Abstract :
Introduction: Economic growth has a direct impact on public health expenditures; also, it indirectly affects public health expenditures through the environment’s quality. Therefore, this study aimed to investigate the relationship between environmental performance index, economic growth, and public health expenditures in countries with high and very high human development index. Methods:The present descriptive-analytical and applied study was performed on 16 countries with high and very high human development index. The time-series data required for the years 2006-2018 were extracted from the World Bank and United Nations database and environmental performance index extracted from the Yale University website. Im, Pesaran and Shin (IPS), Levin, Lin, and Chu (LLC), Augmented Dickey–Fuller (ADF)– Fisher, and Phillips-Perron (PP)–Fisher tests for stationary and Pedroni and Kao tests for cointegration were used. The study model was estimated by the DOLS cointegration method in Eviews 10 software. Results: The mean environmental performance index for selected countries with very high and high human development index was 79.04 and 64.71, respectively; also, the elasticity of public health expenditures to gross national production, environmental performance index, physician supply, and urbanization ratio were 0.96, -2.41, 0.441 and 0.448, respectively. Conclusion: Increasing economic growth, urbanization ratio, and physician supply had a positive effect, and improving environmental performance index had a negative effect on public health expenditures. Therefore, to reduce public health expenditures, policies are recommended to maintain environmental sustainability and reduce environmental pollutants, and to invest in advanced equipment to purify pollutant gases. Maintaining and increasing economic growth is also essential for adopting policies to increase physicians and invest in health infrastructure.
