Major donors heavily rely on GNI per capita to allocate development assistance for health. In our paper, we question this paradigm by analyzing the determinants of health outcomes using cross-sectional data from 99 countries in 2012. We use disability-adjusted life years (Group I) per capita as our main indicator for health outcomes. We consider four primary variables: GNI per capita, institutional capacity, individual poverty and the epidemiological surroundings. We construct a health poverty line of 10·89 international-$ per day, which measures the minimum level of income an individual needs to have access to basic healthcare. We take the contagious nature of communicable diseases into account, by estimating the extent to which the population health in neighboring countries (the epidemiological surroundings) affects health outcomes. We apply a spatial two-stage least-squares model to mitigate the risks of reverse causality, and use additional IV estimations as sensitivity tests. Overall we find that GNI is not a significant predictor of health outcomes once other factors are controlled for.