The triple dividend of health: how SDG3 shapes human, economic, and environmental outcomes in EU
DOI: https://doi.org/10.3846/jbem.2026.27918Abstract
Achieving the Sustainable Development Goals (SDGs) requires understanding how progress in health and well-being (SDG3) impacts human development, economic performance, and environmental sustainability. This study analyses the effects of selected SDG3 indicators on Human Development Index (HDI), Gross Domestic Product (GDP per capita), and renewable energy usage across 27 EU countries (2014–2023), using three panel models with relevant control variables. Applying panel unit root, cointegration tests, and Fully Modified OLS (FMOLS) estimation, results show that better health and well-being significantly promote human development, economic output, and renewable energy adoption. In Model 1, life expectancy and well-being positively influence HDI, while fertility, neonatal mortality, and traffic deaths have negative effects; income inequality mildly reduces HDI. Model 2 finds that subjective well-being and lower tuberculosis incidence boost GDP, though health effects are smaller than on HDI. Model 3 links lower teen fertility and neonatal mortality to higher renewable energy use, suggesting synergy between health progress and clean energy transition. Overall, advancing SDG3 fosters human development, economic prosperity, and environmental sustainability, highlighting the need for integrated policies that simultaneously promote health, equality, education, and clean energy.
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SDG3, human development index, economic growth, renewable energy, health indicators, panel FMOLS, EU-27, sustainable development, cointegration, triple dividendHow to Cite
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References
Acemoglu, D., & Johnson, S. (2007). Disease and development: The effect of life expectancy on economic growth. Journal of Political Economy, 115(6), 925–985. https://doi.org/10.1086/529000
Asongu, S., le Roux, S., & Biekpe, N. (2017). Enhancing ICT for inclusive human development in Sub-Saharan Africa. Technological Forecasting and Social Change, 118, 44–54. https://doi.org/10.1016/j.techfore.2017.01.026
Bădîrcea, R. M., Manta, A. G., Pîrvu, R., F & lorea, N. M. (2020). Corporate social responsibility: An analysis of Romanian banks. In S. Idowu, & C. Sitnikov (Eds.), Essential issues in corporate social responsibility. CSR, sustainability, ethics & governance. Springer, Cham. https://doi.org/10.1007/978-3-030-39229-1_12
Bădîrcea, R. M., Doran, N. M., Manta, A. G., Puiu, S., Meghisan-Toma, G. M., & Doran, M. D. (2022). Linking financial development to Environmental Performance Index—The case of Romania. Economic Research-Ekonomska Istraživanja, 36(1), Article 2142635. https://doi.org/10.1080/1331677X.2022.2142635
Bădîrcea, R. M., Doran, N. M., Manta, A. G., & Cercel, C. (2025). Do European social funds matter in achieving the sustainable development goals? Sustainability, 17(2), Article 381. https://doi.org/10.3390/su17020381
Banik, B., Roy, C. K., & Hossain, R. (2023). Healthcare expenditure, good governance and human development. EconomiA, 24(1), 1–23. https://doi.org/10.1108/ECON-06-2022-0072
Beylik, U., Çıraklı, U., Çetin, M., Ecevit, E., & Şenol, O. (2022). The relationship between health expenditure indicators and economic growth in OECD countries: A Driscoll-Kraay approach. Frontiers in Public Health, 10, Article 1050550. https://doi.org/10.3389/fpubh.2022.1050550
Bloom, D. E., Canning, D., & Sevilla, J. (2004). The effect of health on economic growth: A production function approach. World Development, 32(1), 1–13. https://doi.org/10.1016/j.worlddev.2003.07.002
Bloom, D. E., Kuhn, M., & Prettner, K. (2019). Health and economic growth: Reconciling the micro and macro evidence (OECD Economics Department Working Papers, No. 1556). OECD Publishing. https://doi.org/10.1016/j.worlddev.2024.106575
Bucher, S. (2018). Sustainable development in the world from the aspect of environmental health and human development index: Regional variations and patterns. Problemy Ekorozwoju/Problems of Sustainable Development, 13(1), 87–94.
Celik, B., Celik, H., & Yildirim, S. (2023). Convergence of economic growth and health expenditures in OECD countries: Evidence from non-linear unit root tests. Frontiers in Public Health, 11, Article 1125968. https://doi.org/10.3389/fpubh.2023.1125968
Chmielewska, B., Barratt, I., Townsend, R., Kalafat, E., van der Meulen, J., Gurol-Urganci, I., O’Brien, P., & Khalil, A. (2021). Effects of the COVID-19 pandemic on maternal and perinatal outcomes: A systematic review and meta-analysis. The Lancet Global Health, 9(6), e759–e772. https://doi.org/10.1016/S2214-109X(21)00079-6
Dumitrescu, E.-I., & Hurlin, C. (2012). Testing for Granger non-causality in heterogeneous panels. Economic Modelling, 29(4), 1450–1460. https://doi.org/10.1016/j.econmod.2012.02.014
Dumuid, D., Maher, C., Lewis, L. K., Stanford, T. E., Martín Fernández, J. A., Ratcliffe, J., Katzmarzyk, P. T., Barreira, T. V., Chaput, J. P., Fogelholm, M., Hu, G., Maia, J., Sarmiento, O. L., Standage, M., Tremblay, M. S., Tudor-Locke, C., & Olds, T. (2018). Human development index, children’s health-related quality of life and movement behaviors: A compositional data analysis. Quality of Life Research, 27(6), 1473–1482. https://doi.org/10.1007/s11136-018-1791-x
European Central Bank. (2024). The macroeconomic and fiscal impact of population ageing in the euro area (ECB Occasional Paper 296). https://www.ecb.europa.eu/pub/pdf/scpops/ecb.op296~aaf209ffe5.en.pdf
European Commission, Directorate-General for Economic and Financial Affairs. (2024). 2024 Ageing Report: Economic and budgetary projections for the EU Member States (2022–2070) (Institutional Paper 279). https://economy-finance.ec.europa.eu/publications/2024-ageing-report-economic-and-budgetary-projections-eu-member-states-2022-2070_en
European Commission. (2017). Sustainable development in the European Union. Monitoring report on progress towards the SDGS in an EU context. 2017 edition. Eurostat. https://ec.europa.eu/eurostat/documents/3217494/8461633/KS-04-17-780-EN-N.pdf
European Commission. (2019a). A sustainable Europe by 2030. https://commission.europa.eu/publications/sustainable-europe-2030_en
European Commission. (2019b). The European green deal. https://ec.europa.eu/info/strategy/priorities-2019-2024/european-green-deal_en
European Commission. (2020). Sustainable Development Goals. https://ec.europa.eu/international-partnerships/sustainable-development-goals_en
European Commission. (2022). REPowerEU: Joint European action for more affordable, secure and sustainable energy (COM(2022) 108 final). https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=celex:52022DC0108
European Commission. (2024). Ninth report on economic, social and territorial cohesion. https://ec.europa.eu/regional_policy/information-sources/cohesion-report_en
European Environment Agency. (2023a). The costs to health and the environment from industrial air pollution in Europe – 2024 update. https://www.eea.europa.eu/en/analysis/publications/the-costs-to-health-and-the-environment-from-industrial-air-pollution-in-europe-2024-update
European Environment Agency. (2025a). Air quality status report 2025. doi: 10.2800/9895153. https://www.eea.europa.eu/en/analysis/publications/air-quality-status-report-2025
European Environment Agency. (2025b). Europe’s environment 2025: Air pollution and impacts on human health. https://www.eea.europa.eu/en/europe-environment-2025/thematic-briefings/environment-and-human-health/air-pollution-and-impacts-on-human-health
European Environment Agency. (2021a). EU renewable electricity has reduced environmental pressures; Targeted actions help further reduce impacts (EEA Briefing No. 01/2021). https://www.eea.europa.eu/publications/eu-renewable-electricity-has-reduced
European Environment Agency. (2021b). Air quality in Europe 2021: Health impacts of air pollution. https://www.eea.europa.eu/publications/air-quality-in-europe-2021/health-impacts-of-air-pollution
European Environment Agency. (2023b). Trends and projections in Europe 2023: Tracking progress towards Europe’s climate and energy targets. https://www.eea.europa.eu/en/analysis/publications/trends-and-projections-in-europe-2023
European Parliament. (2017). The European Pillar of Social Rights. European Commission. https://ec.europa.eu/social/main.jsp?catId=1226
European Parliament. (2020). Alignment of the SDGs with EU policies. European Parliamentary Research Service. https://www.europarl.europa.eu/RegData/etudes/BRIE/2020/651944/EPRS_BRI(2020)651944_EN.pdf
European Union. (2018). EU–UN cooperation in a changing global environment. Publications Office of the European Union. https://op.europa.eu/webpub/com/general-report-2018/en/
Eurostat. (2017). SDG 3 – Good health and well-being. Statistics Explained. https://ec.europa.eu/eurostat/statistics-explained/index.php/SDG_3_-_Good_Health_and_well-being
Eurostat. (2022). Statistical requirements compendium. Publications Office of the European Union.
Eurostat. (2024a). Air emissions accounts by NACE Rev. 2 activity. https://ec.europa.eu/eurostat/databrowser/view/ENV_AC_AINAH_R2/default/table?lang=en
Eurostat. (2024b). GDP per capita in PPS. https://ec.europa.eu/eurostat/databrowser/view/tec00114/default/table?lang=en
Eurostat. (2024c). Gini coefficient of equivalised disposable income. https://ec.europa.eu/eurostat/databrowser/view/tessi190/default/table?lang=en&category=t_ilc.t_ilc_ip.t_ilc_di
Eurostat. (2024d). HICP – annual data (average index and rate of change). https://ec.europa.eu/eurostat/databrowser/view/prc_hicp_aind/default/table?lang=en&category=prc.prc_hicp
Eurostat. (2024e). Share of energy from renewable sources. https://ec.europa.eu/eurostat/databrowser/view/nrg_ind_ren/default/table?lang=en
Gavurova, B., & Megyesiova, S. (2022). Sustainable health and wellbeing in the European Union. Frontiers in Public Health, 10, Article 851061. https://doi.org/10.3389/fpubh.2022.851061
Gherțescu, C., Manta, A. G., & Bădircea, R. (2025). Smart agriculture and technological innovation: A bibliometric perspective on digital transformation and sustainability. Agriculture, 15(13), Article 1388. https://doi.org/10.3390/agriculture15131388
He, J., & Richard, P. (2010). Environmental Kuznets curve for CO2 in Canada. Ecological Economics, 69(5), 1083–1093. https://doi.org/10.1016/j.ecolecon.2009.11.030
Im, K. S., Pesaran, M. H., & Shin, Y. (2003). Testing for unit roots in heterogeneous panels. Journal of Econometrics, 115(1), 53–74. https://doi.org/10.1016/S0304-4076(03)00092-7
Ionescu, G. H., Firoiu, D., Tănasie, A., Sorin, T., Pîrvu, R., & Manta, A. (2020). Assessing the achievement of the SDG targets for health and well-being at EU level by 2030. Sustainability, 12(14), Article 5829. https://doi.org/10.3390/su12145829
Johansen, S. (1991). Estimation and hypothesis testing of cointegration vectors in Gaussian vector autoregressive models. Econometrica, 59(6), 1551–1580. https://doi.org/10.2307/2938278
Kao, C. (1999). Spurious regression and residual-based tests for cointegration in panel data. Journal of Econometrics, 90(1), 1–44. https://doi.org/10.1016/S0304-4076(98)00023-2
Karlsson, M., Alfredsson, E., & Westling, N. (2020). Climate policy co-benefits: A review. Climate Policy, 20(3), 292–316. https://doi.org/10.1080/14693062.2020.1724070
Kuzior, A., Vysochyna, A., Androniceanu, A., & Khouri, S. (2025). Health-led economic growth in short and long run: Case of European countries. Economics & Sociology, 18(2), 191–208. https://doi.org/10.14254/2071-789X.2025/18-2/15
Levin, A., Lin, C. F., & Chu, C. (2002). Unit root tests in panel data: Asymptotic and finite-sample properties. Journal of Econometrics, 108(1), 1–24. https://doi.org/10.1016/S0304-4076(01)00098-7
Manta, A. G., Badareu, G., Florea, I. A., Staicu, A. L., & Lepădat, C. V. M. (2023). How much financial development accentuates income inequality in Central and Eastern European countries? Sustainability, 15(18), Article 13942. https://doi.org/10.3390/su151813942
Manta, A. G., Gherțescu, C., Bădîrcea, R. M., Manta, L. F., Popescu, J., & Lăpădat, C. V. M. (2025a). How does the interplay between banking performance, digitalization, and renewable energy consumption shape sustainable development in European Union countries? Energies, 18(3), Article 571. https://doi.org/10.3390/en18030571
Manta, L. F., Manta, A. G., & Gherțescu, C. (2025b). Decoding digital synergies: How mechatronic systems and artificial intelligence shape banking performance through quantile-driven method of moments. Applied Sciences, 15(10), Article 5282. https://doi.org/10.3390/app15105282
Meghișan-Toma, G. M., Puiu, S., Florea, N., Meghișan, F., Bădîrcea, R., & Manta, A. (2022). Sustainable transformation of Romanian companies through industry 4.0, green production and environment commitment. Amfiteatru Economic, 24, 46–60. https://doi.org/10.24818/EA/2022/59/46
Metwally, A. B. M., Nabil, S. M., & Yasser, M. M. (2024). Hydropower & HDI nexus in Nordic countries using VAR techniques. Economies, 12(3), Article 60. https://doi.org/10.3390/economies12030060
Millstein, D., O’Shaughnessy, E., & Wiser, R. (2024). Climate and air quality benefits of wind and solar generation in the United States from 2019 to 2022. Cell Reports Sustainability, 1(6), Article 100105. https://doi.org/10.1016/j.crsus.2024.100105
Miranda-Lescano, R., Muinelo-Gallo, L., & Roca-Sagalés, O. (2024). Human development and inequalities: The importance of social public spending. Structural Change and Economic Dynamics, 69, 363–377. https://doi.org/10.1016/j.strueco.2023.12.008
Neofytidou, A., & Fountas, S. (2020). The impact of health on GDP: A panel data investigation. Journal of Economic Asymmetries, 21, Article e00139. https://doi.org/10.1016/j.jeca.2019.e00139
OECD, & European Union. (2020). Health at a glance: Europe 2020. OECD Publishing. https://doi.org/10.1787/82129230-en
Opreana, A., & Mihaiu, D. M. (2011). Correlation analysis between the health system and human development level within the European Union. International Journal of Trade, Economics and Finance, 2(3), 208–215. https://doi.org/10.7763/IJTEF.2011.V2.106
Pachauri, S., Rao, N. D., & Cameron, C. (2018). Outlook for modern cooking energy access in Central America. Nature Energy, 3(10), 940–943.
Pedroni, P. (2000). Fully modified OLS for heterogeneous cointegrated panels (Working Paper No. 2000-03). Department of Economics, Williams College.
Pedroni, P. (2001). Fully modified OLS for heterogeneous cointegrated panels. In B. H. Baltagi, T. B. Fomby, & R. C. Hill (Eds.), Nonstationary panels, panel cointegration, and dynamic panels (pp. 93–130). Emerald Group Publishing. https://doi.org/10.1016/S0731-9053(00)15004-2
Pervaiz, R., Faisal, F., Ur Rahman, S., Chander, R., & Ali, A. (2021). Do health expenditure and human development index matter in the carbon emission function for ensuring sustainable development? Evidence from a heterogeneous panel. Air Quality, Atmosphere & Health, 14(10), 1773–1784. https://doi.org/10.1007/s11869-021-01052-4
Pîrvu, R., Bădîrcea, R., Manta, A., & Lupăncescu, M. (2018). The effects of the cohesion policy on the sustainable development of the development regions in Romania. Sustainability, 10(8), Article 2577. https://doi.org/10.3390/su10072577
Poenaru, M.-M., Manta, L. F., Gherțescu, C., & Manta, A. G. (2025). Shaping the future of horticulture: Innovative technologies, artificial intelligence, and robotic automation through a bibliometric lens. Horticulturae, 11(5), Article 449. https://doi.org/10.3390/horticulturae11050449
Pradhan, P., Costa, L., Rybski, D., Lucht, W., & Kropp, J. P. (2017). A systematic study of Sustainable Development Goal (SDG) interactions. Earth’s Future, 5(11), 1169–1179. https://doi.org/10.1002/2017EF000632
Rivera, N. M., Ruiz-Tagle, J. C., & Spiller, E. (2024). The health benefits of solar power generation: Evidence from Chile. Journal of Environmental Economics and Management, 126(C), Article 102999. https://doi.org/10.1016/j.jeem.2024.102999
Rocco, L., Fumagalli, E., Mirelman, A. J., & Suhrcke, M. (2021). Mortality, morbidity and economic growth. PLoS ONE, 16(5), Article e0251424. https://doi.org/10.1371/journal.pone.0251424
Sachs, J. D., Lafortune, G., & Fuller, G. (2024). Sustainable Development Report 2024. The SDGs and the UN Summit of the Future. Dublin University Press. https://doi.org/10.25546/108572
Santos, J. V., Padron-Monedero, A., Bikbov, B., Grad, D. A., Plass, D., Mechili, E. A., Gazzelloni, A., Sulo, G., Ngwa, C. H., Kraus, E., Peyroteo, M., Costa, E. M. P., Rinaldi, G., Unim, B., Conrad, F., Kostova, G., Monasta, L., Traini, E., Azzopardi-Muscat, N., ... Haagsma, J. A. (2024). The state of health in the European Union (EU-27) in 2019: A systematic analysis for the Global Burden of Disease study 2019. BMC Public Health, 24, Article 1374. https://doi.org/10.1186/s12889-024-18529-3
Sasse, J.-P., & Trutnevyte, E. (2024). Regional inequalities in air quality and health co-benefits due to climate change mitigation in the European electricity sector. Climatic Change, 177(3), Article 51. https://doi.org/10.1007/s10584-024-03851-x
Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A. B., Daniels, J., Gülmezoglu, A. M., Temmerman, M., & Alkema, L. (2014). Global causes of maternal death: A WHO systematic analysis. The Lancet Global Health, 2(6), e323–e333. https://doi.org/10.1016/S2214-109X(14)70227-X
Sharma, R. (2018). Health and economic growth: Evidence from dynamic panel data of 143 years. PLoS ONE, 13(10), Article e0204940. https://doi.org/10.1371/journal.pone.0204940
Siminică, M. I., Cîrciumaru, D., Manta, A. G., Cârstina, S., Badareu, G., & Gherțescu, C. (2025). FinTech, artificial intelligence, and European Union banks: A double-edged sword for performance? Oeconomia Copernicana, 16(3), 1099–1176. https://doi.org/10.24136/oc.3798
Sosvilla-Rivero, S., Rubio-Guerrero, J. J., & Wohlmann, A. (2025). Public expenditure and economic growth: Further evidence for the European Union. Economies, 13(3), Article 60. https://doi.org/10.3390/economies13030060
United Nations. (2015). The 2030 agenda for sustainable development. https://www.undp.org/
United Nations. (2018). SDG indicator metadata repository. https://unstats.un.org/sdgs/metadata/
United Nations. (2021a). Strengthening the multilateral system. https://www.un.org/en/global-issues/multilateral-system
United Nations. (2021b). Global indicator framework for the Sustainable Development Goals and targets of the 2030 Agenda. https://unstats.un.org/sdgs/indicators/indicators-list/
Weil, D. N. (2014). Health and economic growth. In P. Aghion & S. N. Durlauf (Eds.), Handbook of economic growth (Vol. 2B, pp. 623–682). Elsevier. https://doi.org/10.1016/B978-0-444-53540-5.00003-3
World Health Organization Regional Office for Europe & European Centre for Disease Prevention and Control. (2025). Tuberculosis surveillance and monitoring in Europe 2025—2023 data. https://www.ecdc.europa.eu/en/publications-data/tuberculosis-surveillance-and-monitoring-europe-2025-2023-data
World Health Organization. (2019). Universal health coverage: Moving together to build a healthier world. https://www.who.int/docs/default-source/documents/2019-uhc-report.pdf
World Health Organization. (2023). World health statistics 2023: Monitoring health for the SDGs. https://www.who.int/data/gho/publications/world-health-statistics
Xie, Y., Dai, H., Zhang, Y., & Zhong, H. (2020). Co-benefits of climate mitigation on air quality and human health in Asian countries. Environment International, 136, Article 105513. https://doi.org/10.1016/j.envint.2018.07.008
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