Spatial Inequities in Women's Health: The Global Impact of Household Air Pollution from Solid Fuels

Abstract The health effects of household air pollution from solid fuels (HAP) are significant, particularly for women, who experience greater health impacts from HAP compared to men. This study introduces the unhealthy years (UY) metric as a novel, accessible health outcome measure that employs standard life-table calculations to clearly evaluate the health impacts of HAP without confounding effects. The study examines factors contributing to indoor air pollution-related health issues for females by comparing linear regression (LR) and geographically weighted regression (GWR) models across 204 countries worldwide. Results indicate that women in Asian and African countries experience more years of poor health due to HAP than women in other regions. UY attributed to HAP is influenced by a combination of socio-economic, environmental, and demographic factors. Specifically, a higher reliance on polluting fuels (t = 54.53, p < 0.001) is associated with increased UY for women, while investing in education (t = -11.84, p < 0.001) is associated with a decrease in UY due to HAP, indicating a strong relationship. Additionally, the GWR model provides a better fit than the LR model, with predicted UY values closer to the observed UY-HAP in 2019. Many Pacific Island countries are predicted to experience an increase in UY-HAP according to the GWR model. These findings highlight the need for targeted interventions, including reducing solid fuel use, improving air quality, expanding educational opportunities, and addressing gender disparities in health investments, to substantially improve women's health outcomes, particularly in regions bearing the highest health burdens.