Importance of Sustainable Development Goals 3 and 4 in Relation to overall Sustainable Development

This study investigated the importance of Sustainable Development Goals 3 and 4 for overall sustainable development. Hierarchical cluster analysis was applied to the healthcare systems of 32 European countries, including all EU member states as well as the United Kingdom, Norway, Iceland, and Switzerland. The analysis covers the years 2014 and 2019–2022 and is based on indicators of population health status (life expectancy, healthy life years, perceived health), tertiary educational attainment, preventable and treatable mortality, and healthcare expenditure.

The results reveal a consistent division into two main clusters. Cluster 1 is composed primarily of Western and Northern European countries, along with high-performing non-EU states such as Switzerland, and is characterized by stronger health outcomes, higher education levels, and greater healthcare expenditure. Cluster 2 consists largely of Central and Eastern European member states, which systematically report weaker results across most indicators. In addition, smaller clusters (Clusters 3 and 4) emerge in specific years, grouping countries with distinctive profiles. These include high-performing countries such as Ireland, Luxembourg, and Cyprus, as well as countries with relatively high educational attainment but lower health outcomes, such as Latvia and Lithuania.

Comparison with established healthcare system classifications confirms the relevance of these patterns. The best-performing clusters overlap with advanced Bismarck and Beveridge systems, the high-capacity groups identified by Reibling et al. (2019), and the higher-expenditure groups of Di Gioacchino et al. (2024). Conversely, weaker clusters, particularly those in Central and Eastern Europe, align with Bismarck or mixed models, Etatist Social Health Insurance systems, or low-supply systems, and are typically associated with lower healthcare expenditure.

Overall, the findings highlight persistent regional divides in healthcare performance.