus 0-4% in the three other DOPPS regions. Although many aspects of MBD management and MBD marker achievement are similar in the GCC countries to that seen in other DOPPS study regions, large variability was seen across countries and facilities in the GCC. Mean serum calcium was lower in the GCC despite the much greater use of dialysate Ca of ~3.5 mEq/L which may be due to the relatively low use of vitamin D and higher cinacalcet use, meriting further study. Future work will focus on GCC facility HD practices and patient characteristics most strongly related to the achievement of MBD target levels and associated outcomes.

BackgroundAsthma control is influenced by multiple factors. These factors must be considered when appraising asthma interventions and their effectiveness in the Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates [UAE]). Based on published studies, the most prevalent asthma treatment in these countries are fixed dose combinations (FDC) of inhaled corticosteroid and long-acting beta-agonist (ICS/LABA). This study is a rapid review of the literature on: (a) factors associated with asthma control in the GCC countries and (b) generalisability of ICS/LABA FDC effectiveness studies.MethodsTo review local factors associated with asthma control and, generalisability of published ICS/LABA FDC studies, two rapid reviews were conducted. Review 1 targeted literature pertaining to asthma control factors in GCC countries. Eligible studies were appraised, and clustering methodology used to summarise factors. Review 2 assessed ICS/LABA FDC studies in conditions close to actual clinical practice (i.e. effectiveness studies). Eligibility was determined by reviewing study characteristics. Evaluation of studies focused on randomised controlled trials (RCTs). In both reviews, initial (January 2018) and updated (November 2019) searches were conducted in EMBASE and PubMed databases. Eligible studies were appraised using the Critical Appraisal Skills Program (CASP) checklists.ResultsWe identified 51 publications reporting factors associated with asthma control. These publications reported studies conducted in Saudi Arabia (35), Qatar (5), Kuwait (5), UAE (3), Oman (1) and multiple countries (2). The most common factors associated with asthma control were: asthma-related education (13 articles), demographics (11articles), comorbidities (11 articles) and environmental exposures (11 articles). Review 2 identified 61 articles reporting ICS/LABA FDC effectiveness studies from countries outside of the GCC. Of these, six RCTs were critically appraised. The adequacy of RCTs in informing clinical practice varied when appraised against previously published criteria.ConclusionsAsthma-related education was the most recurring factor associated with asthma control in the GCC countries. Moreover, the generalisability of ICS/LABA FDC studies to this region is variable. Hence, asthma patients in the region, particularly those on ICS/LABA FDC, will continue to require physician review and oversight. While our findings provide evidence for local treatment guidelines, further research is required in GCC countries to establish the causal pathways through which asthma-related education influence asthma control for patients on ICS/LABA FDC therapy.

To identify the primary risk factors contributing to stroke incidents and deaths, analyzing the trends and changes in regional stroke statistics between 1990 and 2021 in the Gulf Cooperation Council (GCC) countries. This longitudinal time trend study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from June to August 2024. The data were recorded from the Institute for Health Metrics and Evaluation (IHME) and the Global Burden of Diseases (GBD) datasets. The incidence, mortality, and disability-adjusted life year (DALY) rates of stroke in the GCC countries, Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE), and their association with environmental pollution, dietary, and metabolic risk factors were documented from 1990 to 2021. From 1990 to 2021, the GCC countries exhibited varied trends in stroke incidence, mortality and DALYs. The UAE had the highest stroke incidence rate in 2021 (106.01 per 100,000). The mortality rates due to stroke decreased in the GCC, except in Kuwait, where they increased by 14.4%. DALYs decreased in GCC countries, with the highest decline in Qatar (56%). Qatar experienced a 59.9% decrease in death rates and a 53.4% reduction in DALYs for hypertension. In GCC countries, hypertension, air pollution, and dietary factors are dominant risk factors for stroke, stroke-related deaths, and DALY rates. The UAE had the highest stroke incidence rate in 2021. However, mortality rates decreased in all GCC countries except Kuwait.

Achieving environmental sustainability whilst minimizing the climate change effect has become a global endeavor. Hence, this study examined the effect of energy consumption, economic growth, financial development, and globalization on CO2 emissions in the Gulf Cooperation Council (GCC) countries. The research utilized a dataset stretching from 1995 to 2018. In a bid to investigate these associations, the study applied cross-sectional dependence (CSD), slope heterogeneity (SH), Pesaran unit root, Westerlund cointegration, cross-sectionally augmented autoregressive distributed lag (CS-ARDL), and Dumitrescu and Hurlin (DH) causality approaches. The outcomes of the CSD and SH tests indicated that using the first-generation techniques produces misleading results. The panel unit root analysis unveiled that the series are I (1). Furthermore, the outcomes of the cointegration test revealed a long-run association between CO2 emissions and the regressors, suggesting evidence of cointegration. The findings of the CS-ARDL showed that economic growth and energy consumption decrease environmental sustainability, while globalization improves it. The study also validated the environmental Kuznets curve (EKC) hypothesis for GCC economies. In addition, the results of the DH causality test demonstrated a feedback causality association between economic growth and CO2 emissions and between financial development and CO2 emissions. Moreover, there is a one-way causality from energy consumption and globalization to CO2 emissions in GCC economies. According to the findings, environmental pollution in GCC countries is output-driven, which means that it is determined by the amount of energy generated and consumed.