Public health policy pathways for balancing ecological challenges, healthcare systems, and social development in rapidly urbanizing economies

Life expectancy is a key indicator of public health and human development, reflecting how environmental conditions and social structures shape population wellbeing. This study examines the determinants of life expectancy in the E-7 economies-Brazil, China, India, Indonesia, Mexico, Russia, and Turkey-from 2000 to 2022. Using panel data from the World Development Indicators, the analysis includes water resource stress, health expenditure, urbanization, education, greenhouse gas emissions, population density, sanitation access, and income inequality. The Cross-Sectionally Augmented Autoregressive Distributed Lag (CS-ARDL) model is employed to account for cross-sectional dependence, slope heterogeneity, and nonstationarity, with robustness checks conducted using Augmented Mean Group (AMG) and Common Correlated Effects Mean Group (CCEMG) estimators. The long-run CS-ARDL results reveal that water resource stress (<i>β</i> = -0.292, <i>p <</i> 0.01), urbanization (<i>β</i> = -0.144, <i>p <</i> 0.05), and greenhouse gas emissions (<i>β</i> = -0.259, <i>p <</i> 0.01) significantly reduce life expectancy, while health expenditure (<i>β</i> = 0.235, <i>p <</i> 0.01) and education (<i>β</i> = 0.281, <i>p <</i> 0.01) improve it. The error correction term confirms a stable long-run adjustment process. These findings highlight the need for integrated policies that enhance water and sanitation systems, promote clean energy transitions, strengthen healthcare and education, and reduce inequality. Coordinated, multisectoral action is vital to achieving sustainable improvements in population health across emerging economies.