If SDG 3 Is the Goal, Which SDGs Deserve Our Attention Most?

The Sustainable Development Goals, established by the United Nations in 2015, offer a comprehensive framework to address critical global issues such as poverty, hunger, health, climate change, and inequality, with the objective of achieving sustainable development by 2030. Achieving these goals is fundamental not only for improving public health outcomes but also for fostering inclusive economic growth (Das et al., 2021; Howden-Chapman et al., 2017). As Smith (1999) highlights, poor health can constrain a household’s ability to generate income or build assets, either by reducing the capacity to work or by increasing healthcare expenditures. Thus, health influences individual and societal development through improved health capital and sustained employment, which is facilitated by reduced morbidity (Grossman, 1972). Conversely, socioeconomic development contributes to improved health outcomes by enhancing access to healthcare, nutritious food, and overall living conditions (Shaw et al., 2005; Bayati et al., 2013). Although this relationship is inherently bi-directional, this essay gives a brief glimpse of how targeted investments in specific development goals can optimize the achievement of SDG 3 (Good Health and Well-being). It identifies key development priorities, examines the associations linking development and health, and argues that strategic alignment of development policies can significantly advance health-related objectives as observed in SDG-3. 

Identifying Priority SDGs

Investing in targeted programmes within the framework of the SDGs holds significant potential to enhance broader developmental outcomes, thereby contributing to the attainment of SDG 3 (Good Health and Well-being). Priority-setting should shift away from short-term gains driven by immediate objectives, and instead align with long-term, sustainable goals. In the current global context, there is an urgent need to prioritize development initiatives that yield both intrinsic and instrumental benefits for health. However, in determining which programmes to prioritize, it is essential to weigh the associated costs and benefits. Preference should be given to interventions that are cost-effective, demonstrate measurable public health impact, and are capable of reaching and benefiting large segments of the population. For instance, targeted investments in SDG 1 (No Poverty) through economic security programmes may prove more cost-effective and yield immediate health benefits compared to large-scale infrastructural investments under SDG 11 (Sustainable Cities and Communities), which typically require substantial public expenditure. Even within individual SDGs, prioritization based on cost-effectiveness is crucial. For example, under SDG 4 (Quality Education), interventions that promote educational engagement among females who aspire to be mothers may generate positive spill-over effects on child education outcomes, particularly in low-income households where universal enrolment may be constrained by socio-economic barriers. Given the interrelated synergies among SDGs, in my view, those most instrumental in advancing SDG 3 (Good Health and Well-being) include SDG 1 (No Poverty), SDG 2 (Zero Hunger), SDG 4 (Quality Education), SDG 6 (Clean Water and Sanitation), and SDG 8 (Decent Work and Economic Growth).

Development-Health Nexus

The relationship between economic growth, development, and health is deeply interconnected. Existing literature generally supports a positive impact of health on economic growth (Fumagalli et al., 2024). Individual health is a critical determinant of economic potential, contributing to national productivity and overall economic performance. One perspective holds that economic growth fosters development, which subsequently enhances population health. Conversely, improved population health drives productivity which ultimately leads to economic growth. This perspective, views health as a "constituent component of development," eliminating the need to defend it value in terms of its indirect contribution to the rise of GDP or personal income. (Ruger, 2003). Further, an individual’s socio-economic position determines how healthy they are and how much healthcare they can afford and consume maintain good health. Evidence suggests a strong positive correlation between average income (or wealth) and indicators of population health (Smith, 1999). Furthermore, income may have an impact on health through enhanced nutritional intake, sanitation, education, also incentivising future family planning. Also, an increase in income can incentivize healthy behaviours i.e., gym membership, high nutritional food, preventive health measures (e.g., vaccines) but also encourage unhealthy lifestyle behaviours i.e., excessive dietary consumption or smoking/ drinking which may lead to diseases such as obesity or cancer. While increased income can positively influence an individual's health and healthcare-seeking behaviour, various developmental barriers may undermine these benefits. Health outcomes are not determined solely by genetics or personal choices but are also shaped by the behaviours and norms of one’s social environment. As Smith (1999) highlights, psych-social factors, such as work-related stress, or lack of social support networks play a significant role in perpetuating the social gradient in health by both directly and indirectly reinforcing unhealthy behaviours. For example, peer smoking habits can significantly affect an individual's likelihood of initiating, maintaining, or quitting smoking. Another important aspect of development that can influence health is “foetal programming,” which suggests that the health of a foetus can be shaped by conditions in the womb. This means that improving living conditions for families with young children and providing good healthcare early in life and can lead to better long-term health outcomes (Smith, 1999).

Critically, as mentioned elsewhere, the relationship between health and economic well-being is fundamentally bidirectional and mutually reinforcing. Improved health strengthens human capital, leading to higher productivity, educational attainment, and long-term earnings (Bloom & Canning, 2001), while economic growth enhances health outcomes by expanding household consumption capacity and enabling greater public investment in healthcare services and infrastructure (Lange & Vollmer, 2017; Marmot, 2005). Higher income levels allow individuals to access preventive and curative health goods, while fiscal expansion improves the quality and availability of public health inputs. Recognizing this two-way association is essential to avoid conceptual confusion and policy misalignment when prioritizing SDG interventions. Although what follows is primarily focused on how targeted SDG investments improve health outcomes (SDG-3), it acknowledges that economic progress can equally serve as a catalyst for better health, just as health investments yield significant economic returns.

SDGs Interactions on Health (SDG-3)

The relationship between economic growth, development, and health provides a foundation for understanding how increases in income and public expenditure influence health outcomes. The SDGs’ strong focus on addressing social determinants of health and strengthening healthcare systems is especially critical, as research indicates that social determinants account for up to 60% of health disparities (Raub & Heymann, 2021). Furthermore, the interconnected nature of the SDGs highlights their collective impact on advancing health and well-being, as reflected in SDG 3.

No Poverty (SDG-1)

Given that poverty is multidimensional, this brief discussion focuses on relative poverty rather than absolute poverty. Individuals with limited financial resources often prioritize purchases out of necessity, frequently overlooking the advantages and disadvantages of the goods they consume due to constrained choices and limited access. In essence, they settle for whatever they can afford. This economic hardship has serious implications for health. Children born into this poverty often face higher mortality risks due to health complications and limited access to healthcare services. More broadly, individuals living in poverty are typically unable to afford nutritious food, clean water, or basic medical care, which exacerbates health disparities. In contrast, an increase in economic resources can significantly improve health outcomes by enabling access to adequate nutrition, safe sanitation, preventive healthcare, and treatment services. It may also help mitigate the effects of aging. However, as Lange and Vollmer (2017) note, higher income levels may also lead to a rise in “diseases of affluence”—health conditions associated with the increased consumption of risky products such as alcohol and tobacco. Reducing financial barriers remains essential. Low-income households also face high allostatic load, as the stress of financial insecurity negatively impacts mental health and often leads to decision fatigue, resulting in poor health-related choices (Guidi et al., 2020). Importantly, individuals who anticipate illness may attempt to save in advance to offset potential healthcare costs or income loss (Smith, 1999). However, this form of precautionary saving is often not feasible for those trapped in chronic poverty. Therefore, alleviating poverty in all its dimensions, as targeted by SDG 1 (No Poverty), is crucial for improving health outcomes and enabling access to healthcare during adverse financial events. Furthermore, progress in poverty reduction is strongly linked to improvements in other key development goals, including SDG 3 (Good Health and Well-being), SDG 4 (Quality Education), and SDG 6 (Clean Water and Sanitation) (Pradhan et al., 2017).

 Zero Hunger (SDG-2)

Advancements through investments in SDG 2: Zero Hunger could play a crucial role in advancing SDG 3: Good Health and Well-being, as adequate nutrition is a core determinant of health outcomes. Undernutrition contributes to weakened immunity, increased disease burden, poor cognitive development, and higher rates of maternal and child mortality (Bloomberg, 2008). Diet is one pathway through which socioeconomic factors can impact health (Jiao, 2024). Interventions to reduce hunger can be significantly strengthened through synergies with SDG 12 (Responsible Consumption and Production) and SDG 6 (Clean Water and Sanitation). For example, minimizing food waste—currently amounting to over 1.3 billion tonnes annually—would not only conserve natural resources but also make more food available for vulnerable populations (Global Hunger, 2020). Addressing hunger also requires targeted economic measures. In households with no or low income, structured social protection mechanisms such as cash transfers and food grants can reduce food insecurity, improve nutrient intake, and promote better health outcomes. These transfers can also support prenatal development by enabling women to access essential nutrition and healthcare, thereby reducing infant mortality. In essence, addressing hunger is not only vital for nutrition but also an entry point for broader public health improvements.

 Quality Education (SDG-4)

An individual’s educational attainment is shaped by conditions within their household, broader economic circumstances, and life course experiences. These factors equally influence the health capital acquired at birth and how it is maintained or improved over time, as health status significantly affects educational engagement and outcomes (SDG-4). Economic disadvantage limits access to quality education, particularly for children in low-income households, leading to lower cognitive development, poor academic performance, and diminished employment prospects—factors that adversely impact both physical and mental health from an early age. Strategic investments in education not only equip individuals with knowledge about disease prevention and healthcare practices but also promote long-term well-being and increase future earning potential, thereby contributing to upward social mobility and improved health outcomes. 

Clean Water and Sanitation (SDG-6)

Expanding and investing in global access to clean drinking water and adequate sanitation is among the most essential and effective interventions for preventing disease and improving public health. However, "improved access" does not always guarantee that water is safe, as it may still contain harmful pathogens or toxins. This challenge is particularly acute in Sub-Saharan Africa, where 42% of the population lacks improved water access, 64% lacks adequate sanitation, and rates of diarrheal disease-related mortality are the highest globally (Montgomery & Elimelech, 2007). Waterborne illnesses significantly contribute to high infant mortality and reduced productivity (Butt et al., 2016; Chang, 2023), particularly in low-income regions. Women and children often bear the burden of water collection, facing a trade-off between the time spent on this task and their educational opportunities and economic productivity. Also, poor hygiene practices, exacerbated by the lack of clean water, further contribute to ill-health. Additionally, water scarcity and drought undermine food security by limiting agricultural output and nutrient intake. Thus, targeted investments in safe water and sanitation infrastructure are crucial for improving population health, reducing mortality, and enhancing long-term economic development.

Decent Work and Economic Growth (SDG-8)

There is a substantial and complementary link between socioeconomic position and health, where investment in SDG 8 (Decent Work and Economic Growth) can play a crucial role in advancing SDG 3 (Good Health and Well-being). Improving job opportunities across all groups, households, and individuals promotes better health outcomes and healthcare-seeking behaviours. Sustained employment within a household enhances the ability to afford healthcare, while decent working conditions directly impact individual health. For example, informal or unsafe jobs, such as in unregulated factories or unsanctioned coal mines, pose significant health risks, including exposure to hazardous environments, long commutes, and low wages, which exacerbate health vulnerabilities. Conversely, economic growth can create formal sector employment opportunities that provide fair wages and safer work environments, thereby reducing disease risk and improving well-being. Moreover, economic resources are essential for accessing healthcare, as direct costs can be prohibitive. Individuals without steady incomes often resort to borrowing, selling limited assets, or other coping mechanisms, which may trap them in cycles of medical poverty (McIntyre et al., 2006). Thus, fostering decent work and sustainable economic growth not only improves income and living standards but also supports healthier lives by reducing financial barriers to healthcare and promoting safer working conditions, ultimately contributing to the achievement of SDG 3.

Investing in other Sustainable Development Goals like reducing poverty, improving education, ensuring clean water, and creating decent jobs can greatly improve health outcomes (SDG 3). When we focus on these connected areas and make sure support reaches those who need it most, people’s health and well-being improve, helping communities grow stronger. In short, working on these goals together is key to building healthier, more resilient societies.

References

Bayati, M., Akbarian, R., Kavosi, Z., Sadraei Javaheri, A., Amini Rarani, M., & Delavari, S. (2013). Socioeconomic determinants of health in western pacific region: A panel data analysis. Social welfare quarterly, 12(47), 111-130.

Bloomberg, J. H. (2008). Maternal and Child Undernutrition 1 Maternal and child undernutrition: global and regional exposures and health consequences. Lancet, 371, 243-60.

Bloom, D. E., Canning, D., & Sevilla, J. P. (2001). The effect of health on economic growth: theory and evidence.

Butt, M., & Khair, S. M. (2016). Cost of illness of water-borne diseases: a case study of Quetta. Journal of applied and emerging sciences, 5(2), pp133-143.

Chang, M. C. (2023). Policy and efficiency evaluation on civil health, well-being, and economic growth in China by investigating waterborne disease. Expert Systems with Applications, 228, 120424.

Das, T., Holland, P., Ahmed, M., Husain, L., Ahmed, M., & Husain, L. (2021). Sustainable development goal 3: good health and well-being. In South-East Asia Eye Health: Systems, Practices, and Challenges (pp. 61-78). Singapore: Springer Singapore.

Fumagalli, E., Pintor, M. P., & Suhrcke, M. (2024). The impact of health on economic growth: A narrative literature review. Health policy, 143, 105039.

Guidi, J., Lucente, M., Sonino, N., & Fava, G. A. (2020). Allostatic load and its impact on health: a systematic review. Psychotherapy and psychosomatics, 90(1), 11-27.

Howden-Chapman, P., Siri, J., Chisholm, E., Chapman, R., Doll, C. N., & Capon, A. (2017). SDG 3: Ensure healthy lives and promote wellbeing for all at all ages. A guide to SDG interactions: from science to implementation. Paris, France: International Council for Science, 81-126.

Jiao, L. (2024). Social Determinants of Health, Diet, and Health Outcome. Nutrients, 16(21), 3642.

Lange, S., & Vollmer, S. (2017). The effect of economic development on population health: a review of the empirical evidence. British medical bulletin, 121(1), 47-60.

Marmot, M. (2005). Social determinants of health inequalities. The lancet, 365(9464), 1099-1104.

McIntyre, D., Thiede, M., Dahlgren, G., & Whitehead, M. (2006). What are the economic consequences for households of illness and of paying for health care in low-and middle-income country contexts?. Social science & medicine, 62(4), 858-865.

Montgomery, M. A., & Elimelech, M. (2007). Water and sanitation in developing countries: including health in the equation. Environmental science & technology, 41(1), 17-24.

Pradhan, P., Costa, L., Rybski, D., Lucht, W., & Kropp, J. P. (2017). A systematic study of sustainable development goal (SDG) interactions. Earth's future, 5(11), 1169-1179.

Ruger, J. P. (2003). Health and development. The Lancet, 362(9385), 678.

Shaw, J. W., Horrace, W. C., & Vogel, R. J. (2005). The determinants of life expectancy: an analysis of the OECD health data. Southern Economic Journal, 71(4), 768-783.

Smith, J. P. (1999). Healthy bodies and thick wallets: the dual relation between health and economic status. Journal of Economic perspectives, 13(2), 145-166.