placestats

Education spending vs. Out-of-pocket health spending

Holds up after adjusting for income

Across 178 countries, Education spending and Out-of-pocket health spending rise and fall together at r = -0.40 (on a scale from −1 to +1, where 0 means no link). It holds up almost unchanged when only countries with similar income (GDP per person) are compared (r = -0.41, q = 0.018, allowing for the many pairs tested).

Comparing countries across the middle half of education spending, 3.1% to 5.3% of GDP, out-of-pocket health spending is better by 7.88% of health spending at the top of that range than the bottom. Comparing only countries with similar national income, the gap is 7.52% of health spending.

Link before adjusting (r)-0.402p = 2.8e-8 · 178 countries
After adjusting for national income-0.406p = 2.1e-8 · likely range [-0.52, -0.27]
p, allowing for regions0.001standard error 0.065 · 7 regions
Check for luck (q)0.018across 12,497 pairs

How to read these.r runs from −1 (one goes up as the other goes down) to +1 (they rise together), and 0 means no link. Adjusting for national income means comparing countries with the same GDP per person, so differences in wealth can’t explain the link. Income is used in percentage terms, since an extra $1,000 means more to a poor country than to a rich one. p is how likely a link this strong would be if there were really none. Below 0.05 means it is unlikely to be chance. Very small values are written in short form: 1.1e-32 means a decimal point followed by 31 zeros and then 11, so very close to zero. The likely range is where the true figure probably lies, and a range that crosses zero means the link could easily be chance. Countries in the same region tend to resemble each other, so the third figure allows for that, which gives a fairer p. The standard error is the typical size of the error in r. Finally, testing this many pairs means some will look strong by luck alone. A q below 0.05 means this link is unlikely to be one of those.

Education spending · % of GDPlink with income +0.12 · independent
Out-of-pocket health spending · % of health spendinglink with income -0.34 · moderate

“Link with income” is how closely each measure tracks GDP per person across countries, from −1 to +1.

Every country as a dot

Education spending · % of GDP →Out-of-pocket health spending · % of health spending →0.000008%16.4%0.0446%80.5%Afghanistan: 4.34% of GDP, 77.1% of health spendingAngola: 2.51% of GDP, 32.5% of health spendingAlbania: 3.09% of GDP, 48.3% of health spendingAndorra: 1.9% of GDP, 11.1% of health spendingUnited Arab Emirates: 3.89% of GDP, 9.67% of health spendingArgentina: 5% of GDP, 24.5% of health spendingArmenia: 2.44% of GDP, 80.5% of health spendingAntigua and Barbuda: 3.11% of GDP, 20.8% of health spendingAustralia: 5.06% of GDP, 15.8% of health spendingAustria: 5.28% of GDP, 16.5% of health spendingAzerbaijan: 3.66% of GDP, 64.6% of health spendingBurundi: 4.5% of GDP, 24.5% of health spendingBelgium: 6.28% of GDP, 21.5% of health spendingBenin: 3.23% of GDP, 42.4% of health spendingBurkina Faso: 5.33% of GDP, 43.8% of health spendingBangladesh: 2.03% of GDP, 79.3% of health spendingBulgaria: 4.5% of GDP, 35.5% of health spendingBahrain: 1.89% of GDP, 28.7% of health spendingBahamas, The: 2.74% of GDP, 27.5% of health spendingBosnia and Herzegovina: 3.25% of GDP, 31% of health spendingBelarus: 5.05% of GDP, 28.5% of health spendingBelize: 4.62% of GDP, 26.8% of health spendingBolivia: 7.54% of GDP, 27.3% of health spendingBrazil: 5.62% of GDP, 26.2% of health spendingBarbados: 3.56% of GDP, 49.5% of health spendingBrunei Darussalam: 4.43% of GDP, 7.41% of health spendingBhutan: 5.85% of GDP, 25.5% of health spendingBotswana: 8.06% of GDP, 4.26% of health spendingCentral African Republic: 1.83% of GDP, 45% of health spendingCanada: 4.84% of GDP, 15.3% of health spendingSwitzerland: 4.86% of GDP, 22% of health spendingChile: 4.91% of GDP, 39.1% of health spendingChina: 3.9% of GDP, 32.2% of health spendingCote d'Ivoire: 3.61% of GDP, 32% of health spendingCameroon: 2.84% of GDP, 67.7% of health spendingCongo, Dem. Rep.: 2.84% of GDP, 38% of health spendingCongo, Rep.: 3.34% of GDP, 28% of health spendingColombia: 5.26% of GDP, 14.7% of health spendingComoros: 2.34% of GDP, 56.6% of health spendingCabo Verde: 4.35% of GDP, 25.7% of health spendingCosta Rica: 5.31% of GDP, 24.1% of health spendingCyprus: 4.74% of GDP, 17.9% of health spendingCzechia: 4.3% of GDP, 14.1% of health spendingGermany: 5.24% of GDP, 10.7% of health spendingDjibouti: 3.75% of GDP, 28.8% of health spendingDominica: 5.39% of GDP, 29.3% of health spendingDenmark: 6.36% of GDP, 13.9% of health spendingDominican Republic: 3.76% of GDP, 25.1% of health spendingAlgeria: 8.98% of GDP, 45% of health spendingEcuador: 3.69% of GDP, 30.9% of health spendingSpain: 4.59% of GDP, 20.9% of health spendingEstonia: 5.21% of GDP, 21.4% of health spendingEthiopia: 2.3% of GDP, 46.3% of health spendingFinland: 6.38% of GDP, 14.1% of health spendingFiji: 4.25% of GDP, 8.31% of health spendingFrance: 5.32% of GDP, 9.23% of health spendingMicronesia, Fed. Sts.: 11.6% of GDP, 2.58% of health spendingGabon: 2.32% of GDP, 17.3% of health spendingUnited Kingdom: 5.91% of GDP, 14.6% of health spendingGeorgia: 3.98% of GDP, 58.8% of health spendingGhana: 2.91% of GDP, 26.7% of health spendingGuinea: 1.72% of GDP, 54.4% of health spendingGambia, The: 2.81% of GDP, 33.8% of health spendingGuinea-Bissau: 2.01% of GDP, 61.6% of health spendingGreece: 3.38% of GDP, 34.3% of health spendingGrenada: 5.13% of GDP, 48.5% of health spendingGuatemala: 3.08% of GDP, 57.2% of health spendingGuyana: 4.45% of GDP, 26.3% of health spendingHonduras: 4.55% of GDP, 53.1% of health spendingCroatia: 4.09% of GDP, 9.38% of health spendingHaiti: 0.965% of GDP, 52.4% of health spendingHungary: 3.8% of GDP, 23.1% of health spendingIndonesia: 1.28% of GDP, 31.1% of health spendingIndia: 4.1% of GDP, 43.9% of health spendingIreland: 2.9% of GDP, 10.6% of health spendingIran, Islamic Rep.: 2.82% of GDP, 43.1% of health spendingIceland: 7.31% of GDP, 14.9% of health spendingIsrael: 5.93% of GDP, 20.5% of health spendingItaly: 4.07% of GDP, 22.3% of health spendingJamaica: 5.51% of GDP, 20.2% of health spendingJordan: 3.23% of GDP, 34.5% of health spendingJapan: 3.34% of GDP, 12.2% of health spendingKazakhstan: 4.86% of GDP, 27.6% of health spendingKenya: 4.02% of GDP, 24.2% of health spendingKyrgyz Republic: 6.83% of GDP, 42.3% of health spendingCambodia: 2.18% of GDP, 60.6% of health spendingKiribati: 16.4% of GDP, 2.91% of health spendingSt. Kitts and Nevis: 3.5% of GDP, 41.8% of health spendingKorea, Rep.: 5.41% of GDP, 33.7% of health spendingKuwait: 6.44% of GDP, 10% of health spendingLao PDR: 1.23% of GDP, 44.8% of health spendingLebanon: 1.22% of GDP, 29.7% of health spendingLiberia: 2.27% of GDP, 63.2% of health spendingSt. Lucia: 3.85% of GDP, 37.1% of health spendingSri Lanka: 1.83% of GDP, 54.8% of health spendingLesotho: 6.62% of GDP, 13.2% of health spendingLithuania: 4.25% of GDP, 31.4% of health spendingLuxembourg: 3.74% of GDP, 8.5% of health spendingLatvia: 4.32% of GDP, 35.1% of health spendingMorocco: 6.02% of GDP, 37.3% of health spendingMoldova: 6.56% of GDP, 27.5% of health spendingMadagascar: 3.05% of GDP, 27.4% of health spendingMaldives: 5.17% of GDP, 18% of health spendingMexico: 4.06% of GDP, 41.2% of health spendingMarshall Islands: 7.7% of GDP, 1.05% of health spendingMali: 4.18% of GDP, 47.2% of health spendingMalta: 4.71% of GDP, 30.9% of health spendingMyanmar: 2% of GDP, 71.1% of health spendingMongolia: 5.21% of GDP, 48.8% of health spendingMozambique: 5.98% of GDP, 10.4% of health spendingMauritania: 7.61% of GDP, 43.8% of health spendingMauritius: 4.25% of GDP, 45.2% of health spendingMalawi: 2.75% of GDP, 12% of health spendingMalaysia: 3.51% of GDP, 37.1% of health spendingNamibia: 9.08% of GDP, 7.49% of health spendingNiger: 4.07% of GDP, 51.5% of health spendingNigeria: 0.319% of GDP, 71.9% of health spendingNicaragua: 2.87% of GDP, 37.6% of health spendingNetherlands: 5.18% of GDP, 11.8% of health spendingNorway: 5.43% of GDP, 13.7% of health spendingNepal: 3.69% of GDP, 59.4% of health spendingNaoero: 5.78% of GDP, 0.732% of health spendingNew Zealand: 5.21% of GDP, 12.7% of health spendingOman: 4.38% of GDP, 6.31% of health spendingPakistan: 1.95% of GDP, 52.9% of health spendingPanama: 2.47% of GDP, 40.5% of health spendingPeru: 4.36% of GDP, 27% of health spendingPhilippines: 3.97% of GDP, 44.4% of health spendingPalau: 3.44% of GDP, 12.1% of health spendingPapua New Guinea: 0.782% of GDP, 8.55% of health spendingPoland: 4.31% of GDP, 16.2% of health spendingPortugal: 4.55% of GDP, 28.2% of health spendingParaguay: 3.53% of GDP, 36.3% of health spendingWest Bank and Gaza: 5.43% of GDP, 42.1% of health spendingQatar: 3.23% of GDP, 7.43% of health spendingRomania: 3.28% of GDP, 23% of health spendingRussian Federation: 4.16% of GDP, 28.4% of health spendingRwanda: 4.61% of GDP, 4.1% of health spendingSaudi Arabia: 4.48% of GDP, 14.1% of health spendingSenegal: 6.16% of GDP, 44.3% of health spendingSingapore: 2.19% of GDP, 25.4% of health spendingSolomon Islands: 8.29% of GDP, 3.16% of health spendingSierra Leone: 2.62% of GDP, 54.5% of health spendingEl Salvador: 3.32% of GDP, 32.5% of health spendingSan Marino: 2.9% of GDP, 13.1% of health spendingSomalia, Fed. Rep.: 0.000008% of GDP, 30.8% of health spendingSerbia: 3.4% of GDP, 32.1% of health spendingSao Tome and Principe: 5.03% of GDP, 16.7% of health spendingSuriname: 2.87% of GDP, 19.7% of health spendingSlovak Republic: 4.66% of GDP, 20.2% of health spendingSlovenia: 5.28% of GDP, 11.7% of health spendingSweden: 7.32% of GDP, 13.4% of health spendingEswatini: 6.03% of GDP, 11% of health spendingSeychelles: 4.45% of GDP, 28% of health spendingChad: 3.2% of GDP, 51.7% of health spendingTogo: 4.14% of GDP, 64.3% of health spendingThailand: 2.52% of GDP, 9.93% of health spendingTajikistan: 5.44% of GDP, 62.4% of health spendingTurkmenistan: 4.29% of GDP, 77.4% of health spendingTimor-Leste: 5.24% of GDP, 6.99% of health spendingTonga: 5.31% of GDP, 5.86% of health spendingTrinidad and Tobago: 3.23% of GDP, 45.3% of health spendingTunisia: 6.73% of GDP, 37.9% of health spendingTurkiye: 3.1% of GDP, 19% of health spendingTuvalu: 12.8% of GDP, 0.0446% of health spendingTanzania: 3.16% of GDP, 27.9% of health spendingUganda: 2.56% of GDP, 32.2% of health spendingUkraine: 5.14% of GDP, 45.3% of health spendingUruguay: 4.76% of GDP, 17.1% of health spendingUnited States: 5.42% of GDP, 10.9% of health spendingUzbekistan: 5.47% of GDP, 64.1% of health spendingSt. Vincent and the Grenadines: 6.46% of GDP, 26.6% of health spendingViet Nam: 2.89% of GDP, 39.2% of health spendingVanuatu: 7.64% of GDP, 8.38% of health spendingSamoa: 5.46% of GDP, 13.4% of health spendingSouth Africa: 6.02% of GDP, 6.69% of health spendingZambia: 4.07% of GDP, 10.3% of health spendingZimbabwe: 0.385% of GDP, 10.6% of health spendingAFGANDARMBGDDZAFSMKIRNGAPNGTUVZWE

best-fit line line after adjusting

Four ways to measure the link

MethodrpCountries
Standard (Pearson), not adjusted-0.4022.8e-8178
By rank (Spearman), not adjusted-0.4131.0e-8178
Standard (Pearson), adjusted for national income-0.4062.1e-8178
By rank (Spearman), adjusted for national income-0.3851.2e-7178

The rank version uses only each country’s place in line, from lowest to highest, so a few extreme countries count for less. The adjusted and unadjusted versions use the same 178 countries: those that report both measures and GDP per person. So the gap between them comes from the adjustment, not from a change in which countries are counted. Drop in the size of r after adjusting: -0.004 (a minus sign means it grew).

How solid is it?

Leaving out one country at a time, r ranges from -0.427 (without ZWE) to -0.382 (without TUV). The bar above shows that range on a scale from −1 to +1, with the solid line at the full result. The single country that moves r most: TUV (+0.024).

Within each region

Countries are not separate, unrelated cases, and neighbors share a lot. A link that holds inside each region is far more believable than one that shows up only when comparing regions.

nr
East Asia & Pacific29-0.52
Europe & Central Asia48-0.35
Latin America & Caribbean31-0.40
Middle East, North Africa, Afghanistan & Pakistan18+0.05
Sub-Saharan Africa44-0.41

By income third

If the link shows up only in the richest third of countries, it is a feature of rich countries, not a general pattern.

nr
Poorest third60-0.51
Middle third59-0.27
Richest third59-0.32

By largest religious group

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
Christians105-0.47
Muslims44-0.05

By last european coloniser

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
France24+0.05
Never a European colony21+0.11
Spain19-0.74
United Kingdom59-0.53

Without outliers (countries far outside the middle half of countries on either measure, by more than one and a half times the width of that middle half): r = -0.332 after dropping 5 countries.

Two series, one country

Both measures over the years for one country you pick. The two charts are stacked so they share only the years along the bottom.

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Over time, within countries

Everything above compares countries with each other at one moment. This section compares each country only with itself over 24years. So a link here can’t come from anything about a country that stays the same, such as its history, geography, institutions or culture.

Within countries over time, there is no link that is clearly more than chance (r = -0.066, comparing each country only with itself over the years, and each year only with the same year elsewhere). Whatever the cross-country picture shows, countries whose education spending moved did not tend to see their out-of-pocket health spending move with it.

Across countries (adjusted)-0.406for comparison
Within countries-0.090each country vs itself
…and vs the same year elsewhere-0.066q = 0.248 · 177 countries
Year-on-year changes-0.048q = 0.057
Read with care.
  • Almost all of the second indicator's variation is between countries, so the within-country estimate rests on a small part of the data.

3,132 country-years (one country in one year), 177 countries, 2000–2023, about 18 years each on average. Share of the variation that happens within countries over time: 19% for Education spending, 9% for Out-of-pocket health spending. The margins of error allow for each country appearing many times, and for each year’s value being close to the year before.

Year-to-year changes are a cautious test, not a final answer. Looking only at changes from one year to the next removes each country’s own trends. But it also makes measurement mistakes louder, which pulls the results toward zero. A near-zero result here is weak evidence of no link, not proof.

With one measure years behind the other

0.10−0.1-100+10years Out-of-pocket health spending trails Education spending →lag -10: r = 0.005 (n = 2,070)lag -9: r = 0.010 (n = 2,179)lag -8: r = 0.013 (n = 2,288)lag -7: r = -0.003 (n = 2,388)lag -6: r = 0.004 (n = 2,489)lag -5: r = -0.004 (n = 2,591)lag -4: r = -0.026 (n = 2,720)lag -3: r = -0.039 (n = 2,826)lag -2: r = -0.055 (n = 2,945)lag -1: r = -0.065 (n = 3,048)lag +0: r = -0.066 (n = 3,132)lag +1: r = -0.047 (n = 3,137)lag +2: r = -0.044 (n = 3,077)lag +3: r = -0.039 (n = 2,957)lag +4: r = -0.043 (n = 2,872)lag +5: r = -0.041 (n = 2,786)lag +6: r = -0.043 (n = 2,697)lag +7: r = -0.018 (n = 2,594)lag +8: r = 0.002 (n = 2,485)lag +9: r = 0.010 (n = 2,383)lag +10: r = -0.010 (n = 2,268)

Same year (lag 0): -0.066. A peak away from zero does not show which comes first. These series change slowly — this year’s value is close to last year’s. That makes the curve smooth and nearly symmetric, whatever produced the data. Even a sharp peak at one lag (a gap of some years) would not prove that one measure changes the other.

The data


% of GDP
% of health spending		Years
Kiribati KIR16.4%2.91%2023
Tuvalu TUV12.8%0.0446%2023
Micronesia, Fed. Sts. FSM11.6%2.58%2020, 2023
Namibia NAM9.08%7.49%2024, 2023
Algeria DZA8.98%45%2024, 2023
Solomon Islands SLB8.29%3.16%2023
Botswana BWA8.06%4.26%2020, 2023
Marshall Islands MHL7.7%1.05%2022, 2023
Vanuatu VUT7.64%8.38%2024, 2023
Mauritania MRT7.61%43.8%2024, 2023
Bolivia BOL7.54%27.3%2024, 2023
Sweden SWE7.32%13.4%2022, 2024
Iceland ISL7.31%14.9%2022, 2024
Kyrgyz Republic KGZ6.83%42.3%2023
Tunisia TUN6.73%37.9%2023

World Bank, World Development Indicators
World Bank, World Development Indicators

Sources

Education spending

Government expenditure on education, total (% of GDP)

UNESCO Institute for Statistics · CC BY 4.0 · updated quarterly

Out-of-pocket health spending

Out-of-pocket expenditure (% of current health expenditure)

World Health Organization Global Health Expenditure Database · CC BY 4.0 · updated quarterly

The share of a country's health spending paid by patients themselves when they get care. Health spending as a share of GDP is already on the site and shows how much is spent. This shows who pays.

How this was computed

Data used: most recent value in 2010-2025; values come from 2013–2025. To adjust for income, each measure is first predicted from GDP per person (in percentage terms, on a log scale) with a straight-line fit. Only what is left over is then compared. This is called a partial correlation. The line is drawn the standard way (ordinary least squares), which picks the line that comes closest to all the countries at once. The error margins allow for countries in the same region resembling each other, using 7 World Bank regions. The q-value corrects for testing all 12,497 pairs at once, using the Benjamini–Hochberg method. Underlying data last updated DYB 2024. How the country data works · explore Education spending and Out-of-pocket health spending

This page shows that two measures go together. It does not show that Education spending changes Out-of-pocket health spending, or the reverse. These figures also describe countries, not individual people. See the ecological fallacy.

More links with Education spending or Out-of-pocket health spending