The Relative Importance of Globalization and Public Expenditure on Life Expectancy in Europe: An Approach Based on MARS Methodology

Background: There has been a widespread debate about the overall impact of globalization on population, not just economically, but also in terms of health status. Moreover, the current health crisis is going to force governments to review the structure of the public budget to most effectively alleviate the negative economic and health effects on the population. Objective: The aim of this paper is to analyze the relative importance of globalization and the public budget composition—specifically the participation of public expenditure on healthcare, social services and environment in gross domestic product (GDP)—on life expectancy at birth in European countries during the period 1995–2017. Methods: The Multivariate Adaptive Regression Splines (MARS) methodology was applied to analyze the socioeconomic determinants of life expectancy at birth. Results: Our findings show that globalization has no relative importance as an explanatory variable of life expectancy in European countries, while government expenditure on social protection is the most relevant followed by public expenditure on health, gross national income per capita, education level of the population and public expenditure on environmental protection. Conclusion: European strategies intended to impact on health outcome should spend more attention to the composition of public budget.