Purpose: The study explores the complex relationship between environmental degradation, healthcare expenditure and health outcomes in the Caucasus region and Russia between 2000 and 2020. Methodology: We employ ARDL (Autoregressive Distributed Lag) and Granger causality analyses to assess the impact of greenhouse gas emissions on healthcare expenditure and quality of life indicators in Armenia, Azerbaijan, Georgia, and Russia. Findings: Our results reveal a significant and lasting impact of carbon dioxide and methane emissions on healthcare expenditures, but we did not find a clear causal link between greenhouse gas emissions and quality of life indicators. This points to an intricate correlation between environmental factors and health systems. Implications: we emphasize the need for sustainable development strategies that effectively address both environmental and health challenges. Originality: This study fills a critical gap in the existing literature on the intersection of environmental economics and public health. It offers valuable insights for policymakers grappling with the dual challenges of environmental degradation and healthcare management.