Live and let live: understanding the temporal drivers and spillovers of life expectancy in Europe for public planning

Eur J Health Econ. 2023 Apr;24(3):335-347. doi: 10.1007/s10198-022-01469-3. Epub 2022 May 26.


The European continent has one of the longest life expectancies in the world, but still faces a significant challenge to meet the health targets set by the Sustainable Development Goals of the United Nations for 2030. To improve the understanding of the rationale that guides health outcomes in Europe, this study assesses the direction and magnitude effects of the drivers that contribute to explain life expectancy at birth across 30 European countries for the period 2008-2018 at macro-level. For this purpose, an aggregated health production function is used allowing for spatial effects. The results indicate that an increase in the income level, health expenditure, trade openness, education attainment, or urbanisation might lead to an increase in life expectancy at birth, whereas calories intake or quantity of air pollutants have a negative impact on this health indicator. This implies that health policies should look beyond economic factors and focus also on social and environmental drivers. The results also indicate the existence of significant spillover effects, highlighting the need for coordinated European policies that account for the synergies between countries. Finally, a foresight analysis is conducted to obtain projections for 2030 under different socioeconomic pathways. Results reveal significant differences on longevity projections depending on the adoption, or not, of a more sustainable model of human development and provides valuable insight on the need for anticipatory planning measures to make longer life-spans compatible with the maintenance of the welfare state.

Keywords: Europe; Health production function; Life expectancy; Spatial panel model; Sustainable development.

MeSH terms

  • Developing Countries
  • Educational Status
  • Europe
  • Humans
  • Infant, Newborn
  • Life Expectancy*
  • Longevity*
  • Socioeconomic Factors