Abstract. This article aims to detect empirically, the nexus dynamic interrelationships between health expenditure, totally and disaggregated, economic growth, fertility rate, life expectancy and CO2 emissions in selected middle-income MENA countries. Article results show a significant and robust positive association between health expenditure and economic growth, in one hand, and negative associations between economic growth and all which of, fertility rate, life expectancy and CO2 emissions, on the other hand. Moreover, a negative nexus between fertility rate and life expectancy has been detected. Public, private and external health expenditure affect economic growth positively and significantly, meanwhile affect fertility rate negatively, except health public expenditure, which seems to encourage fertility rate. This indicates that disaggregated health expenditure matters for examination. Furthermore, negative impact of CO2 emissions on growth and life expectancy can crowd out health expenditure positive impacts on both growth and life expectancy. A series of recommendations have been introduced such as increasing health share in public spending, and for more effective government health expenditure and control pollution and CO2 emissions. Furthermore, health spending, policies and system has to function as well to mitigate impacts of high fertility, in marginalized, rural and fungible population and areas.

Keywords: health expenditure, economic growth, fertility rate, life expectancy, CO2 emissions.