Abstract
BACKGROUND: Air pollution has become a serious threat to public health. Epidemiological and clinical evidence in recent years has shown air pollutants are associated with respiratory diseases. We aimed to analyze the impact of environmental factors on influenza incidence by examining the most polluted countries in the world. METHODS: To analyze the relationship between environmental factors and influenza incidence in eighteen countries, we used a system generalized method of moments (GMM) using data from 2010 to 2020. RESULTS: The results suggest a positive effect of air pollution (PM(2.5) and NO(2)) and population density on the incidence of influenza. While government health expenditures and education have a negative effect on influenza in the studied countries. CONCLUSION: Our results confirmed the importance of environmental and social factors in the incidence of influenza. Furthermore, our results are interesting and informative for policymakers to design public health policies synchronized with other policies such as education, industrial, and environmental policies, for better management of influenza.