An Evaluation Study on the Impact of Debt-Constrained Health Financing on Life Expectancy

Yao Tianen; Yang Xinyu; Guan Chongyu; Xu Ming

Abstract：Objective:It examines how health financing and related factors,including development assistance for health and innovative health financing tools,effect on life expectancy amid high public debt and debt distress in low-income countries,and analyze the role of innovative financing instruments.Methods:Global panel data were used to construct a fixed-effects model to assess the effects of health financing,income,trade openness,government corruption,and population growth on life expectancy,and mediation analysis was performed.Results:Health financing,income,trade openness,and government corruption had significant positive effects on life expectancy,while population growth had a significant negative effect.Mediation analysis showed that governance corruption reduced the effectiveness of health financing,producing a negative indirect effect that accounted for 2.1%of the total effect.Although innovative financing instruments such as debt swaps and pandemic bonds can provide additional resources to the health sector,their effectiveness was weakened by corruption in resource allocation and financing environments.Conclusions:Strengthening health financing is essential to improving population health,but governance corruption undermines efficiency and limits the sustainability of innovative financing tools.It is recommended that policymakers enhance governance and transparency while promoting the application of debt swaps and pandemic bonds to improve global health outcomes under debt constraints.