Contributions of aquatic environments to household health expenditure: Empirical evidence from Japan

Abstract

A growing number of academic works have presented empirical evidence on the positive impacts of nature exposure on human health, however, the associations between surrounding nature (especially aquatic environments) and health expenditure have been rarely examined up until now. The major purpose of this paper is to fill in this research gap using health expenditure data at the household level and fine-scale land cover information that was reclassified into four categories (i.e. deciduous forests, evergreen forests, inland freshwater and coastal saltwater). Employing a classical health economics approach, namely, a two-part model with a generalized linear model, this study found that freshwater coverage around residence would have significantly inverse effects on household health spending. As no such significant associations were found for other land cover types, this highlights the importance of surrounding freshwater environments in determining household health expenditure. These findings were mostly robust to the alternative model specifications and different buffer sizes around residence.