Cross-border impact of agricultural fertilizer use: Environmental spillovers and healthcare costs in European countries

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This study empirically examines the cross-border environmental and health impacts of mineral fertilizer use in European countries by applying spatial panel models. Specifically, it evaluates how nitrogen and phosphate fertilizers affect public health expenditures and water quality within national borders and adjacent countries. To accurately capture transboundary influences, the analysis uses a spatial weights matrix based on shared land borders constructed from geospatial data (Natural Earth shapefiles), enabling the assessment of spillover effects between neighboring countries. The models cover the timespan 2006–2021 for 29 European nations, except those that do not have common land borders (island countries), with available and comparable data. The results confirm significant spatial effects. The spatial lag model revealed strong direct and spillover effects for health expenditure, particularly for nitrogen and pesticide use, indicating that increased agricultural intensity in one country can raise health costs in neighboring states. Phosphate and potash use were associated with reductions in health expenditure, though the interpretation may reflect regional differences in environmental management. In contrast, the spatial error model best explained unsafe drinking water outcomes, highlighting the role of unobserved, spatially correlated environmental pressures. Nitrogen and pesticide use were linked to increased water contamination, while phosphate showed a strong but context-dependent negative association.

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    • Figure 1. Country-specific fixed effects from a spatial panel model of health expenditure per capita
    • Table 1. Variables and their sources
    • Table 2. Results of the spatial panel fixed effects lag model of the estimation of the impact of fertilizer and pesticide use on current health expenditure per capita
    • Table 3. Results of the spatial panel fixed effects error model of the estimation of the impact of fertilizer and pesticide use on current health expenditure per capita
    • Table 4. Results of the spatial panel fixed effects lag model of the estimation of the impact of fertilizer and pesticide use on health expenditure as a percentage of GDP
    • Table 5. Results of the spatial panel fixed effects error model of the estimation of the impact of fertilizer and pesticide use on health expenditure as a percentage of GDP
    • Table 6. Results of spatial panel fixed effects lag model: Impact of fertilizer and pesticide use on unsafe drinking water (Environmental Performance Index)
    • Table 7. Results of spatial panel fixed effects error model: Impact of fertilizer and pesticide use on unsafe drinking water (Environmental Performance Index)
    • Table A1. Spatial spillover effects of agricultural fertilizers and pesticides on current health expenditure per capita
    • Table A2. Spatial spillover effects of agricultural fertilizers and pesticides on current health expenditure (% of GDP)
    • Table A3. Spatial spillover effects of agricultural fertilizers and pesticides on Environmental Performance Index: Unsafe drinking water
    • Conceptualization
      Aleksandra Kuzior, Stanislav Vasylishyn, Vladyslav Hrei, Maksym Huzenko, Olena Akymenko, Oleksii Solohub, Tetiana Vasylieva
    • Funding acquisition
      Aleksandra Kuzior
    • Project administration
      Aleksandra Kuzior
    • Writing – original draft
      Aleksandra Kuzior, Stanislav Vasylishyn, Vladyslav Hrei, Maksym Huzenko, Olena Akymenko, Oleksii Solohub, Tetiana Vasylieva
    • Writing – review & editing
      Aleksandra Kuzior, Stanislav Vasylishyn, Vladyslav Hrei, Maksym Huzenko, Olena Akymenko, Oleksii Solohub, Tetiana Vasylieva
    • Resources
      Stanislav Vasylishyn
    • Validation
      Vladyslav Hrei, Maksym Huzenko
    • Data curation
      Maksym Huzenko
    • Formal Analysis
      Maksym Huzenko
    • Investigation
      Maksym Huzenko
    • Methodology
      Maksym Huzenko
    • Software
      Maksym Huzenko, Olena Akymenko
    • Visualization
      Maksym Huzenko, Oleksii Solohub
    • Supervision
      Tetiana Vasylieva