Direct and indirect effects of economic sanctions on women’s health: a mediation analysis

This study contributes to the literature on the unintended consequences of economic sanctions by exploring how sanctions impact women’s health. We argue that sanctions impair women’s health through two mechanisms: government spending on healthcare and out-of-pocket health costs. Using structural equation modeling (SEM), we identify the causal pathways linking sanctions to female health outcomes. Results from mediation analysis using panel data from 193 countries between 2000 and 2019 indicate that the sanctions-women’s health relationship is strongly mediated by government spending and out-of-pocket costs, both of which are measures of financial health resources. A key finding is that sanctions-induced financial constraints lead target governments to cut back on health spending, which in turn results in higher out-of-pocket medical expenses and diminished health outcomes. The study further reveals that the effect of economic sanctions on health is more pronounced for women than for men.