Population health, labour productivity dynamics and competitiveness in the EU-27: an exploratory cross-country cluster analysis

Population health is widely regarded as an input to labour supply and economic performance, and health indicators are embedded in international competitiveness frameworks. Comparative evidence on how health, productivity dynamics and competitiveness co-occur across European Union (EU) member states remains fragmented: existing EU-level comparisons assess each domain separately and rank countries on a single scale, and such rankings are known to be sensitive to methodological choices. This study develops an exploratory, country-level typology of the EU-27 that describes how population health, health behaviour, sickness absence, cumulative labour productivity growth, digitalisation and competitiveness cluster together. Six country-level indicators, each taken from its most recent comparable reference year (2019–2022; one observation per country), were compiled from the WHO, Eurostat, the European Commission and the World Economic Forum: healthy life expectancy at birth (HALE), the share of adults reporting non-work-related physical activity, the share of employed persons reporting sickness absence, the real labour productivity per hour worked index (2015 = 100, measuring cumulative growth 2015–2020), the Digital Economy and Society Index (DESI) and the Global Competitiveness Index (GCI). Standardised variables were grouped with k-means clustering. The number of clusters was assessed with elbow, silhouette, gap statistic, Calinski–Harabasz and Davies–Bouldin criteria, and stability was examined with hierarchical and k-medoids clustering, leave-one-variable-out, variable-replacement, bootstrap resampling, leave-one-country-out and productivity reference-year analyses, quantified with the adjusted Rand index (ARI) and the Jaccard coefficient. Statistical criteria pointed to between two and four groups; a four-cluster solution was adopted as a nested refinement of the coarser partitions, accounting for 70.7% of total variance and resolving a poorly separated southern group present at k = 3. North-Western Europe combined the most favourable health, behavioural, digital and competitiveness profiles with the highest reported sickness absence. South-Western Europe showed the longest healthy life expectancy but moderate physical activity and digitalisation. Central and Eastern Europe had the weakest health profile, the lowest reported absence and the fastest cumulative productivity growth since 2015, while Croatia, Cyprus and Greece recorded the lowest competitiveness, digitalisation and productivity growth. The partition was robust to alternative algorithms (ARI 0.84–0.93) and moderately sensitive to variable selection (ARI 0.53–1.00). The North-Western and Central-Eastern clusters were highly stable under bootstrap resampling (mean Jaccard 0.87), whereas the three-country South-Eastern cluster was the least stable (0.61) and dissolved when the productivity index was taken from 2019 instead of 2020. The typology is descriptive and does not identify causal mechanisms. It indicates, however, that similar population health profiles coexist with quite different productivity and competitiveness outcomes across the EU-27, and that digitalisation consistently separates country groups. The two large clusters form a stable core; the small South-Eastern group is the least stable element and partly reflects the 2020 pandemic shock to productivity. The typology may support cross-country benchmarking and the tailoring of health and digital policy monitoring to regional profiles.