How Selected Health Risks Relate to Healthcare Expenditure

The sustainability of public budgets and the financing of healthcare are among the important topics in today’s public debate. A new study, The impact of health risks on healthcare expenditure in European countries, focuses on how selected risk factors may be associated with healthcare expenditure at the country level. The authors, Jarmila Zimmermannová, Karel Helman and Miroslav Hájek, focused primarily on the consumption of alcohol, tobacco and other risk substances, as well as selected environmental indicators. 

Two Perspectives on One Health: How Did the Authors Proceed? 

The researchers worked with data from 2013 to 2021 from selected European countries. The aim was to determine whether selected factors can help explain differences in healthcare expenditure between individual countries. 

They used two main approaches: 

• Harmful consumption model, which examined the relationship between expenditure on alcohol, tobacco and other substances and healthcare expenditure. 
• Environmental model, which explored the relationship between emissions and healthcare expenditure. 

In the analysis, the authors also took GDP per capita into account as a specific variable in order to better separate the influence of countries’ economic level from the risk factors under review. In addition, they divided the countries into groups according to health profiles, the level of healthcare expenditure and the development of greenhouse gas emissions, so that they could compare different types of countries. The authors used fixed-effects panel regression, a model that helps better distinguish differences between countries from changes over time. 

What Did the Analysis Show? 

The results of the mathematical models both supported some of the initial assumptions and produced one more surprising finding. 

Alcohol and Risk Substances 

For alcohol and other risk substances, the results indicated that higher consumption is associated with higher healthcare expenditure. Differences between individual groups of European countries were clear. In more developed countries, this relationship was stronger than in less developed countries. 

• In economically less developed countries with a high level of risk (especially post-communist countries, including the Czech Republic): by 0.24 euros per capita. 
• In developed countries with a high level of risk (e.g. Germany, France): by 0.63 euros per capita. 
• In developed countries with a low level of risk (e.g. Scandinavia): by 3.71 euros per capita. 

The authors interpret these differences as showing that more developed countries usually invest more in healthcare and, at the same time, respond more intensively to changes in healthy lifestyles. The study shows that alcohol is associated in the model with an increase in healthcare expenditure. Across all groups of countries examined, if alcohol consumption per capita increases by 1 euro, healthcare costs rise by more than 1 euro.

The Emissions Paradox 

In the case of emissions, the authors found a negative relationship between the amount of greenhouse gases and healthcare expenditure. This does not mean that higher emissions in themselves reduce health expenditure. Rather, it shows that countries with different emission levels also differ in how much funding they allocate to healthcare and what their overall priorities are. 

In the model including all countries, higher greenhouse gas emissions by 1 tonne per capita correspond to lower healthcare expenditure by 124.43 euros per capita. The authors interpret this result as indicating that more developed countries usually invest more both in environmental measures and in healthcare, while some less developed countries invest less in both areas. The study therefore shows that there are links between environmental conditions and healthcare expenditure, and that these links differ between countries. 

What Does This Mean in Practice? 

The study does not point to a simple cause or a single universal conclusion. Rather, it suggests that risky behaviour, harmful consumption and the state of the environment may be related to healthcare expenditure, and that these relationships differ between European countries. At the same time, the results need to be read with caution, as the authors themselves point out the limitations of causal interpretation of the models. 

For public debate, the key conclusion is that the long-term sustainability of healthcare cannot be addressed only through treatment, but also through prevention and the reduction of risky behaviour. The authors also recommend better coordination between health and environmental policy, as this may help support the stability of healthcare system financing in the future.