Economic development and health outcomes: Evidence from cardiovascular disease mortality in Europe

The impact of economic growth on health outcomes has generated various conflicting results in recent years, particularly with the emergence of cardiovascular disease as one of the most salient global health issues. This paper looks at the relationship between economic development and health outcomes. We first estimate an empirical model using data on annual cardiovascular disease mortality in a panel of 27 European countries, over the period 2003 to 2014, together with per capita GDP levels in each country. We also include a number of additional determinants of health outcomes as prescribed by the literature, including various socio-economic, lifestyle and contextual variables. The results show that there is a statistically-significant inverted U-shaped relationship, whereby as income increases mortality rates first rise, before declining at subsequent levels of development. This trajectory persists even after the inclusion of the other determinants of health, as well as other robustness checks. We then seek to explain the persistence of the inverted U-shaped income-mortality relationship using a microeconomic model of consumer choice, with our findings suggesting that this relationship is consistent with a scenario of increasing returns to scale from healthcare investment. The results emphasise the importance of investment in the latest healthcare technologies and continued improvements to public healthcare systems, particularly within developing countries, in conjunction with efforts to boost economic growth.