Macro-level indicators of household and ambient air pollution mortality risk: Global evidence

Household and ambient air pollution (HAAP), a major global health risk, is linked to a lower quality of life and is responsible for over six million premature deaths globally each year. We investigate country-level socioeconomic, environmental, energy, and health determinants of HAAP mortality rates, using regression analyses and global mapping of predicted probabilities of high HAAP mortality risk. While related studies are predominantly country-specific based on micro-level factors, our study provides global evidence from 150 countries based on a broad range of macro-level indicators. Our findings reveal that greater rural access to clean cooking fuels and technology and increased healthcare expenditures are critical for reducing HAAP deaths, whereas rurality and energy deprivation significantly increase such mortality risks. While advanced economies demonstrate clear resilience to HAAP mortality risks, emerging and developing economies are disproportionately vulnerable. Contrary to related literature, our analyses also reveal that males are more at risk of HAAP mortality than females. We further contextualise our global evidence with previous country-specific case studies on HAAP risks. Our research helps to appraise the progress towards achieving the United Nations Sustainable Development Goals 3, 5, and 7, addressing their associated targets and indicators, providing guidance for policymakers to strengthen efforts to reduce HAAP mortality and improve living conditions globally.