Global analysis of the impacts of air pollution on global health expenditures and implications for sustainable development
Air pollution has become a major global challenge, imposing substantial health and economic burdens while threatening progress toward the Sustainable Development Goals (SDGs). This study investigates the impact of air pollution on healthcare expenditure using panel data from 95 countries over the period 2010-2020. Two complementary indicators of air pollution, emissions per unit area (EMS) and ambient PM2.5 concentration, are employed to distinguish pollution intensity from population exposure. Pooled Ordinary Least Squares (OLS) models with robust standard errors are estimated to examine the direct effects of air pollution, while interaction models are used to assess the moderating roles of urbanization, industrialization, and national income levels. The results indicate that EMS significantly increases healthcare expenditure, whereas PM2.5 exhibits a counterintuitive negative association, suggesting that institutional capacity, preventive healthcare, and policy responses may influence the pollution-healthcare expenditure relationship. Urbanization mitigates the adverse effect of PM2.5, and heterogeneous impacts are observed across income groups. The findings contribute to the literature by integrating dual pollution indicators and crosscountry heterogeneity, providing evidence to support policies aimed at strengthening environmental governance, improving preventive healthcare systems, and advancing sustainable development.