A Comparative Analysis of the Determinants of Male, Female, and Total Life Expectancy in United States and China

Health is wealth, and ensuring healthy lives and promoting well-being for all are fundamental to achieving Sustainable Development Goal 3 (SDG-3) and fostering sustainable socioeconomic development. Previous studies have primarily examined the economic, social, or institutional determinants of life expectancy (LE) in isolation, with limited attention given to their combined effects within a comprehensive analytical framework for China and United States. To address this gap, the present study investigates the determinants of LE by integrating environmental, economic, social, and institutional factors. Specifically, CO2 emissions (CO2e) represent the environmental dimension; GDP and health expenditure capture the economic dimension; population growth and education reflect the social dimension; the rule of law and government effectiveness represent institutional quality. This study estimates three separate models for male life expectancy (MLE), female life expectancy (FLE), and total life expectancy (TLE) using the ARDL model, with the FMOLS estimator employed to assess the robustness of the long-run results. The findings reveal that CO2e and population growth adversely affect MLE, FLE, and TLE in both China and the United States. In contrast, GDP, health expenditure, education, the rule of law, and government effectiveness significantly improve LE across all three models. From a policy perspective, these countries' governments should prioritize reducing CO2e through cleaner energy technologies and stricter environmental regulations while continuing to invest in healthcare systems and educational development. Strengthening institutional quality by enhancing the rule of law and improving government effectiveness can further increase the efficiency and accessibility of health services, thereby contributing to longer LE in both China and the United States.