Share Of Gross Domestic Product Research Articles

National Health Expenditure Projections, 2023-32: Payer Trends Diverge As Pandemic-Related Policies Fade.

Health care spending growth is expected to outpace that of the gross domestic product (GDP) during the coming decade, resulting in a health share of GDP that reaches 19.7percent by 2032 (up from 17.3percent in 2022). National health expenditures are projected to have grown 7.5percent in 2023, when the COVID-19 public health emergency ended. This reflects broad increases in the use of health care, which is associated with an estimated 93.1percent of the population being insured that year. In 2024, Medicaid enrollment is projected to decline significantly as states continue their eligibility redeterminations. Simultaneously, private health insurance enrollment is projected to increase because of the extension of enhanced subsidies for direct-purchase health insurance under the Inflation Reduction Act (IRA) of 2022, as well as a temporary special enrollment period for qualified people losing Medicaid coverage (after eligibility redeterminations). Over the course of 2024-26, the IRA expands Medicare's drug benefit generosity and implements drug price negotiations for beneficiaries; concurrently, the extended enhanced subsidies for direct-purchase health insurance expire in 2026. During 2027-32, personal health care price inflation and growth in the use of health care services and goods contribute to projected health spending that grows at a faster rate than the rest of the economy.

Moderating the Role of Trade Openness on Foreign Portfolio Investment and Economic Growth among East Africa Community Countries

Purpose: This study investigates the impact of foreign portfolio investment (FPI) on economic growth in East Africa using panel data for Kenya, Uganda, Tanzania, Rwanda, and Burundi from 1974-2022. Methodology: The analysis employs a panel vector error correction model to estimate the short and long-run effects of FPI on growth. The study relied on secondary data sources for the period 1974-2022 with an annual frequency, implying 49 years of data. Data on foreign investment variables and macroeconomic control variables were sourced from the World Bank database, National Statistical Bureaus, Central Banks, and Stock Exchanges of the respective countries. Findings: The results indicate that FPI significantly positively impacts economic growth in East Africa. A 1% increase in FPI inflows as a share of Gross Domestic Product (GDP) boosts annual real GDP growth by approximately 10.7% in the long run. The findings are robust to the inclusion of moderating variables like trade openness. Unique Contribution to Theory, Practice and Policy: The empirical analysis aimed to validate the Modern Portfolio Theory by examining if greater foreign portfolio investment flows contributed positively to economic growth in the East African region. The results lend support to policy efforts in East Africa to attract greater FPI through capital market reforms, regional integration, and macroeconomic stability. However, further developing financial markets and enhancing absorptive capacity is essential to leverage FPI more effectively for sustainable growth financing.

Charting the course: India’s health expenditure projections for 2035

ObjectivesUnderstanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket (OOP) expenses. The current study analyzed health expenditure patterns in India and forecasted future trends and patterns until 2035. MethodsData on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development (OECD) iLibrary and National Health Accounts 2019 databases. Gross domestic product (GDP) data from the World Bank was also utilized. Descriptive statistics analyzed the composition and pattern, while the exponential smoothing model forecasted future health expenditures. ResultsThe findings revealed that expenditure made by OOP is the primary health financing source, followed by government and pre-paid private spending. The percentage of GDP allocated to total health expenditure remains stable, while the per capita health expenditure fluctuates. Variations in expenditure among states are observed, with Karnataka relying heavily on pre-paid private coverage. Future projections suggest a decline in per capita and total health expenditure as a share of GDP, with a slight increase in the government’s share. Pre-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute terms. ConclusionThe study highlights variations in health spending in India, characterized by high OOP spending, limited public coverage, and a need for investments, and reforms to improve healthcare access and equity.

An analysis of financial protection and financing incidence of out-of-pocket health expenditures in Kazakhstan from 2018 to 2021

Universal health coverage relies on providing essential medical services and shielding individuals from financial risks. Our study assesses the progressivity of out-of-pocket (OOP) payments, identifies factors contributing to healthcare expenditure inequality, and examines catastrophic health expenditures (CHE) prevalence in Kazakhstan from 2018 to 2021. Using retrospective analysis of National Statistics Bureau data, we employed STATA 13 version for calculations CHE incidence, progressivity, Lorenz and concentration curves. In 2020–2021, OOP expenditures in Kazakhstan decreased, reflecting a nearly twofold reduction in the CHE incidence to 1.32% and 1.24%, respectively. However, during these years, we observe a transition towards a positive trend in the Kakwani index to 0.003 and 0.005, respectively, which may be explained by household size and education level factors. Increased state financing and quarantine measures contributed to reduced OOP payments. Despite a low healthcare expenditure share in gross domestic product, Kazakhstan exhibits a relatively high private healthcare spending proportion. The low CHE incidence and proportional expenditure system suggest private payments do not significantly impact financial resilience, prompting considerations about the role of government funding and social health insurance in the financing structure.

An Autoregressive Transformer Model For Crisis Management Using Twitter Tweets

A disaster is a major event that lasts for a long time and causes a lot of damage to people, property, the economy, or the environment. The damage is so bad that the group or society that is affected can't handle it on its own. When a disaster happens, it costs developing countries the most. More than 95% of all deaths from hazards happen in developing countries, and as a share of gross domestic product, losses from natural hazards are 20 times higher in developing countries than in developed nations. To minimize the loss at the time of disaster and to overcome it quickly, a survey is taken on how to manage disaster effectively using Machine Learning and social networks. Social media platforms like Twitter, Instagram and Facebook acts as a communication medium during disaster and also help to take preventive measures before the occurrence of the disaster. Machine learning algorithms also helps in response and recovery phase after the occurrence of the disaster. The paper aims to provides an elaborated review on the concepts of Machine Learning (ML) along with social media and addresses how various other technologies like use of physical sensors, Remote sensors, Graphical Information System (GIS), Internet of Things (IoT) and Neural Network[1]s like Artificial Neural Network (ANN), Deep Neural Network (DNN) can combine with Machine Learning algorithms for the management of disaster efficiently using social media. Finally, based on the study, a generalized autoregressive pre-training method called XLNet is proposed which overcomes the limitations of BERT using its autoregressive formulation and directions for the future research is explained further.

Asia's Leading Percentage Share of Global GDP (2000-2022): Trends, Drivers, and Implications

This study explores the intricate correlation between Gross Domestic Product (GDP) and exports in the top ten Asian economies from 2000 to 2022. Employing a quantitative research approach, the investigation utilizes extensive secondary data to discern patterns and dynamics impacting economic output within international trade. The analysis presents statistically significant connection between export potential and GDP across the sampled countries. According to the study, Asia's percentage share of global GDP has been growing steadily since 2000, indicating sustained economic growth in the region. Factors such as economic reforms, globalization, and technological advancements emerge as pivotal contributors to Asia's evolving role in the global economic landscape. Acknowledging limitations, including presumptions of a linear relationship and the exclusion of country-specific contextual factors, underscores the necessity for prudent interpretation. By amalgamating these findings with a comprehensive research methodology encompassing data collection, statistical analyses, and hypothesis testing, this study furnishes a holistic understanding of the multifaceted interactions shaping the economic trajectories of these nations.

Why did agriculture's share of Australian gross domestic product not decline for a century?

AbstractThe agricultural sector's share of gross domestic product (GDP) in growing economies typically declines but, for a century from the early 1850s, Australia's did not. Drawing on recent structural transformation literature, this paper seeks explanations for this unusual phenomenon, which is all the more striking because agriculture's share of employment continued to decline throughout and growth in manufacturing was being stimulated by tariff protection from imports. Several factors contributed, including a huge land frontier that took more than a century for settlers to explore, rapid declines in initially crippling domestic and ocean trade costs for farm products, the absence of a need to do any processing of the two main exports during that period (gold and wool) and innovations by farmers and via a strong public agricultural R&D system that contributed to farm labour productivity nearly doubling over those 10 decades. The ban on iron ore exports from 1938 and low export prices for fuels, minerals and metals during the two world wars and in the intervening decades also contributed.

Wasted GDP in the USA

Whether or to what extent Gross Domestic Product (GDP) can measure human development is disputed. This article develops a notion of “wasted GDP”, with a case study on the performance of the USA based on analysis of Human Development Index (HDI) data. Like Herman Daly’s notion of ‘uneconomic growth’, the perspective of wasted GDP addresses the benefits and costs of economic growth and favors prioritization of policies that promote genuinely sustainable wellbeing. Over the last three decades, the USA has fallen behind several other highly developed countries in the HDI, despite solid economic growth. More than 20 countries, large and small, now outperform the USA on the Human Development Index, and 27 countries currently do better than the USA by nonincome HDI. 21 countries outperform the USA by this measure despite having a lower GDP per capita. The notion of “wasted GDP” implies that GDP is wasted if it does not support welfare. While a country´s welfare performance is measured by nonincome HDI, a comparison with better-performing countries that have a lower GDP indicates the share of GDP that is wasted from a human development perspective. The results, based on highly conservative estimates, show that the top 5 performers by lowest GDP per capita achieve better outcomes than the USA with an average GDP per capita that is 37.5% lower. All better performers achieve better outcomes with an average GDP per capita that is 26.9% lower. Without any wasted GDP, the annual US CO2 emissions could have been at least 1.268 million tonnes lower (all better performers estimate) and possibly as much as 1.767 million tonnes lower (top 5 performers estimate), accounting for 3.6–5.0% of global emissions. Similarly, the USA´s material footprint could have been between 2.625 million and 3.659 million tonnes lower, accounting for 2.7–3.8% of humanity´s global material footprint.

Health, wealth, and medical expenditures among the elderly in rural Tanzania: experiences from Nzega and Igunga districts

BackgroundThe per capita health expenditure (HE) and share of gross domestic product (GDP) spending on elderly healthcare are expected to increase. The gap between health needs and available resources for elderly healthcare is widening in many developing countries, like Tanzania, leaving the elderly in poor health. These conditions lead to catastrophic HEs for the elderly. This study aimed to analyse the association between measures of health, wealth, and medical expenditure in rural residents aged 60 years and above in Tanzania.MethodsThe data of this study were collected through a cross-sectional household survey to residents aged 60 years and above living in Nzega and Igunga districts using a standardised World Health Organization (WHO) Study on Global Ageing and Adult Health (SAGE) and European Quality of Life Five Dimension (EQ-5D) questionnaires. The quality of life (QoL) was estimated using EQ-5D weights. The wealth index was generated from principal component analysis (PCA). The linear regression analyses (outpatient/inpatient) were performed to analyse the association between measures of health, wealth, medical expenditure, and socio-demographic variables.ResultsThis study found a negative and statistically significant association between QoL and HE, whereby HE increases with the decrease of QoL. We could not find any significant relationship between HE and social gradients. In addition, age influences HE such that as age increases, the HE for both outpatient and inpatient care also increases.ConclusionThe health system in these districts allocate resources mainly according to needs, and social position is not important. We thus conclude that the elderly of lower socio-economic status (SES) was subjected to similar health expenditure as those of higher socio-economic status. Health, not wealth, determines the use of medical expenditures.

Investigation of selected key indicators of circular economy for implementation processes in sectorial dimensions

The main goal of this study is to investigate and to evaluate the selected indicators of the circular economy to advance the development of effective tools and policies regarding the circular economy system. This investigation is supported by the three research questions covering the topics of dependence of the circular economy on the use of reusable material, help with the reuse of circular material for economic sectors to establish a platform for effective policy development and implementation, and finally, the necessity of quantifying circular economy indicators to obtain an accurate picture of the circular economy sector relationships. The eight research hypotheses are considered, five of which are rejected. The gross investment of the circular economy sector in tangible goods in the both explored variants – expressed in the currency units also as the share of gross domestic product, circular economy sector value added at factor cost, the glass packaging waste recycling rate, the metallic packaging waste recycling rate, and the municipal waste act in the statistically significant way. The study applies a regression analysis technique with consistently validating test outcomes. The discussion section introduces the implications of the analytical outcomes with a potential of the setting current policies in the circular economy system and the construction of the new ones.

Problems of comprehensive assessment of the impact of global business structures on the development of the national economy

The paper is devoted to the activities of enterprises and their impact on the state economy. The activities of enterprises are aimed at achieving economic and social results and making a profit in addition, it is related to the provision of the needs of each person, is subject to the influence of many factors and covers a wide range of organizational, technological, economic and financial issues. The paper analyzes the main aspects of the economic significance of the activities of enterprises for the effective functioning of the national economy. Business has been proven to be of global importance through financial inflows, foreign investment and share of gross domestic product. Stability of enterprise activity, achievement of competitive advantages, strengthening of the enterprise’s position on the market – all this is achieved by implementation of rational and carefully developed economic policy of business entities and state policy. That is why the problem of formation and management of the economic policy of the enterprise becomes especially relevant. The main aim of the research is to identify the risks and prospects of enterprise activity on the national economy in modern conditions. Support for the economy is provided only by those enterprises that correctly and competently determine the requirements of the market, organize the production of competitive products and services that are in demand, skillfully carry out highly qualified creative labor staff All this requires fundamental and in-depth economic knowledge, and therefore, appropriate training of economics specialists. The paper describes the state of enterprise activity, possible threats, prospects, and further vectors of development in the post-war period. The practical value of the research is reflected in the results of the work and its follow-up scientific research. The authors concludes that the following steps have been taken in recent years to improve the relationship between entrepreneurship and the national economy: comprehensive regulation of the business sector, development of a simplified program for permitting procedures and registration of property rights, high-quality and modern procedures for starting and closing a business, obtaining administrative services at the highest level, observance of state control over the activities of business entities and reforming the provision of administrative services, mitigation of taxation.

Corruption and stock market development: Developing vs. developed economies

This paper looks at the impact of corruption on stock market development, emphasizing the difference between developing and developed economies and the role corruption may play in preventing firms from listing. Guided by a theoretical model that explains why corruption’s impact on stock market development may differ, we use a sample of 87 economies worldwide over the period 1995–2017 to test for that difference. For the full sample we find no evidence that corruption has a significant effect on stock market development, but this changes when we split the sample into two groups: high-income and low-income countries. For the subsample of poorer (developing) countries, the corruption-stock market development relationship remains insignificant or weak. For the subsample of high-income (developed) countries, however, we find a significant relationship between lower levels of corruption and stock market capitalization as a share of gross domestic product. Our results further indicate that higher levels of income and investment reduce the impact of that relationship. Our results are robust to alternative estimation specifications and confirm the importance of macroeconomic fundamentals (i.e., income, investment, domestic credit, and macroeconomic stability) for the development of stock markets. In particular, those fundamentals seem more important for developing economies before reduced corruption will have as much (if any) of an impact.

Effect of External Shocks on the Predictability of Remittance Flows From Developed Countries

The present analysis has explored the effect of external shocks on the predictability of remittance outflows, by relying on an unbalanced panel of 24 developed countries over the period from 1996 to 2020. The indicator of predictability of remittance outflows for a given country in a given year is the deviation of the remittance outflows (as a share of gross domestic product) from its trend. Results are obtained by means of the within-fixed effects estimator, and indicate that external shocks reduce the predictability of remittance outflows, with a larger negative effect on the positive predictability of these capital outflows than on the negative predictability of these capital outflows. The negative effect of external shocks on the predictability of remittance outflows operates through the economic growth channel, with the magnitude of this negative effect being higher in countries with low economic growth rates. Finally, external shocks reduce the predictability of remittance outflows in countries that experience a decline in migrant inflows. This finding has implications for the economic and development prospects of migrants’ countries of origin. JEL Classification: F24, F43, O11

The Global Macroeconomic Burden of Burn Injuries.

Standardized estimates of global economic losses from burn injuries are lacking. The primary objective of this study was to determine the global macroeconomic consequences of burn injuries and their geographic distribution. Using the Institute of Health Metrics and Evaluation database (2009 and 2019), mean and 95% uncertainty interval (UI) data on incidence, mortality, and disability-adjusted life-years (DALYs) from injuries caused by fire, heat, and hot substances were collected. Gross domestic product (GDP) data were analyzed together with DALYs to estimate macroeconomic losses globally using a value of lost welfare approach. There were 9 million global burn cases (95% UI, 6.8 to 11.2 million) and 111,000 deaths from burns (95% UI, 88,000 to 132,000 deaths) in 2019, representing a total of 7.5 million DALYs (95% UI, 5.8 to 9.5 million DALYs). This represented welfare losses of $112 billion (95% UI, $78 to $161 billion), or 0.09% of GDP (95% UI, 0.06% to 0.13%). Welfare losses as a share of GDP were highest in low- and middle-income countries (LMICs) of Oceania (0.24%; 95% UI, 0.09% to 0.42%) and Eastern Europe (0.24%; 95% UI, 0.19% to 0.30%) compared with high-income country regions such as Western Europe (0.06%; 95% UI, 0.04% to 0.09%). Mortality-incidence ratios were highest in LMIC regions, highlighting a lack of treatment access, with southern sub-Saharan Africa reporting a mortality-incidence ratio of 40.1 per 1000 people compared with 1.9 for Australasia. Burden of disease and resulting economic losses because of burn injuries are substantial worldwide and are disproportionately higher in LMICs. Possible effective solutions include targeted education, advocacy, and legislation to decrease incidence and investing in existing burn centers to improve treatment access.

Interdependence between climate change and migration: Does agriculture, geography, and development level matter in sub‐Saharan Africa?

AbstractConcerns about the human effects of climate change have contributed to forecasts of how populations in drought‐prone and flood‐prone areas would respond to these events. Empirical studies have predicted that human migration has been among the critical resilient strategy in responding to the impact of climate change. To obtain a more comprehensive understanding of the climate–migration relationship, the impacts of climate change on international migration flows from sub‐Saharan Africa nations to South Africa are investigated empirically in this paper. The study employed static and dynamic models and panel data from 35 countries in sub‐Saharan Africa, spanning 1990 to 2017. The findings are as follows: (1) The analysis shows that historical temperature has a positive and statistically significant effect on outmigration in agriculture‐dependent nations. (2) The analysis shows that agricultural value added as a share in gross domestic product has a negative and statistically significant effect on outmigration in agriculture‐dependent nations. (3) The results also show that geographic location and development level of a country, in addition to dependency on agriculture, are key factors in the climate change–international migration nexus. Policy implications are discussed.

The cost of premature death from cancer attributable to alcohol: Productivity losses in Europe in 2018

BackgroundMore than 1.9 million people die from cancer each year in Europe. Alcohol use is a major modifiable risk factor for cancer and poses an economic burden on society. We estimated the cost of productivity lost due to premature death (under 65 years of age) from alcohol-attributable cancer in the European Union (EU) plus Iceland, Norway, Switzerland, and the United Kingdom (UK) in 2018. MethodsWe estimated cancer deaths attributable to alcohol using a Levin-based population attributable fractions method and cancer deaths in 2018 from the Global Cancer Observatory. Lost productivity was estimated for all alcohol-attributable cancer deaths by sex, cancer site, and country. Productivity losses were valued using the human capital approach. ResultsAn estimated 23,300 cancer deaths among people aged less than 65 in the EU plus Iceland, Norway, Switzerland and the UK in 2018 were attributable to alcohol (18,200 males, 5100 females). This equated to €4.58 billion in total productivity losses in the region and 0.027 % of the European Gross Domestic Product (GDP). The average cost per alcohol-attributable cancer death was €196,000. Productivity lost to alcohol-attributable cancer per capita was highest in Western Europe. Hungary, Romania, Slovakia, Latvia, Lithuania, and Portugal had the highest rate of premature mortality from alcohol-attributable cancer and the highest productivity lost as a share of national GDP. ConclusionOur study provides estimates of lost productivity from alcohol-attributable cancer death in Europe. Cost-effective strategies to prevent alcohol-attributable cancer deaths could result in economic benefits for society and must be prioritised.

Water-constrained green development framework based on economically-allocable water resources

Water as a main driver for sustainable development (SD) should be optimally allocated to different users to support economic, social, and environmental functions. Traditional approaches are not able to account for all the mentioned functions simultaneously, therefore a change in the allocation approaches is necessary. This paper proposes a new framework for inter-sectoral water allocation called “water-constrained green development” (WCGD) to better meet the SD goals. The framework optimally allocates economically-allocable water (EAW), which is the total available water resources left after subtracting the amount of water required for drinking, sanitation, and environment (DSE), to different job classes. It was tested in Sistan Region- a low-developed area in southeast of Iran- which stands on agriculture. In the recent years, because of water crisis, intensity of dust problem, lack of sustained occupation, and immigration, the region’s rate of population growth has been negative. Also, due to decrease of Helmand River inflow, Hamoun wetland, being the major source of food and shelter for the Sistan’s residents, has been degraded. Therefore, Sistan Region needs to take a new development route. The shares of occupation and gross domestic product (GDP) in the agricultural sector of Sistan are respectively 29.1 and 14.8%, whereas they are on average 1 and 7% in Iran. Application of the proposed framework in Sistan Region under three scenarios of available EAW resources showed that the optimal reallocation of water among 15 job classes can improve job availability and GDP of the region currently suffering from poor economy and employment conditions. Based on the optimal job pattern obtained, the share of GDP of Sistan’s agricultural sector drops to 7.1% while the shares of industrial and service sectors increase respectively from 9.7 and 75.4% to 13.7 and 79.2%, which are close to those of the country averages. Also, under the WCGD-based optimal solution, 68, 14, and 18% of people will respectively be employed in service, industry, and agriculture sectors. Additionally, the total available jobs and GDP will increase by 8.9 and 51.1%, respectively, leading to improved socio-economic well-being of the region’s people and protection of its environmental resources.

Перераспределение ресурсов между частным и общественным сектором пространственной экономики: агент-ориентированный подход

Redistribution of resources between the private and public sectors is a key issue of state policy analysis, including at the regional level. The article examines how changes in tax rates and social transfers affect the redistribution of financial resources, fixed capital and labour. The study utilised a spatial agent-based model focused on microeconomic decisions of households and enterprises. Fixed capital depends on investment policies of private and public companies; demand and supply are balanced in the labour market for a given total labour force. Tax rates and distribution of social transfers are seen as the institutional framework for making microeconomic decisions. At the meso- and macro-levels, state policy changes affect the economic structure of regions, industries, public and private sectors. The use of capital, labour and financial resources was assessed to calculate the relative size of the public sector. Simulations of changes in transfers and taxes show opposite trends in the proportion of the sectors. At given tax rates, the expansion of social transfers reduces social inequality and causes profound structural changes in the economy due to decreased provision of public goods and increased income of recipient households. The size of the public sector in terms of the use of financial resources remains practically unchanged: its share in gross domestic product decreased from 32.2 % to 30.4 %. However, the shares of capital (by 9.9 %) and labour (by 14.7 %) noticeably declined in this sector, indicating a redistribution of capital and labour from the public to the private sector. On the contrary, tax hike leads to an increase in the main indicators characterising the share of the public sector, while most of the private sector indicators fall sharply and social inequality rises significantly.

Statistical Analysis of Factors Influencing Economic Growth in Zambia

Abstract: The focus of this research is to investigate the factors influencing the economic growth in Zambia. The motivation of this research is due to the unsustainable growth trends that Zambia has been experiencing in recent years. There is an assessment on whether it’s a Least Developed Country status is beared on the vulnerability to a Mid Income Trap therefore by using adapted unit root model, Granger causality tests were conducted to establish which variables affect Zambia's Gross Domestic Product (GDP) per capita income level and predispose it to the Middle Income Trap (MIT). Thus, per capita income, labor productivity, agriculture share to GDP, and manufacturing industry share to GDP were investigated. The results have shown that agriculture share of GDP strongly affects GDP per capita income while manufacturing share of GDP has a weaker effect on GDP per capita. The results obtained further indicate that a change in agriculture share of GDP strongly affects the manufacturing output. Therefore, Zambia should increase investment in agriculture and manufacturing to maintain a positive GDP per capita income growth and to catalyze growth in the secondary sectors

Spatiotemporal Evolution and Drivers of Total Health Expenditure across Mainland China in Recent Years.

A substantially growing health expenditure has become an important global issue. Thus, how and why health expenditure is rising should be urgently investigated in systematic research. The Bayesian space-time model and the Bayesian least absolute shrinkage and selection operator (LASSO) model were employed in this study to investigate the spatiotemporal trends and influence patterns of total health expenditure per capita (THEPC) and total health expenditure (THEE) as a share of the gross domestic product (GDP) on the Chinese mainland from 2009 to 2018. The spatial distribution of THEE as a share of GDP in mainland China has shaped a distinct geographical structure with the characteristic of 'west high/east low'. Its local increasing trends formed a geographical structure that exhibited a 'north high/south low' feature. The heterogeneity of the influence patterns of health expenditure was observed from east to west across China. Natural environmental factors, such as air pollution and green coverage, along with changes in dietary structures, have increasingly influenced the growth of health expenditures.