# Heterogeneous associations of health expenditure, environmental pollution, and economic growth on life expectancy in BRICS economies

**Authors:** Mohammad Ridwan, Zulfiquar Ali Antor, Afsana Akther, Jeremy Ko, Hossein Ali Fakher, Chun Kai Leung, Wai-Kit Ming

PMC · DOI: 10.3389/fpubh.2026.1767163 · Frontiers in Public Health · 2026-02-24

## TL;DR

The study examines how factors like healthcare spending, pollution, and economic growth affect life expectancy in BRICS countries, finding mixed and varied relationships.

## Contribution

The paper introduces a distribution-sensitive panel framework with quantile regression to analyze heterogeneous effects on life expectancy in BRICS economies.

## Key findings

- Healthcare expenditure is positively associated with life expectancy in BRICS countries.
- Economic growth and pollution show mixed relationships with life expectancy, depending on the development stage.
- Trade openness is generally linked to lower life expectancy, while urbanization effects depend on infrastructure and environmental conditions.

## Abstract

This study investigates the associations between economic growth, healthcare expenditure, environmental pollution, urbanization, trade openness, and life expectancy in BRICS economies from 2000 to 2024 using a distribution-sensitive panel framework. Quantile regression is applied to capture heterogeneity across different levels of life expectancy, supported by robustness checks using PCSE, DKSE, and F-GLS estimators, and validated through panel cointegration and dependence tests. The results show that healthcare expenditure is positively associated with life expectancy, while the relationships for economic growth and pollution are mixed and vary with development stage. Urbanization exhibits both supportive and adverse associations depending on infrastructure capacity and environmental pressure, and trade openness generally relates to lower life expectancy. These findings suggest that policy responses should be tailored rather than uniform across countries. Strengthening the efficiency of healthcare systems, coordinating industrial growth with pollution management, and adopting environmental and health safeguards in trade and urban policy can help BRICS governments align economic expansion with sustainable improvements in population well-being.

## Full text

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## Figures

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## References

92 references — full list in the complete paper: https://tomesphere.com/paper/PMC12971982/full.md

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Source: https://tomesphere.com/paper/PMC12971982