Population and Environment

, Volume 39, Issue 1, pp 1–25 | Cite as

Household air pollution as a silent killer: women’s status and solid fuel use in developing nations

  • Kelly F. AustinEmail author
  • Maria Theresa Mejia
Original Paper


Household air pollution is a leading cause of death globally, as 4.3 million people die prematurely each year from illness attributable to use of solid fuels (WHO 2016a). Many studies contend that gender inequalities are likely to greatly shape the global distribution of solid fuel use and its negative health consequences. We conduct an analysis of 91 developing nations using structural equation models on the prevalence of female indoor air pollution deaths among women and the ratio of female to male indoor air pollution deaths. The results illustrate that women’s status is a robust predictor of solid fuel use, and that improved women’s status also correlates directly with lower female to male indoor air pollution deaths ratios and indirectly with reduced female death prevalence through lower solid fuel dependence. Women’s status additionally mediates the effects of some other notable predictors, such as economic development. Overall, the results bring attention to a “silent killer” in less-developed nations and illustrate that greater female empowerment is an important avenue in addressing this global pandemic.


Gender Global health Indoor air pollution Solid fuels Women’s health 


  1. Arbuckle, JL. (1996). Full information estimation in the presence of incomplete data. In G. A. Marcoulides & R. E. Schumacker (Eds.), Advanced structure equation modeling issues and techniques (pp.243–277). Mahway, N.J.: L. Erlbaum Associates.Google Scholar
  2. Austin, K., & Noble, M. (2014). Measuring gender disparity in the HIV pandemic: a cross-national investigation of female empowerment, inequality, and disease in less-developed nations. Sociol Inq, 84(1), 102–130.CrossRefGoogle Scholar
  3. Banik, B. K. (2010). Female perceptions of health hazards associated with indoor air pollution in Bangladesh. Journal of Sociology and Anthropology, 2(9), 206–212.Google Scholar
  4. Blumberg, R.L. 1984. A general theory of gender stratification. Sociological Theory 2, 23–101.Google Scholar
  5. Boadi, K. O., & Kuitunen, M. (2005). Factors affecting the choice of cooking fuel, cooking place and respiratory health in the Accra Metropolitan Area, Ghana. J Biosoc Sci, 38, 403–412.CrossRefGoogle Scholar
  6. Bollen, K. A. (1989). Structural equations with latent variables. New York: John Wiley Press.CrossRefGoogle Scholar
  7. Bollen, K.A. & Pearl, J. (2013). Eight myths about causality and structural equation models. Pp 310–328 in Handbook of Causal Analysis for Social Research, edited by Stephen Morgan. New York: Springer Press.Google Scholar
  8. Brady, D., Kaya, Y., & Beckfield, J. (2007). Reassessing the effect of economic growth on well-being in less-developed countries, 1980-2003. Stud Comp Int Dev, 42, 1–35.CrossRefGoogle Scholar
  9. Bruce, N., Perez-Pailla, R., & Albalak, R. (2000). Indoor air pollution in developing countries: a major environmental and public health challenge. Bull World Health Organ, 78, 1078–1092.Google Scholar
  10. Burke, P. J. (2013). The national-level energy ladder and its carbon implications. Environ Dev Econ, 18(4), 484–503.CrossRefGoogle Scholar
  11. Burke, P. J., & Dundas, G. (2015). Female labor force participation and HouseholdDependence on biomass energy: evidence from National Longitudinal Data. World Dev, 67, 424–437.CrossRefGoogle Scholar
  12. Burroway, R. (2012). A cross-national analysis of sex-specific HIV prevalence rates and women’s access to property land, and loans in developing countries. Int J Sociol, 42(2), 47–67.CrossRefGoogle Scholar
  13. Cai, L., & Chongsuvivatwong, V. (2006). Rural-urban differentials of premature mortality burden in south-west China. Int J Equity Health, 5(13), 1–9.Google Scholar
  14. Coburn, C., & Restivo, M. and Shandra, J. M. (2014). The African Development Bank and Women’s Health: a cross-national analysis of structural adjustment and maternal mortality. Social Science Research. In press; available online 16 October 2014.Google Scholar
  15. Collins, R. 1993. Towards and integrated theory of gender stratification. Sociologial Perspectives, 36(3), 185–216.Google Scholar
  16. Collins, R., Chafetz, J. S., Blumberg, R. L., & Turner, J. (1993). Toward an integrated theory of gender stratification. Sociol Perspect, 36(3), 185–216.CrossRefGoogle Scholar
  17. Dutta, S. (2003) Mainstreaming gender in energy planning and policies. Available via United Nations Development Programme (UNDP). Cited 9 Nov 2014.
  18. Fullerton, D. G., Bruce, N., & Gordon, S. B. (2008). Indoor air pollution from biomass fuel smoke is a major health concern in the developing world. Trans R Soc Trop Med Hyg, 102(9), 843–851.CrossRefGoogle Scholar
  19. Gajate-Garrido, G. (2013). The impact of indoor air pollution on the incidence of life threatening respiratory illnesses: evidence from young children in Peru. J Dev Stud, 49(4), 500–515.CrossRefGoogle Scholar
  20. Heltberg, R. (2004). Fuel switching: evidence from eight developing countries. EnergyEconomics, 26(5), 869–887.Google Scholar
  21. Hosier, R. (2004). Energy ladder in developing nations. Encyclopedia of Energy, 2, 423–425.CrossRefGoogle Scholar
  22. Jin, Y., Ma, X., Chen, X., Cheng, Y., Baris, E., & Ezzati, M. (2006). Exposure to indoor air pollution from household energy use in rural China: the interactions of technology, behavior, and knowledge in health risk management. Soc Sci Med, 62, 3161–3176.CrossRefGoogle Scholar
  23. Kaplan, D. 2009. Structural equation modeling: foundations and extensions. Thousand Oaks, CA: SAGE Publications.Google Scholar
  24. Knight, K. W., & Rosa, E. A. (2012). Household dynamics and Fuelwood consumption in developing countries: a cross-National Analysis. Popul Environ, 33(4), 365–378.CrossRefGoogle Scholar
  25. Lewin, K. M. (2009). Access to education in sub-Saharan Africa: patterns, problems, and possibilities. Comp Educ, 45(2), 151–174.CrossRefGoogle Scholar
  26. Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., et al. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet, 380(9859), 2224–2260.CrossRefGoogle Scholar
  27. Link, C. F., Axinn, W. G., & Ghimire, D. J. (2012). Household energy consumption: community context and the Fuelwood transition. Soc Sci Res, 41(3), 598–611.CrossRefGoogle Scholar
  28. Matinga, M. N., Annegarn, H. J., & Clancy, J. S. (2013). Healthcare provider views on the health effects of biomass fuel collection and use in rural eastern cape, South Africa: an ethnographic study. Soc Sci Med, 97, 192–200.CrossRefGoogle Scholar
  29. McKinney, L. (2014). Gender, democracy, development, and overshoot: a cross-national analysis. Popul Environ, 36(2), 193–218.CrossRefGoogle Scholar
  30. Medalia, C. and Chang, V. 2011. Gender equality, development, and cross-national sex gaps in life expectancy. Int J Comp Sociol, 52(5):371–89.Google Scholar
  31. Mishra, V., Smith, K. R., & Retherford, R. D. (2005). Effects of cooking smoke and environmental tobacco smoke on acute respiratory infections in young Indian children. Popul Environ, 26(5), 375–396.CrossRefGoogle Scholar
  32. Muthen, L. K. and Muthen, B. O. 2007. Mplus User’s Guide. 5th ed. Los Angeles, CA: Muthen and Muthen.Google Scholar
  33. Pandey, V. L., & Chaubal, A. (2011). Comprehending household cooking energy choice in Rural India. Biomass Bioenergy, 35(11), 4724–4731.CrossRefGoogle Scholar
  34. Person, B., Loo, J. D., & Cohen, A. L. (2012). It is good for my Family’s health and cooks food in a way that my hear loves?’ qualitative findings and implications for scaling up an improved cook stove project in rural Kenya. Int J Environ Res Public Health, 9, 1566–1580.CrossRefGoogle Scholar
  35. Ridgeway, C. L., & Smith-Lovin, L. (1999). The gender system and interaction. Annu Rev Sociol, 25, 191–216.CrossRefGoogle Scholar
  36. Shandra, J. M., Shandra, C. L., & London, B. (2008). Women, non-governmental organization, and deforestation: a cross-national study. Popul Environ, 30(1), 48–72.CrossRefGoogle Scholar
  37. Shen, C., & Williamson, J. B. (2001). Accounting for cross-national differences in infant mortality decline (1965–1991) among less developed countries: effects of Women’s status, economic dependency, and state strength. Soc Indic Res, 53(3), 257–288.CrossRefGoogle Scholar
  38. Shrestha, I. L., & Shrestha, S. L. (2005). Indoor air pollution from biomass fuels and respiratory health of the exposed population in Nepalese households. Int J Occup Environ Health, 11, 150–160.CrossRefGoogle Scholar
  39. Van de Poel, E., O’Donnell, O., & Van Doorslear, E. (2007). Are urban children really healthier? Evidence from 47 developing countries. Soc Sci Med, 65(7), 1986–2003.CrossRefGoogle Scholar
  40. Wermuth, L., & Monges, M. M. (2012). Gender stratification: a structural model for examining case examples of women in less-developed countries. Frontiers, 23(1), 1–22.CrossRefGoogle Scholar
  41. West, C., & Zimmerman, D. (1987). Doing gender. Gend Soc, 1(2), 125–151.CrossRefGoogle Scholar
  42. Wickrama, K. A. S., & Lorenz, F. O. (2002). Women’s status, fertility decline, and women’s health in developing countries: direct and indirect influences of social status on health. Rural Sociol, 67(2), 255–277.CrossRefGoogle Scholar
  43. World Bank (2014) World Development Indicators Online. Available via World Bank. Cited 10 Jun 2013.
  44. World Health Organization (WHO) (2014) Global Health Observatory Data Repository. Available via World Health Organization. Accessed 1 Jul 2014.
  45. World Health Organization (WHO) (2016a). Household air pollution and health. Available via World Health Organization Fact Sheets, Fact Sheet No 292. Cited 5 Feb 2016.
  46. World Health Organization (WHO) (2016b). Global Health Observatory Data Repository. Available via World Health Organization. Accessed 7 Jul 2016.
  47. World Health Organization (WHO) (2016c). Indicator and measurement registry, mortality attributed to household air pollution. Available at: Accessed on 15 Jul 2016.
  48. World Health Organization (WHO) (2016d). Burning opportunity: clean household energy for health, sustainable development, and well-being of women and children. Available at: Accessed 10 Nov 2016.

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of Sociology and Anthropology, Health, Medicine and SocietyLehigh UniversityBethlehemUSA

Personalised recommendations