Reassessing the health–agriculture nexus: evidence from super-efficiency DEA and panel models in OECD countries

BACKGROUND: Agricultural productivity and health expenditures are closely interconnected, influencing both economic development and social welfare. Despite growing interest in the health-agriculture nexus, empirical evidence on their bidirectional relationship across Organisation for Economic Co-operation and Development (OECD) countries remains limited. METHODS: This study investigates the relationship between health expenditures and agricultural productivity using an dataset covering 38 OECD countries from 2010 to 2021. In the first stage, agricultural productivity was measured using a Super-Efficiency Data Envelopment Analysis (DEA) model, allowing for the ranking of efficient countries beyond the conventional efficiency frontier. In the second stage, panel data models were employed to examine the effects of health expenditure indicators on agricultural productivity and the reverse effects of agricultural productivity on health expenditures. RESULTS: The findings indicate substantial heterogeneity in agricultural productivity across OECD countries. Panel estimations reveal that public health expenditures have a positive and statistically significant effect on agricultural productivity, whereas private and out-of-pocket health expenditures exhibit limited or insignificant effects. Furthermore, higher agricultural productivity is associated with increases in per capita and public health expenditures, suggesting a reciprocal relationship between agricultural performance and health investment. The results highlight the importance of health financing in strengthening labor productivity and supporting sustainable agricultural development. CONCLUSIONS: Health expenditures contribute not only to improved population health but also to enhanced agricultural efficiency and economic performance. Policies aimed at expanding public healthcare investments, particularly in rural areas, may generate productivity gains in agriculture while promoting broader sustainable development objectives. By integrating Super-Efficiency DEA with panel econometric techniques, this study provides novel empirical evidence on the health-agriculture nexus in OECD countries and offers relevant policy implications for both health and agricultural sectors.