Page 212 - GHES-3-2

Global Health Economics and
Sustainability
Health behaviors during COVID-19 pandemic

1. Introduction China has increased from RMB 513.8 to RMB 1292.2
($83.6 – $208.2) from 2012 to 2017, with an annual growth
It is undeniable the coronavirus disease 2019 (COVID-19) rate of 25.6% (Zhang et al., 2018). However, to the best of
pandemic has caused an innumerable amount of infections our knowledge, research examining fitness expenditure
and to a further extent, some confirmed cases resulting (i.e., purchasing of fitness equipment and/or health
into fatalities as well. To support this, the World Health supplements) remains scarce. In addition, purchasing and
Organization (WHO) reported a cumulative total of 776 wearing of PPE, such as masks, was commonplace even
million confirmed infection cases worldwide with China before the pandemic (Zhang & Mu, 2018). One reason was
contributing toward a total of 99.4 million and the US to combat air pollution that is more pronounced within
contributing 103 million cases (WHO, 2024). In addition, urbanized areas of China (e.g., Beijing and Shanghai).
they also reported a worldwide cumulative total of ~7.1 Notably, Zhang & Mu (2018) reported that there were
million deaths related to COVID-19 (WHO, 2024). substantial increases in purchases of particulate-filtering

Regarding China, the Coronavirus Resource Center by facemasks during extreme pollution episodes. Finally,
Johns Hopkins University of Medicine (2023) reported a wearing facemasks was the norm for professionals who
cumulative total of 101,356 deaths related to COVID-19. specifically worked in the healthcare and medical industry
Similarly, the WHO also reported a similar number of to reduce their risk of contracting infections when working
~122,000 deaths, too (WHO, 2024). Despite the various with patients (Mukerji et al., 2017).
sources having reported confirmed cases and deaths, the At present, there have been studies that investigated
cumulative total of hospitalizations remains equivocal. medical expenditure as a predictor of COVID-19-related
Nonetheless, addressing the pandemic was not outcomes (Khan et al., 2020). In this specific study,
inexpensive, as evidenced by An et al. (2022) who reported Khan et al. (2020) examined the association between
a single COVID-19-induced hospitalization within China medical expenditure and COVID-related fatalities within
costs a median of RMB 15,438.55 (RMB 14,029.73 – 86 different countries with at least 1,000 confirmed
16,637.47) or $2,158.06 ($1,961.13 – 2,325.65) per patient. COVID-19 cases as of April 30, 2020. To add to this,
In addition, total costs associated with overall patient Koumpias et al. (2022) performed a retrospective cohort
hospitalizations totaled approximately $373.20 million as of study wherein they reported COVID-19 diagnoses being
May 20, 2020 (An et al., 2022). Aside from hospitalizations, correlated with increased medical expenditure. However,
the worldwide financial burden the pandemic imposed can to the best of our knowledge, the use of medical and/or
be further attributed to drastic diagnostic, preventative and fitness expenditure as a prospective means to predict PPE
medical expenditures for personal protective equipment purchasing behavior and the level of ease in managing
(PPE) and other preventative measures (Elola-Somoza daily expenses during and throughout the pandemic is
et al., 2021; Hafidz et al., 2023; Richards et al., 2022). yet to be examined. The conclusions from the former
Moreover, not only can the purchasing of this equipment question can shed light on the effects of utilizing the
exacerbate the burden, but the pandemic has resulted in potential association for assessing supplies of PPE in the
job losses and as a result, lessened income, significantly event of future pandemics. Answers to the latter question
affecting individuals and households in their ability to can provide information about the association between
cover daily expenses during and following the pandemic medical expenditure and ease of covering daily expenses,
(Findling et al., 2021; Ruengorn et al., 2021). since medical expenditure may serve as a financial proxy
Acknowledging this, the financial impact caused by for how individuals can comfortably mediate their life
the pandemic can be gleaned, but a question remains if expenses following a future public health emergency.
pre-COVID-19 healthcare expenditure (i.e., medical and/ Regarding the use of fitness expenditure (i.e., purchasing
or fitness expenditure) is associated with PPE purchasing of fitness equipment and/or health supplements) for the
behavior during the early outbreaks of the pandemic in proposed associations, there is a paucity of research within
China within primary respondents of their respective the literature suggesting its predictive usage. Nonetheless,
households. In addition, a further question remains as to fitness expenditure can serve as a financial proxy for how
if these expenditures are associated with any degree of ease much individuals spend on their health and wellness.
amongst individuals/households in covering their daily To the best of our understanding, no previous studies
expenses following the onset of the pandemic. have explored these associations among residents in
For context, there is a wealth of research examining the mainland China. Therefore, we plan to enrich the
medical expenditure of mainland residents of China pre- knowledge about health-related expenditures during
pandemic. For one, medical expenditure per capita within the COVID-19 pandemic by examining the association

Volume 3 Issue 2 (2025) 204 https://doi.org/10.36922/ghes.6619