The Relationship Between Public Health Expenditure and Urban Economic Resilience

Erdong Chen ^1* Huaxin Zhang ²

• ¹ Liaoning University, Shenyang, China
• ² South China Agricultural University, Guangzhou, Guangdong Province, China

Achieving urban economic resilience in response to external shocks is a critical goal in sustainable development. Public health expenditure plays a vital role in enhancing urban economic resilience by improving health levels, optimizing resource allocation, and strengthening economic risk resistance. However, the mechanisms and regional effects of public health expenditure remain underexplored. This study utilizes panel data from 284 Chinese cities between 2008 and 2021. An econometric model incorporating intermediary variables such as technological innovation and per capita GDP was developed to assess the direct and indirect impacts of public health expenditure on urban economic resilience. A spatial econometric model was further employed to analyze spatial spillover effects. Public health expenditure significantly enhances urban economic resilience, with technological innovation and per capita GDP as key mediating pathways. Regional analysis reveals the strongest effects in eastern cities, moderate effects in central cities, and weaker or negative effects in western cities. Spatial analysis highlights substantial spillover effects on neighboring cities, driven by resource sharing and technology diffusion. The study demonstrates that optimizing public health expenditure, fostering innovation, and strengthening regional collaboration can improve urban resilience. These findings provide empirical evidence and practical recommendations for policymakers to promote highquality urban development and regional equity.