Multidimensional energy poverty and acute respiratory infection in children under 5 years of age: evidence from 22 low-income and middle-income countries

• Published in: Journal of epidemiology and community health (1979) 2023-11, Vol.77 (11), p.687-693
• Main Authors: Stevens, Merel, Yang-Huang, Junwen, Nieboer, Daan, Zhou, Shuang, Osman, Kwabena Agyapong, Raat, Hein, van Grieken, Amy
• Format: Article
• Language: English
• Subjects: Age; Air pollution; Biogas; Biomass; child health; Children; Energy; Energy poverty; health surveys; Households; Income; Indoor air pollution; Indoor air quality; Indoor environments; Infections; Low income groups; Original Research; Outdoor air quality; Poverty; Questionnaires; Regression analysis; Respiratory tract infection; respiratory tract infections; Socioeconomic factors; Variables
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech-2023-220540

BackgroundIn low-income and middle-income countries (LMICs), energy poverty has predominantly been studied from the unidimensional perspective of indoor air pollution. Acute respiratory infection (ARI) in children under 5 years of age is the most important disease associated with indoor air pollution attributable to solid fuel use in LMICs. This study aimed to extend the existing knowledge on the association between energy poverty and ARI among children under 5 years of age in LMICs, by adopting a multidimensional perspective.MethodsUsing Demographic and Health Surveys from 22 LMICs, data from 483 088 children were analysed (mean age 2.00 years (SD 1.41); 51.3% male). Energy poverty was measured using the Multidimensional Energy Poverty Index (MEPI) (range 0–1), which comprises five dimensions of essential energy services. Binary logistic regression models were conducted to study the association between MEPI and ARI, adjusting for child, maternal, household and environmental characteristics.ResultsA 0.1 increase in MEPI score was associated with greater odds of ARI (aOR 1.05; 95% CI 1.04 to 1.07). Likewise, MEPI indicators using biomass for cooking (aOR 1.15; 95% CI 1.07 to 1.23) and lack of access to electricity (aOR 1.17; 95% CI 1.10 to 1.26), entertainment/education appliances (aOR 1.07; 95% CI 1.02 to 1.13) and household appliances (aOR 1.12; 95% CI 1.04 to 1.21) were associated with greater odds of ARI.ConclusionMultidimensional energy poverty was associated with greater odds of ARI in children under 5 years of age living in 22 LMICs. Hence, our findings justify the design and implementation of interventions that address energy poverty from a multidimensional perspective, integrating energy affordability and accessibility.