Unpacking the roles of urbanization and ecological pressure as drivers of health outcomes with a test of the malaria recession hypothesis in Next-11 countries

Despite their continental heterogeneity, the Next-11 economies bear a common context of structural and environmental realities. These conditions predispose such large proportions of their populations to malaria, rendering it a recurrent public health and socio-economic problem. It is within this context that this study explores the linkage between urbanization and environmental sustainability and health outcomes. Using the Feasible Generalized Least Squares (FGLS) estimation method, the study specifically tests the malaria recession hypothesis in the Next-11 countries during the period 2000–2022. For robustness, the model is also tested using the Method-of-Moments Quantile Regression (MMQREG). Findings indicate that urbanization, human capital development and ecological footprint significantly reduce malaria-related mortality rates, which supports the malaria recession hypothesis. Conversely, government expenditure on health is statistically insignificant. The findings are further supported by the Dumitrescu-Hurlin panel causality test to confirm the causal dynamics among the variables. These findings stress the significance of structure and environment in influencing health dynamics in ways other than traditional healthcare expenditure. Based on these outcomes, the study concludes that the Next-11 countries need an integrated policy framework to effectively control malaria. This specifically includes incorporating the health factor in urban planning such as investments in drainage systems, waste management systems, and preventive health services. Moreover, the strengthening of environmental regulations and an emphasis on education to increase human capital are necessary to mitigate environmental pressures that support malaria infection and advance health conditions in general.