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Low-cost trap: The multidimensional health risks and burdens of household pollutive fuels

Author

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  • Pei, Jiajia
  • Li, Lingyan
  • Duan, Mimi
  • Xia, Haoming
  • Yang, Jianping
  • Zhang, Yao

Abstract

Exploring the impact of pollutive fuels on human health is the key to systematically advancing the green and low-carbon transition of household energy and achieving the United Nations 2030 Sustainable Development Goals (SDGs). Leveraging data from the 2011–2020 China Health and Retirement Longitudinal Study, focusing on middle-aged and older individuals who are susceptible to air pollution, this study integrated “energy-health-economy” into a unified analysis framework, constructed a time-varying Cox model to quantify the multidimensional health risks and medical expenditure burdens associated with pollutive fuels in households, and further explored the underlying mechanisms. Our findings are as follows: (1) middle-aged and older adults who use pollutive fuels for cooking have a 26 % higher risk of depression, 25 % higher risk of cognitive impairment, 43 % higher risk of functional disability, and 54 % higher risk of chronic lung disease than clean fuel users. (2) Pollutive fuel use leads to an additional medical expenditure burden of 204.25, 1140.58, and 999.64 CNY (28.65, 159.97, and 140.20 USD) among individuals with depression, functional disability, and chronic lung disease, respectively. (3) Residents with low educational attainment, low consumption levels, and those living in western regions rural areas, and regions with low healthcare access face greater health risks and higher medical costs due to pollutive fuels, with women particularly vulnerable. (4) Pollutive fuels increase multidimensional health risks and the burden of medical expenses by increasing air pollution, reducing indoor cleanliness, limiting social activities, and disrupting sleep duration.

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  • Pei, Jiajia & Li, Lingyan & Duan, Mimi & Xia, Haoming & Yang, Jianping & Zhang, Yao, 2026. "Low-cost trap: The multidimensional health risks and burdens of household pollutive fuels," Energy Policy, Elsevier, vol. 208(C).
    • Handle: RePEc:eee:enepol:v:208:y:2026:i:c:s0301421525004537
    DOI: 10.1016/j.enpol.2025.114946
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