Household and ambient air pollution mortality risk: global insights from macro-level indicators

Household and ambient air pollution (HAAP) pose a major global health risk, contributing to over six million premature deaths annually and significantly diminishing quality of life. We examine macro-level socio-economic, environmental, energy, and health determinants of HAAP mortality rates across 150 countries. While prior research often focuses on micro-level factors or single-country analyses, our study provides one of the first comprehensive global assessments, incorporating a wide array of indicators. Our findings highlight critical pathways to reducing HAAP-related deaths. Increased rural access to clean cooking fuels and higher healthcare expenditure emerge as pivotal solutions, while rurality amplifies mortality risks. Advanced economies exhibit greater resilience to HAAP mortality, whereas emerging and developing economies remain highly vulnerable, with notable disparities among them. Contrary to conventional assumptions, males face higher HAAP mortality risks than females, a pattern supported by descriptive statistics and global GIS mapping of predicted probabilities from regression models. Our results are robust across alternative models and consistent over time. To contextualise these findings, we integrate evidence from prior country-specific case studies, bridging local insights with global trends. This research advances understanding of progress toward UN Sustainable Development Goals (SDGs 3, 5, and 7) and provides useful insights for policymakers to mitigate HAAP mortality risks and improve living conditions globally.