Abstract
Background: There has been a widespread debate about the overall impact of globalization on population, not just economically, but also in terms of health status. Moreover, the current health crisis is going to force governments to review the structure of the public budget to most effectively alleviate the negative economic and health effects on the population. Objective: The aim of this paper is to analyze the relative importance of globalization and the public budget composition—specifically the participation of public expenditure on healthcare, social services and environment in gross domestic product (GDP)—on life expectancy at birth in European countries during the period 1995–2017. Methods: The Multivariate Adaptive Regression Splines (MARS) methodology was applied to analyze the socioeconomic determinants of life expectancy at birth. Results: Our findings show that globalization has no relative importance as an explanatory variable of life expectancy in European countries, while government expenditure on social protection is the most relevant followed by public expenditure on health, gross national income per capita, education level of the population and public expenditure on environmental protection. Conclusion: European strategies intended to impact on health outcome should spend more attention to the composition of public budget.
Highlights
In Western countries, life expectancy at birth has experienced a remarkable increment in the last century because of the decrease in the probability of death favored by medical and technological advances, reduction of infant mortality rates, changes in nutritional habits and lifestyle, improvement of living conditions and education and the population’s access to health services
The proposed Multivariate Adaptive Regression Splines (MARS) model was implemented in the predefined dataset, being necessary to group the obtained results based on two fundamental aspects, the significance of the employed model and the relative importance of the variables, as well as the overall goodness of the fit
Our findings show that environmental expenditures are one of the least important socioeconomic factors related to life expectancy at birth [47]; this does not mean that this type of public expenditure has no effect on health status, but this item has less relevance than other factors such social and healthcare expenditures
Summary
In Western countries, life expectancy at birth has experienced a remarkable increment in the last century because of the decrease in the probability of death favored by medical and technological advances, reduction of infant mortality rates, changes in nutritional habits and lifestyle, improvement of living conditions and education and the population’s access to health services. Three categories of health status determinants have been repeatedly considered in the existing literature, concerning developed countries and focusing on a macro perspective [1]: health resources, lifestyle-related factors and socioeconomic factors. There has been a widespread debate about the overall impact of globalization on population, not just economically, and in terms of health status. The current health crisis is going to force governments to review the structure of the public budget to most effectively alleviate the negative economic and health effects on the population. Objective: The aim of this paper is to analyze the relative importance of globalization and the public budget composition— the participation of public expenditure on healthcare, social services and environment in gross domestic product (GDP)—on life expectancy at birth in European countries during the period
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