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The effects of national culture and human development on environmental

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Article  in  Environment Development and Sustainability · February 2014

DOI: 10.1007/s10668-013-9464-y

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Environ Dev Sustain (2014) 16:79–101
DOI 10.1007/s10668-013-9464-y

The effects of national culture and human development

on environmental health

Naz Onel • Avinandan Mukherjee

Received: 8 March 2013 / Accepted: 17 May 2013 / Published online: 26 May 2013
Ó Springer Science+Business Media Dordrecht 2013

Abstract While there is considerable research on environmental performance of coun-

tries, there is very little that focuses on environmental health as a component of envi-
ronmental performance and how environmental health is affected by national culture and
human development. This study proposes and empirically tests three models that examine
the effects of cultural values and human development on environmental health by incor-
porating different variables from Human Development Index, Hofstede’s Cultural
Dimensions, and Environmental Performance Index. Multiple linear regression models
were employed to test the hypotheses on a sample of 67 countries. Empirical results
conclude that cultural dimensions of individualism and uncertainty avoidance, as well as
human development components of life expectancy at birth, education, and income sig-
nificantly influence environmental health performance of countries when we execute
separate models. A combined model of the effects of national culture and human devel-
opment on environmental health, however, shows only significant effects of human
development components. Theoretical and policy implications are discussed.

Keywords National culture  Human development  Environmental health 

Environmental performance  Cultural dimensions

1 Introduction

Human health is determined by a broad variety of internal and external factors. Internal
factors include individual behaviors and genetic inheritance, while external factors

N. Onel (&)
Environmental Management, Earth and Environmental Studies, College of Science and Mathematics,
Montclair State University, Montclair, NJ 07043, USA
e-mail: onelgarmkhb1@mail.montclair.edu

N. Onel  A. Mukherjee
Department of Marketing, School of Business, Montclair State University, Montclair, NJ 07043, USA
e-mail: mukherjeeav@mail.montclair.edu

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80 N. Onel, A. Mukherjee

comprise quality and accessibility of healthcare, and the wide-ranging external environ-
ment such as the quality of water, air, and living conditions (Hernandez and Blazer 2006).
Today, the significant and detrimental effects of environmental factors on human health are
widely accepted (Iles 1997). In fact, in many parts of the world, environmental factors,
such as pollution and degradation, are being increasingly responsible for ill-health of the
world population (WHO 1997; UNDP 1998). Rapidly industrialized societies generate
variety of pollutants and wastes that affect human health adversely. For instance, millions
of people are exposed to unnecessary physical and chemical hazards in their living envi-
ronment and work place constantly. According to WHO (2012), more than one billion
people lack access to safe drinking water, and the water supply for more than three billion
people lacks minimally acceptable sanitation requirements. Every year, an estimated 40 per
cent of all child deaths are caused by diarrheal diseases around the world (Unicef 2009),
largely caused by contaminated food or water. At any given moment, 267 million people
suffer from malaria, again caused by environmental factors. Every year, two million people
die from it (WHO 2012). Tuberculosis causes deaths of nearly two million people every
year, and at any given time, more than twelve million are affected by it (GlobalHealth-
Policy 2010). Hundreds of millions suffer from sicknesses caused by poor nutrition (Yassi
et al. 2001; Moeller 2005), mainly as a result of land degradation. All these and many more
similar examples demonstrate that the health of millions of people around the world highly
depends on their access to unaltered environmental goods such as clean air and uncon-
taminated water. In fact, a wide range of domestic as well as international bodies, such as
the World Bank, World Health Organization (WHO), and United Nations (UN), now
recognize the significance of environmental conditions on human health (Iles 1997).
According to the World Health Organization, environmental health encompasses ‘‘those
aspects of the human health and disease that are determined by factors in the environment’’
(WHO 2011). It addresses all the external factors (e.g. physical, chemical, and biological)
to an individual and all the related factors impacting behaviors of this individual. Over the
last four decades, the scope of environmental health issues has expanded significantly,
from a narrow focus which simply takes into account refuse and sewage, to consideration
of increasingly widespread and multifaceted phenomena that involve many connections
between different social, economic, ecological, and political factors. Given the greater
visibility of impacts, the kinds of environmental problems that cause direct effects on
human health, such as air, water pollution, or waste disposal, are more readily recognized
as environmental health problems. Additionally, the quality and accessibility of basic
environmental goods (e.g. water and soil) have been recognized as the main sources of
environmental health problems (Iles 1997). Even though all of the aforementioned prob-
lems can be seen as infrastructure development issues which are solvable through scientific
and technological advancements, there is ever increasing concern about environmental
health issues and acknowledgement that the solutions to the problems will need trans-
disciplinary studies that take different approaches and aspects into account. Cultural
characteristics (e.g. individualism and masculinity) and human development dimensions
(e.g. education and income) of the nations could be important predictors of environmental
health.
In recent years, culture is viewed as increasingly important to understand environmental
issues, and therefore, it is getting more and more common to see culture-focused research
(De Mooij and Hofstede 2010). Functioning of groups and individuals in terms of their
self-conception, relation to authority, and dilemmas faced by conflicts and the ways of
dealing with them are all affected by cultural values. Hence, cultural models help define
the patterns of basic problems and are evidence for potential root causes (Kluckhohn and

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National culture and human development 81

Strodtbeck 1961; Inkeles 1997). As Husted (2005) points out, it could also explain envi-
ronmental outcomes of the nations. Similarly, according to Packalén (2010), sustainability
of the nations could only be attainable if we take cultural aspects of the entire society into
account. He states that ‘‘a vital culture and sustainable development go hand in hand’’ (p.
118).
Although scholars have argued that national culture (e.g. Husted 2005; Park et al. 2007;
Peng and Lin 2009), social capital/human development (e.g. Grafton and Knowles 2004;
Peng and Lin 2009), and economic development (e.g. Grossman and Krueger 1995; Xing
and Kolstad 2002; Antoci 2009; Peng and Lin 2009; Kestemont et al. 2011) are important
factors in determining the level of environmental performance, none of these studies in the
literature have tried to compare and evaluate the relationship between national culture and
human development with environmental health. The purpose of this paper is to provide a
greater understanding of the relationship between national culture, human development,
and environmental health. To the best of our knowledge, this is the first paper to dem-
onstrate an overall relationship between these three constructs.
In this paper, we explore the statistical significance and relative importance of different
dimensions of national culture, adopted from Hofstede’s work (1980, 1991, 2001) and
Human Development Index variables, provided by the United Nations Development
Programme (UNDP) in explaining environmental health of nations. Specifically, this study
attempts to answer the following research questions: (1) Is there a relationship between
national culture dimensions and environmental health of a country? (2) is there an asso-
ciation between certain human development components and environmental health of the
countries? (3) how does a combination of culture and human development dimensions of
countries affect environmental health of the nations? In the following sections, we first
review the literature to develop a set of hypotheses and then test the hypotheses on a
sample of 67 countries. Finally, we discuss the findings and conclude the article by sug-
gesting new directions for future studies.

2 Literature review and hypotheses development

Previous studies addressing national culture and its effects on different outcomes at the
country-level have mainly focused on human resource management, organization behavior,
innovation, research and development, international business, alliance formation, and soci-
etal outcomes (Bradley et al. 2006). Of these studies, a few of them have focused on ethical
behaviors (e.g., Husted 1999, 2000, 2005) and environmental impacts (Park et al. 2007;
Packalén 2010). According to Park et al. (2007), the willpower, determination, and capability
to protect the environment from harmful actions are influenced by many intra-country socio-
cultural factors. If the culture of the communities makes their people more conscious of
environmental conditions, high environmental sustainability can be achieved more easily.
Furthermore, in these kinds of communities, it would be much easier and quicker to restore
the environment if damages occur. Also, if we consider the influence of socio-cultural factors
on ethical decision making (Vitell et al. 1993), it can be inferred that the will and ability to
protect the environment and environmental health are influenced by the cultural factors. In
addition, environmental values, attitudes, and eventually environment-related behaviors
could also be affected by cultural aspects at the individual level (Onel and Mukherjee 2012).
Taking Hofstede’s (1980) cultural framework as the basis, some studies in the literature
have examined the relationships between cultural values and societal outcomes. For
instance, Vitell et al. (1993) developed a conceptual framework to examine ethical decision

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82 N. Onel, A. Mukherjee

making in business settings and how culture influences this decision-making process. This
framework helped in filling the major gap in the conceptualization of business ethics
relative to different influences. Based on Vitell et al.’s (1993) framework, Bryan W.
Husted tried to prove the association between cultural values and un/ethical behaviors such
as corruption and software piracy activities with empirical studies (Husted 1999, 2000).
These studies of Husted have confirmed the significant relationships between cultural
values and ethical behaviors. In his 2005 study, Husted also developed a framework
regarding how national culture of the countries could affect environmental sustainability of
the nations. Husted (2005) argued that ‘‘a focus on the economic causes of environmental
sustainability is inadequate and that national culture must also be included in a complete
discussion of the phenomenon’’ (p. 349). In this empirical study, he examined the rela-
tionship between Hofstede’s cultural dimensions and environmental sustainability and
found that different levels of power distance, individualism, and masculinity of the
countries are related to various levels of social and institutional capacity for environmental
sustainability. In another study, Park et al. (2007) were only able to find power distance and
masculinity as significant factors in effecting environmental performance across countries.
Similarly, a more recent study by Peng and Lin (2009) showed that the same factors, power
distance, and masculinity are the most effective and consistent predictors of environmental
performance of a country. Even though Ringov and Zollo (2007) also found the same
cultural dimensions to be significant in environmental performance, their focus mostly
involved corporate-level environmental activities and not the country-level performance.
The possible link between national culture and environmental conditions has been
discussed by some other researchers as well. For instance, Cohen and Nelson (1994)
suggested that the effects of culture on normative ethical beliefs concerning what is
generally correct behavior creates the mechanism of a link between culture and the
environment. The authors see these ethical beliefs as the determinants of common business
practices and necessary government regulations of business activities. Most importantly,
widely held perceptions of acceptable business actions within a given society lead to an
environment that reflects these perceptions. Cohen and Nelson’s study suggests that the
environmentally responsible behavior perceptions can differ across countries significantly.
Similarly, Elgin (1994) supports the idea that achieving environmental sustainability can
only be possible if we can understand and confront the deeper-level problems and chal-
lenges in our culture and consciousness. Gorham (1997) suggested that cultural factors
function at different levels in a society, from policies set by top government officials to
agencies that serve these policies, and the officials who are responsible with the imple-
mentation of these policies. Decision-making processes of these individuals are signifi-
cantly affected by the cultural factors. Similarly, Park et al. (2007) also mention how the
public and private institutions reflect a nation’s culture that leads to significant differences
in terms of environmental sustainability of that nation.
Adopting a slightly different tack, some other researchers have focused on the rela-
tionship between culture and environment with regard to mediating effects of different
factors. Following Bradley et al.’s (2006) suggestion of considering theoretically contex-
tual-mediated factors in national culture frameworks, Peng and Lin (2009) showed that
education of a country plays a bridging role to connect cultural values and environmental
behavior. By using cross-national data of 51 countries, the authors found that there is an
indirect effect of population growth and cultural variables on environmental performance
of a country through the mediating effect of education.
There is also research in the literature focusing on the direct relation between social/
human and natural capital. For instance, Narayan and Pritchett (1996) and Ward (1998)

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National culture and human development 83

examined that the connectedness and closeness of people in a society would affect the
environmental condition of that nation. Furthermore, Kellert (1996) proposed that people’s
attitudes toward natural habitat and conservation activities change depending on the cul-
tural background of the individuals. He pointed out that there is a significant cross-cultural
variability in terms of how these attitudes vary from culture to culture. For example, while
Germans demonstrate high interest in wild nature, ecological processes, and conservation
of them, Japanese people lack interest in them and show less support (Kellert 1996).
Similarly, Pretty and Ward (2001) suggest that better quality of natural environment is
directly related to social and human capitals which are connected to the cultural features of
the specific community. In an empirical study focusing on social capital and national
environmental performance of the countries, Grafton and Knowles (2004) examined a
sample of 35 countries. By gathering data largely from high-income countries and social
capital data from the third wave of the World Values Survey (Inglehart et al. 2000),
Grafton and Knowles (2004, p. 366) argued that their preliminary ‘‘findings provide very
little empirical support for the hypothesis that higher levels of social capital and related
variables improve cross-national environmental quality.’’ They also acknowledged the
possible drawbacks of using World Values Survey’s empirical specifications of social
capital for their study.
Although these studies have demonstrated that various cultural dimensions could affect
the environmental performance of nations, none of them has examined the factors spe-
cifically leading to environmental health, which is defined as a component of environ-
mental performance. In this research study, we are interested in exploring the relationships
between national culture, human development, and environmental health.

2.1 National culture

In this section, we build a model for environmental health and its cultural antecedents
based on the cross-cultural management literature. Although culture is defined by many in
different ways, the most accepted definitions consider culture to consist of shared beliefs,
values, knowledge, and goals that guide people’s actions (Milton 1997; Hofstede 2001).
Hofstede (1984) defines culture as ‘‘the collective programing of the mind which distin-
guishes the members of one category of people from another’’ (p. 51). In this study, we are
mainly interested in understanding how specific cultural values/dimensions of a country
actually impact environmental health of that country.
Several researchers have attempted to measure culture and cultural differences. These
include the following: the Hofstede model (Hofstede 2001; Hofstede and Hofstede 2005);
concepts developed by Schwartz and Bilsky (1987) and Trompenaars (1993); and the
GLOBE model (House et al. 2004). Among these studies, the culture scores developed by
Hofstede have been the most widely applied (Shi and Wang 2011). As Taras et al. (2010)
point out, ‘‘virtually all later models of culture include Hofstede’s dimensions and have
conformed to his approach’’ (p. 406). By using IBM employees as the study’s subjects,
Hofstede (1980) developed four main work-related dimensions that could characterize
various cultures around the globe. These dimensions are the following: (1) High versus
Low Risk Avoidance (UAI), (2) Collectivism versus Individualism (IND), (3) High- versus
Low-Power-Distance (PDI), and (4) Masculine versus Feminine (MAS). He surveyed the
employees between 1967 and 1973 in more than 70 countries to extract data on their
cultural attributes. These four dimensions of culture have been widely accepted and found
to be very effective by researchers who have tried to explain different socio-economic
trends in various cultural settings (e.g. Kogut and Singh 1988; Nakata and Sivakumar

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84 N. Onel, A. Mukherjee

1996; Lu et al. 1999; Singhapakdi et al. 1999; Christie et al. 2003; Park et al. 2007).
Hofstede and Bond (1988) later added a fifth dimension of culture, Confucian dynamism
(long-term vs. short-term orientation), but data for this dimension are limited to only 23
countries. Other than data limitation, this fifth dimension is argued to have an inherent
‘‘philosophical flaw,’’ which is one of the reasons behind its limited application as a
cultural dimension by researchers (see Fang 2003). In this study, we examine the impact of
Hofstede’s national culture framework with four dimensions on national environmental
health performance in a cross-country setting.

2.1.1 Individualism–collectivism

The first cultural dimension, individualism/collectivism, looks at the functioning of the

society in the context of interpersonal relationships as well as achievements from indi-
vidualistic and collectivistic standpoint. In individualistic societies, individuals take
responsibility mainly considering their own benefits and those of their immediate families
(Hofstede 1980; Triandis 1995; Ringov and Zollo 2007). If a society is highly individu-
alistic, the importance of the individual in the society and individual rights become sig-
nificantly influential. On the other hand, if the society has low individualistic nature, the
personal rights become less important and benefits to the society as a whole become more
influential. These societies typically can be defined as collectivistic. In these societies,
individuals can take responsibilities for the other members of the group they belong to,
such as extended families and friends (Hofstede 2001). There is a considerable close tie
between these individuals in collectivist societies. Because of this connectedness and
special importance to the shared interests in these communities, we can expect collectiv-
istic societies to exhibit higher levels of environmental consciousness. In fact, Park et al.
(2007) support this idea and state that higher levels of environmental sustainability could
be achieved in collectivistic societies. However, we should also consider the importance of
social movements to help sustain environmental protection activities.
Individualism/collectivism of countries affects how members of the society function,
and this in turn predicts how such societies perceive cause-related movements. When we
look at environmental movements, we see the emergence of activities of different interest
groups which are highly dispersed in nature. In general, these activities are not carried out
from the centralized associations (Vogel 1987; Dobson 1990). It is also very rare to see
collectivist societies to congregate for the purpose of improvement of the environment they
live in. Contrarily, in individualistic cultures, environmental interest group activities seem
to be greatly diverse and widespread (Katz et al. 2001). In this case, as supported by Husted
(2005), if a country has a high individualistic tendency, that country would be expected to
have more environmental groups and, as a result, more social as well as institutional
capacity to respond to environmental problems. All these should lead to a better envi-
ronmental health condition for the society. Thus, we expect as follows:
Hypothesis 1 The higher the level of individualism of a country, the higher is the
environmental health of the country.

2.1.2 Power distance

This cultural dimension examines the degree of perceived equality among people in a
given society. Hofstede (1991, p. 28) defines power distance as ‘‘the extent to which the
less powerful members of institutions and organizations within a country expect and accept

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National culture and human development 85

that power is distributed unequally.’’ In high-power-distance countries, subordinates are

highly dependent on their superiors. There is a strong parallel between high-power-dis-
tance and paternalism (Hofstede 2001; Husted 2005). In paternalism, superiors expect
loyalty from their subordinates as a return for their favors. If the favors are done to them,
then the subordinates need to show loyalty. In this kind of societies, decisions are made on
the basis of a balance between favors and loyalty, not the merit. So, if the protection of the
environment is crucial for the general health of the society, and if that specific society is
characterized by high levels of power distance, then the decision cannot be made solely
based on how the results of that decision could be vital for the society. In this case, we can
say that even if the environmental conditions are affecting the human health destructively,
the decision making regarding the environmental issues would be different in high-power-
distance and low-power-distance societies. Metz (1991) gives a good example of this
assumption in his research paper and examines deforestation program implementations in
Nepal in the context of power distance influence. He points out that the power distance
dimension may hinder the implementation of the programs in various different ways.
According to Husted (2005), if a society has high level of power distance, it causes agents
to focus on internal politics of the agencies instead of the problem’s main technical merits.
Furthermore, high-power-distance societies lack the necessary debate capacity for better
environmental conditions due to great respect toward authority. This respect to the higher
authorities and resulting weaker capacity for debate usually lead to weaker private sector
responsiveness to social issues in high-power-distance countries (Katz et al. 2001; Husted
2005). As Husted (2005) suggests, in the societies that have lower level of power distance,
it is much easier to openly discuss social and environmental initiatives and come up with
necessary solutions. Furthermore, citizens in these countries are more likely to have equal
rights and wealth (Peng and Lin 2009) to work on and support environmental improvement
activities collaboratively. Hence, we would expect that societies with low level of power
distance tend to be more protective of the environmental health of the country. Thus, we
propose as follows:
Hypothesis 2 The higher the level of power distance in a country, the lower is the
environmental health of the country.

2.1.3 Uncertainty avoidance

Hofstede (2001, p. 161) defines uncertainty avoidance as ‘‘the extent to which the members
of a culture feel threatened by uncertain or unknown situations.’’ Individuals with high
uncertainty avoidance are generally concerned with security in life and therefore do not
tolerate ambiguous situations or deviations from the norms. They feel secure if everything
happens the way it always does, without any variations (Hofstede 1980). Contrarily,
individuals with low uncertainty avoidance are perceived to be more tolerant to risks in life
and less concerned with security. According to Kale and Barnes (1992), strong resistance
to change can be seen in societies with high levels of uncertainty avoidance, while lower
resistance to change exists in societies with low uncertainty avoidance. Peng and Lin
(2009) explain this by pointing out the close link between change and uncertainty. When
there is a change, it would come with its uncertainties. Individuals in high uncertainty
avoidance cultures tend to be strict and dogmatic. They feel threatened by unknown
situations. If the environmental conditions are deteriorating, this may affect the society’s
health conditions adversely which could lead to unknown future for the citizens of that
society. Hence, it is reasonable to assume that individuals in high uncertainty avoidance

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86 N. Onel, A. Mukherjee

cultures would desire to have stable environmental health conditions to avoid risks in their
lives. Thus, we propose as follows:
Hypothesis 3 The higher the level of uncertainty avoidance of a country, the higher is the
environmental health of the country.

2.1.4 Masculinity–femininity

Hofstede (2001) proposed this cultural dimension in terms of the degree to which society
emphasizes (or does not emphasize) the traditional male achievement. According to
Hofstede, ‘‘Masculinity stands for a society in which social gender roles are clearly dis-
tinct: Men are supposed to be assertive, tough, and focused on material success; women are
supposed to be more modest, tender, and concerned with the quality of life. Femininity
stands for a society in which social gender roles overlap: Both men and women are
supposed to be modest, tender, and concerned with the quality of life’’ (p. 297). In a society
with high level of masculinity, usually there is a higher degree of inequality in terms of
genders. Hofstede (1985, p. 348) points out that masculinity is ‘‘a preference for
achievement, heroism, assertiveness, and material success.’’ This explains the materialistic
nature of the masculinity cultural dimension. On the other hand, low masculine societies
have a lower level of differentiation between genders (Heffernan and Farrell 2005). These
‘‘more feminine’’ societies tend to emphasize modesty, social interaction, and caring for
the vulnerable (Ringov and Zollo 2007).
Since the societies that have highly masculine characteristics place low value on caring
for others and quality of life, it can be expected that individuals in these societies tend to
care less for the environmental conditions that may affect the members of the community
adversely. Tice and Baumeister (2004) suggest that masculinity generally restrains helping
behaviors in a society. If the individuals would not be willing to protect each other against
environmental degradation, then it can be easily inferred that these communities could face
environmental health problems. This leads us to hypothesize that higher levels of mas-
culinity will have a negative impact on environmental responsiveness as well as envi-
ronmental health conditions. Thus, we hypothesize as follows:
Hypothesis 4 The higher the level of masculinity of a country, the lower is the envi-
ronmental health of the country.

2.2 Human development

According to UNDP, human development is considered as more than just an increase or

decrease in national income. UNDP defines it as creating an environment in which people can
be productive by reaching their full potential. They can support their lives creatively and meet
their needs and interests the way they want to. The real wealth of nations is considered to be
the ‘‘people.’’ Development could be possible if nations are able to expand their citizens’
choices in their lives that they value the most. Therefore, human development paradigm
addresses much more than just economic growth, indeed one of broadening people’s choices
(UNDP 2011b). These definitions help us to expect high human development to bring better
living standards for the communities. For instance, Gorobets (2011) suggests that a high
percentage of healthy population can be seen as the principal indicator of sustainable human
development. Thus, if the living conditions are better for the society as a result of high human
development, we would expect the health of the environment and health of society to be
enhanced, compared to the low human development societies.

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National culture and human development 87

UNDP uses composite indices to determine human development of each country. The
agency combines educational attainment, income, and health indicators to come up with a
composite Human Development Index, named as the HDI (UNDP 2011c). For this
research study, we will use all these three sub-divisions of Human Development Index to
explore the relationship between human development and environmental health.

2.2.1 Educational attainment

There is extensive literature attesting to the link between education and human health, such
as mortality, morbidity, functional limitations, and health behaviors. Hernandez and Blazer
(2006) point to the connection between lower educational attainment and inferior health
outcomes through the life course of a human being. They provide an example of infant life
expectancy. For instance, the probability of an infant born to a Caucasian mother with
fewer than 12 years of schooling dying before the first birthday is 2.4 times higher than an
infant born to a Caucasian mother with 16 or more years of education (Hernandez and
Blazer 2006). This association between maternal education and infant mortality has been
defined as ‘‘gradient’’ (NCHS 1998). For instance, Hernandez and Blazer (2006) observed
that there was a higher incidence of cigarette smoking, obesity, lead levels in blood
streams, midlife health issues, and chronic conditions such as diabetes and hypertension
among lower educated people compared to their higher educated peers. Of course, we can
assume that not all aforementioned health issues could be directly related to the envi-
ronmental conditions. But if we consider that protecting and improving the environmental
health would need a broader worldview that could be emphasized and advanced with
educational attainment, we can establish the link between education and environmental
health. For example, the quality of drinking water that communities can access could get
affected from the surrounding agricultural and industrial activities as well as domestic use
of the resource by individuals. Agricultural fertilizers, pesticides, industrial discharges, and
household wastewaters can easily reach to underground aquifers as a result of surface
runoff. Unfortunately, this polluted water can be detrimental to human health and cause
illness and even death. As an example, approximately two million children die annually
from diarrheal diseases caused by unsafe drinking water which is considered as one of the
greatest killers (UNICEF 2007). However, if the community is knowledgeable enough to
see the connection between the harmful practices they adopt and detrimental health out-
comes, they can alter their actions toward conserving the limited resources. So, in addition
to acquisition of knowledge and skills that promote health leading to healthier behaviors
(Cutler and Lleras-Muney 2006), higher level of schooling can affect the attitudes toward
environmental health.
Furthermore, lower educational attainment can cause a lack of understanding of the
importance that environmental protection could have. Since such a population cannot pay
the necessary attention to the environment, environmental health can become deteriorated.
Based on the above perspective, we propose the following hypothesis:
Hypothesis 5 The higher the level of educational attainment, higher is the environmental
health of the country.

2.2.2 Income

Similar to education, there is extensive literature supporting a strong relation between

income and health. Research has been conducted at both individual and aggregate levels.

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88 N. Onel, A. Mukherjee

For instance, comparing the top ([$70,000 in 1984 dollars) income earners to the bottom
(\$15,000) income earners revealed that wealth and recent family income were the
indicators that were most strongly associated with subsequent mortality among working-
age adults (Duncan et al. 2002). However, higher income in itself is too rough a criterion.
The landmark work of Sen (1993) clearly demonstrated that national policies with regard
to distribution of income and how income is spread in a population are more critical factors
influencing human health. Naturally, studies investigating the relationship between income
and human health have extended their focus to specific neighborhoods and other geo-
graphic areas. Various studies that adopted multilevel designs included quality of neigh-
borhood in their investigations and conceptualized place with income attributes (Kawachi
and Berkman 2003). The results of these studies showed that living in the disadvantaged
neighborhood imposes an additional risk to human health. For example, a study conducted
by the Department of Housing and Urban Development on neighborhood mobility
(Moving to Opportunity study, MTO) found that moving from a poor to a wealthier
neighborhood improved adults’ health attributes significantly (Clark 2008). When Kawachi
and Berkman (2003) defined disadvantaged neighborhoods, they also included adverse
physical and social environments, such as exposure to more air pollution. These approa-
ches help us to infer that income-related adverse environmental health outcomes are
possible to observe in low-income neighborhoods.
Income and environmental quality are often directly related to each other, especially
when higher income samples are contrasted with lower income samples. Also, environ-
mental quality is accepted to be inversely related to various physical (and psychological)
health problems. In other words, income of the individuals in a society is generally accepted
to be highly associated with exposure to a wide variety of environmental quality indicators in
the surrounding environment, at home, on the job, in school, as well as in one’s neighbor-
hood, which in turn cause negative health effects on individuals (Evans and Kantrowitz
2002; Cakmak et al. 2006; Evans et al. 2008). In fact, numerous studies in the literature focus
on the environmental pollutants and income, especially hazardous wastes and air pollution in
poor communities. Also, a few case studies suggest the connection between higher levels of
contaminated drinking water and low-income societies (Calderon et al. 1993; WHO 2006).
For instance, Cieselski et al. (1991) showed that in North Carolina, migrant farmers with
very low-income received water that tested 44 % to be positive for coliform and 26 % for
fecal coliform. The same region’s comparable farms of higher income families, on the other
hand, had the levels at 0 % for both kinds of coliforms. Similarly, Chicano populations living
along the U.S./Mexico border that had low levels of income were also plagued by polluted
drinking water. According to the study by Calderon et al (1993), approximately 50 % of the
Chicano population in Texas did not have access to safe drinking water, a condition that was
largely assumed to be the reason for the significant increase in water-borne diseases in this
population. Clearly, as supported by various studies, there is a significant link between
income of the population and health of the communities that is directly related to multiple
environmental risks surrounds them. Therefore, we propose:
Hypothesis 6 The higher the level of income of a country, the higher is the environ-
mental health of the country.

2.2.3 Life expectancy

An individual’s health condition is an important determinant of the living standards and

human development. As mentioned earlier, UNDP measures human development by

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combining indicators of educational attainment, health, and living standards. Therefore, we

use health as the last indicator of Human Development Index in this study. This indicator is
measured with a component ‘‘life expectancy at birth’’ by UNDP. Life expectancy at birth
is defined by OECD as ‘‘the average number of years a newborn can expect to live if he or
she experienced the age-specific mortality rates prevalent in a particular year’’ (OECD
2009). According to Mariani et al. (2009), the way individuals value future is highly
impacted by their life expectancy. Usually, if they have a higher life expectancy, they
would feel more sympathetic to coming generations as well as their own future. Therefore,
Mariani et al. (2009) conclude that if someone expects to live longer, that person would be
keen to invest more in environmental quality and future generations. Increased investment
in environmental quality eventually will lead to better living conditions and improvement
in environmental health. Thus, we can assume that:
Hypothesis 7 The higher the level of life expectancy at birth, the higher is the envi-
ronmental health of a country.

3 Methodology

3.1 Conceptual model

On the basis of literature review and hypothesis construction, three regression models were
developed for statistical testing:
Environmental health ¼ a1 þ b11 individualism þ b12 power dis tan ce
ð1Þ
þ b13 uncertainty avoidance þ b14 masculinity þ e1

Environmental health ¼ a2 þ b21 education þ b22 income þ b23 life expectancy at birth
þ e2
ð2Þ
Environmental health ¼ a3 þ b31 individualism þ b32 power distance
þ b33 uncertainty avoidance
þ b34 masculinity þ b35 education þ b36 income
þ b37 life expectancy at birth þ e3 ð3Þ

where, a, regression constant; b, path coefficient (i.e. standardized regression coefficient,

beta weight); e, causes outside the model.
The research framework as applied through the three models is illustrated in Figs. 1, 2,
and 3. Figure 1 depicts the relationship between cultural variables and environmental
health, while Fig. 2 explores the associations between income, health, and educational
attainment with environmental health. Figure 3 demonstrates the combined effects of
culture and human development on environmental health.

3.2 Sample

The data for this research came from three international data sources: the Hofstede culture
study, the UNDP, and the World Economic Forum. The data of cultural dimensions were
obtained from the Hofstede’s study (1991). The data of environmental performance were
taken from the Yale Center for Environmental Law and Policy/Global Leaders of

123
90 N. Onel, A. Mukherjee

Fig. 1 Model 1: Effects of cultural dimensions (i.e. individualism, power distance, uncertainty avoidance,
and masculinity) on environmental health

Fig. 2 Model 2: Effect of human development variables, education, income, and life expectancy at birth,
on environmental health

Tomorrow Environmental Task Force of the World Economic Forum. The human
development data of GNP per capita, income, education, and health were collected from
the UNDP database.
We first obtained country-level data of environmental health performance from the
Environmental Performance Index (EPI) report (2010) and excluded those countries not
included in Hofstede’s (1991) country list. Finally, we collected these country’s Human
Development Index data from the UNDP 2010 report. The data collected for Human
Development Index and Environmental Performance Index are both from the year 2010.
Hofstede’s scores on national culture are considered to be relatively stable over time and
are still used in numerous publications.

3.3 Measures

3.3.1 Dependent variable

3.3.1.1 Environmental health Environmental health, as a dependent variable, was mea-

sured by the environmental health performance data provided by the Environmental

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National culture and human development 91

Fig. 3 Model 3: Combined effects of culture and human development on environmental health

Performance Index (EPI). The EPI was developed by the Yale Center for Environmental Law
and Policy (YCELP) and the Center for International Earth Science Information Network
(CIESIN) of Columbia University, in collaboration with the World Economic Forum and the
Joint Research Centre of the European Commission. The index assigns scores to each country
on two key objectives: (1) environmental health and (2) ecosystem vitality (EPI 2010).
Environmental health refers to the extent to which deficiencies in water quality, air pollution,
and other factors cause health issues and reductions in quality of life. Ecosystem vitality
measures the health of a country’s ecosystem by evaluating such factors as agriculture,
biodiversity and habitat, climate change, fisheries, and forestry. When measuring the vari-
ables, the EPI utilizes a proximity-to-target methodology focused on a core set of environ-
mental outcomes linked to policy goals. The Environmental Performance Index (EPI) in its
2010 report ranked 163 countries on 25 performance indicators that are tracked across ten
policy categories covering both environmental public health and ecosystem validity. Per-
formance indicators used by EPI provide a general picture in terms of how close countries are
in implementing environmental policy goals. Since we are mainly interested in the human
health consequences related to environmental conditions, we used the environmental health
measures for the purpose of this study.

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92 N. Onel, A. Mukherjee

In the index, ‘‘environmental health’’ is determined by the human health-related variables,

such as child mortality, indoor air pollution, drinking water, adequate sanitation, and urban
particulates. Sub-categories of the environmental health are given as: (1) environmental
burden of disease (with 25% weight assigned to it), (2) air pollution effects on human
(12.5 %), and (3) water effects on human (12.5 %). Both air and water indicators are also
divided into two different groups: For air, they are indoor and outdoor pollutions (each has
6.25 % weight), and for water, they are access to water and sanitation (also 6.25 % weight for
each) (EPI 2010).

3.3.2 Independent variables

3.3.2.1 Culture The cultural variables of power distance, individualism, masculinity, and
uncertainty avoidance were measured using data published by Hofstede (1991) for 67
countries. The Hofstede measures of culture are widely cited and used by many scholars.

3.3.2.2 Human Development For the measurement of human development, we used the
2010 data provided by the United Nations Development Programme (UNDP). The UNDP
provides a Human Development Index (HDI) which is ‘‘a summary composite index that
measures a country’s average achievements in three basic aspects of human development:
health, knowledge, and income’’ (UNDP 2011a). It was introduced in 1990 as an alter-
native measurement to conventional methods of measuring national development (e.g.
level of income and rate of economic growth). The HDI combines life expectancy, edu-
cational attainment, and income indicators into a composite Human Development Index.
For each dimension in the index, the HDI sets a minimum and a maximum value (i.e.
goalposts) and then examines where each country stands in terms of distance to these
values. The HDI values are expressed as between 0 and 1.

3.3.2.3 Education The education component of the Human Development Index is

measured by two elements: mean years of schooling and expected years of schooling.
Adults aged 25 years are taken into account for mean years of schooling, and children of
school going age are taken into account for expected years of schooling. Mean years of
schooling is calculated by considering duration of schooling at each level of education.
Expected years of schooling, on the other hand, is calculated based on enrollment by age at
all levels of education. The population of official school age for each level of education is
also considered for estimating expected years of schooling. In the estimations, normali-
zation has been used by giving a minimum value of zero and maximum value of actual
observed maximum value of the indicators from the relevant countries in the time series
between 1980 and 2010. This last step provides a combined education index value for each
country that we used in the study.

3.3.2.4 Health UNDP measures health by evaluating life expectancy at birth for each
country. The life expectancy at birth is calculated using a 20-year minimum value and
83.2-year maximum value. Similar to the education component, the observed maximum
value in the time series 1980–2010 from the countries is used as the maximum value.

3.3.2.5 Income The income (or wealth) component of the HDI is measured by gross
national income (GNI) per capita (PPP US$). For this component, the value for minimum
income is considered as $163 (PPP) and the maximum is considered as $108,211 (PPP),

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which are both observed in the same time series. By using the logarithm of income, HDI
aims to reflect the diminishing significance of income with increasing GNI.

4 Data analysis and results

4.1 Data analysis

A summary of descriptive statistics and correlation matrix for the variables of pooled
cross-national data are provided in Table 1. There are significant correlations between the
dependent variable—ENV. HEALTH—and the independent variables including power
distance, individualism, life expectancy, education, and income. Consistent with the results
of Peng and Lin (2009), we found education to be significantly correlated with income,
power distance, and individualism. Contrary to their results, however, we also found
correlation of education with life expectancy at birth.
Furthermore, the results of the correlation matrix showed a high correlation between
individualism and power distance as seen in Peng and Lin (2009) and Husted (2005) and
acknowledged by Hofstede (1991). According to Hofstede (1991), if we held economic
variables constant, this relationship would disappear. Similar to Peng and Lin (2009), since
we included income in the model 3, we need not be concerned about this potential effect.
In addition to these correlations, we also found significant correlations between power
distance and human development variables (i.e. life expectancy, education, and income),
and similarly, individualism and human development variables.

4.2 Statistical results

Table 2 summarizes the statistical results of Models 1, 2, and 3 in the study. Environmental
health was used as a dependent variable for all models.
Model 1 used the four dimensions of national culture as independent variables and
environmental health as the dependent variable. Model 1 was statistically significant with
an R2 of 0.383. Regression results showed that individualism and uncertainty avoidance
index have significant positive effects on environmental health (see Table 2). From the
regression analysis of Model 1, we can infer the following results for each variable:

4.2.1 Individualism

The effect of individualism on environmental health was significant. This result shows that
when the country’s individualism level is high, the country will have higher levels of
environmental health. Hence, H1 was supported.

4.2.2 Power distance

The results of the study did not show any significant effect of power distance on envi-
ronmental health. Therefore, H2 was not supported.

4.2.3 Uncertainty avoidance

The statistical analyses showed that when the level of uncertainty avoidance of a country
was high, the environmental health of that country was high. This result supported H3.

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 94

123
Table 1 Descriptive statistics and correlation matrix
Variable PDI IDV MAS UAI Life exp. Education Income Env. Mean SD
health

PDI 1.000 -0.666** 0.074 0.164 -0.364** -0.575** -0.445** -0.465** 59.746 20.827
IDV 1.000 0.091 -0.225 0.415** 0.669** 0.597** 0.545** 41.746 23.483
MAS 1.000 0.049 0.069 0.082 0.068 0.092 50.194 16.941
UAI 1.000 0.160 0.043 0.047 0.122 64.806 22.295
Life exp. 1.000 0.792** 0.878** 0.912** 0.851 0.141
Education 1.000 0.856** 0.884** 0.689 0.172
Income 1.000 0.932** 0.676 0.171
Env. health 1.000 71.743 21.481
N = 67
** p \ 0.01, two-tailed test
N. Onel, A. Mukherjee
National culture and human development 95

Table 2 Summary of results

Hypotheses Standardized beta p-value Results

Model 1: Regression analysis of the effects of National Culture on Environmental Health R2 = 0.383, F
Sig. = 0.000
H1. Individualism ? Environmental Health 0.463 0.001 Supported
H2. Power Distance ? Environmental Health -0.203 0.141 Not Supported
H3. Uncertainty Avoidance ? Environmental Health 0.256 0.015 Supported
H4. Masculinity ? Environmental Health 0.053 0.609 Not Supported
Model 2: Regression analysis of the effects of Human Development on Environmental Health R2 = 0.925, F
Sig. = 0.000
H5. Education ? Environmental Health 0.267 0.000 Supported
H6. Income ? Environmental Health 0.387 0.000 Supported
H7. Life expectancy at birth ? Environmental Health 0.361 0.000 Supported
Model 3: Regression analysis of the combined effects of National Culture and Human Development on
Environmental Health R2 = 0.963, F Sig. = 0.000
H1. Individualism ? Environmental Health -0.041 0.491 Not Supported
H2. Power Distance ? Environmental Health -0.042 0.402 Not Supported
H3. Uncertainty Avoidance ? Environmental Health 0.035 0.365 Not Supported
H4. Masculinity ? Environmental Health 0.025 0.487 Not Supported
H5. Education ? Environmental Health 0.263 0.002 Supported
H6. Income ? Environmental Health 0.421 0.000 Supported
H7. Life expectancy at birth ? Environmental Health 0.329 0.000 Supported

4.2.4 Masculinity–femininity

The results of the study showed that the environmental health of a country was not affected
by the level of masculinity–femininity of the country. So, the last hypotheses H4 related to
culture were not supported.
Model 2 examined the relationship between the three human development variables of
education (education index), income (income index), and life expectancy (life expectancy
at birth index) as independent variables with environmental health as the dependent var-
iable. The results of the regression analysis showed statistically significant relationships
between life expectancy, education, and income, and environmental health. The overall
model provided an R2 of 0.925 with 0.000 significance (Table 2). From the regression
analysis of Model 2, we can infer the following results for each variable:

4.2.5 Educational attainment

The first component of human development, educational attainment, had a significant

effect on the environmental health with p value of .0.000. Thus, H5 was supported.

4.2.6 Income

The effect of income on environmental health was significant. This result shows that when
the country’s level of income is high, the country will have higher levels of environmental
health. Hence, H6 was supported.

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96 N. Onel, A. Mukherjee

4.2.7 Health

As the indicator of health, life expectancy at birth component of the HDI showed a
significant effect on environmental health. Thus, H7 was supported.
The last regression analysis addressed the combined effects of National Culture and
Human Development on environmental health as shown in Model 3 (Table 2). When we
incorporated all seven independent variables into the model, it gave us slightly different
results. The model was perfectly significant with an R2 value of 0.963. Of the independent
variables, only HDI components of life expectancy, education, and income showed sig-
nificant effects on environmental health. Thus, Hypotheses 5, 6, and 7 were supported in
Model 3 as well. However, none of the cultural dimensions showed a significant effect on
environmental health in Model 3. This is in contrast with Model 1, where individualism
and uncertainty avoidance were significant. The p values for cultural variables in Model 3
were as follows: 0.491 for individualism, 0.402 for power distance, 0.365 for uncertainty
avoidance, and 0.487 for masculinity. Therefore, Hypotheses 1, 2, 3, and 4 were not
supported in the combined Model 3. The mutual dependency of the indicators (see
Table 1), particularly the significant correlations of the human development variables with
power distance and individualism, possibly swamped the culture effects in the combined
regression model.

5 Discussion and conclusion

In this study, we examined the impact of Hofstede’s national culture framework and
Human Development Index on national environmental health performance. The results of
the study show that national culture can predict the national environmental health per-
formance of the countries. Based on a statistical analysis of the latest available year’s
(2010) pooled cross-national data of 67 countries, our results indicate that national culture
and human development directly influence environmental health performance in separate
models. The results also show that when we employ a combined model, only human
development dimensions have significant effects on environmental health of a country.
The study shows that two of the four cultural dimensions, individualism and uncertainty
avoidance, are associated with environmental health of a country when we only consider
Hofstede’s cultural dimensions without taking into account the effects of human devel-
opment. When a nation is more individualistic as a culture, each individual’s own interest
becomes more important, and as a result, individuals would be more willing to assume
responsibilities mainly for these personal interests. For the most part, environmental
movements emerged as a result of interest group activities that were vastly dispersed
(Ringov and Zollo 2007). As pointed out by Katz et al. (2001), when we compare col-
lectivist cultures and individualistic cultures, it is more common to see prevalent and
diverse environmental interest group activities in individualistic national cultures. In this
case, as supported by Husted (2005), if a country has a high individualistic tendency, that
country would be expected to have more environmental groups and, as a result, more social
as well as institutional capacity to respond to environmental problems. Since in highly
individualistic countries, the importance of individuals in the society and their personal
rights are very influential, it is possible for individuals to force the society and policy
makers to implement rules and regulations to protect the environmental health. Further-
more, members of the individualistic countries consider being healthy and being a part of a
healthy community as an individual right. As a result, a country with a high individualistic

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National culture and human development 97

tendency should have more environmental groups and thus have a greater social capacity to
respond to environmental problems. This, in turn, would help the society to sustain a
healthier environment. All these should lead to a better environmental health condition for
a society that has higher individualism as a cultural dimension as supported by the first
model of this study.
The results of the study also show that there is a correlation between uncertainty
avoidance and environmental health of a country. People living in high uncertainty
avoidance cultures have a strong resistance to change, while people in low uncertainty
avoidance cultures are willing to take risks and exhibit lower resistance to change (e.g.
Kale and Barnes 1992; Nakata and Sivakumar 1996). This supports our assumption that
low uncertainty avoidance cultures would not fear if the environmental degradation is a
fact. Therefore, we can say that people in high uncertainty avoidance cultures prefer to
have stable environmental health conditions compared with people in low uncertainty
avoidance cultures. The former group would be sensitive to any detrimental change in
environmental health conditions. Our first model demonstrates this assumption to be true.
While previous studies have made significant advances in using cultural variables to
predict ethical behaviors and environmental performance effects, none of them focused on
the combined effects of culture and human development dimensions on environmental
health of the different nations. This article makes a contribution by proposing a combined
model which examines the joint effects of national culture and human development on
environmental health. Interestingly, we have found that none of the cultural dimensions of
a country would be significant enough to affect environmental health of a country when we
add all human development variables into the model.
Our assumption that there is an association of income, education, and life expectancy
with environmental health is supported by the results of this study. All three UNDP
measures of human development—income, health, and education—showed a direct effect
on environmental health in both second and third models. Income is associated with
exposure to a wide variety of environmental quality indicators in the ambient environment,
at home, in school, on the job, and in one’s neighborhood (Evans and Kantrowitz 2002).
So, as shown by previous studies (e.g. Kawachi and Berkman 2003; Kling et al. 2004),
each incremental rise in income helps individuals to improve their surrounding health-
related conditions. The result also supports the ‘‘Moving to Opportunity’’ study conducted
by the U.S. Department of Housing and Urban Development which found that moving
from a poor to a wealthier neighborhood was associated with significant improvements in
health conditions (Kling et al. 2004). The poor bear a disproportionate burden of exposure
to suboptimal, unhealthy environmental conditions. Our study confirms that income is
directly related to environmental health.
The results of this study also show that there is a significant association between edu-
cation dimension of the human development and environmental health of a country. Envi-
ronmental scholars support the idea that educational institutions occupy a unique position in
that they educate and mold the next generation of society’s decision-makers (Walton et al.
2000); therefore, formal education is considered critical for achieving environmental and
ethical awareness, values, attitudes, skills, and behavior (Peng and Lin 2009). Our results
support this relationship between educational attainment and environmental health.
According to the results of this study, the last measure of human development—health,
or in other words, life expectancy at birth—also shows a strong relationship with envi-
ronmental health. This result is expected because if someone expects to live longer, we
would anticipate he/she would be willing to invest more in environmental activities. They
would be worried for themselves and forthcoming generations because they would value

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98 N. Onel, A. Mukherjee

future more than the others. As mentioned earlier, higher longevity makes people more
sympathetic to future generations and/or their future selves (Peng and Lin 2009). Our
results also align with this assumption. If the level of life expectancy at birth of a country is
high, the environmental health of that country is also expected to be high.
Even though there is a growing body of research focusing on the relationship between
social and cultural factors and health (e.g. Berkman and Kawachi 2000; Marmot and
Wilkinson 2006), there is a paucity of studies in the literature examining the possible
relationship between cultural and social factors and environmental health. We believe this
study facilitates a first step toward a more detailed and comprehensive examination of this
issue in the future.
While our research explains the linkages between different cultural dimensions, human
development variables, and environmental health, many obstacles remain. For instance,
some types of environmental degradation have long latency period in their effects on
human health, and other degradation occurs on such a scale that it defies foresight and data
gathering. Additionally, many risk factors may interact synergistically, making it extre-
mely difficult to isolate their effects. All these need consideration when focusing on
different environmental outcomes. Therefore, future research may consider changes over
different time periods to identify a more dynamic relationship between different national
culture dimensions, human development variables and environmental health. It is possible
that future data might show different results regarding these relationships.

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