Objective: To analyze the impacts of demographic structure and environmental quality on resident health expenditures. Methods: Building non-spatial panel model and spatial panel model, using 2000-2013 inter-provincial panel data to analyze. Results: Demographic structure, environmental quality and its interaction has significant positive impact on resident health expenditures. Demographic transition and the deterioration of environmental quality could interpret the growing resident health expenditures. Conclusion: Aging population and the deterioration of environmental quality are two major problems troubling in health system. We should pay more attention on the two challenges when we construct and reform the medical security system.