How Carbon Efficiency And Corporate Governance Shape ESG Ratings : evidence from listed companies in the Nordic healthcare sector

Abstract

This study examines the relationships among ESG ratings, carbon efficiency, and corporate governance in publicly listed healthcare firms in the Nordic region. Against the backdrop of growing attention to ESG performance, the research aims to clarify how ESG ratings are influenced by environmental outcomes and governance structures, offering insights for investors, regulators, and other stakeholders. Using secondary data from corporate disclosures and Refinitiv Eikon, the analysis applies a quantitative, deductive research design based on pooled cross-sectional data. Multiple regression, moderation analysis, and visual methods were used to assess both direct and interaction effects. The results show that neither carbon efficiency nor the selected governance indicators have a statistically significant direct effect on ESG ratings. However, the study identifies a meaningful moderating role for board independence: independent boards strengthen the link between carbon efficiency and ESG performance, allowing environmental outcomes to translate more effectively into higher ESG scores. These findings highlight the conditional and multidimensional nature of ESG assessments and suggest that governance influences ESG performance primarily through interaction effects rather than direct impacts.