Inequality, Development, and the Environment: Determinants of Health Outcomes in Sub‐Saharan Africa

ABSTRACT Since 1990, Sub‐Saharan Africa (SSA) has made significant health progress, marked by rising life expectancy and declining child mortality. However, persistent challenges—including income inequality, reliance on natural resource extraction, and increasing environmental risks threaten these gains. This study analyses how socioeconomic, environmental, and energy‐related factors influence health outcomes across 48 SSA countries from 1990 to 2023. Using panel econometric methods, it examines the effects of income inequality, human development, electricity access, natural resource dependence, air pollution, renewable energy adoption, and public health expenditure on life expectancy, child mortality, and mortality from non‐communicable diseases. Results show that income inequality, air pollution, and resource dependence reduce life expectancy, while access to electricity, greater renewable energy adoption, and higher public health expenditure improve longevity. Child survival is also enhanced by progress in human development, renewable energy adoption, and increased public health expenditure. Conversely, mortality from non‐communicable diseases rises with both income inequality and human development, reflecting SSA's epidemiological shift toward chronic diseases. Sub‐regional variations are evident, including a counter‐intuitive positive association between income inequality and life expectancy in West Africa. Overall, the study highlights the need for integrated policies to reduce income inequality, expand renewable energy and electricity access, invest in public health systems, and address environmental risks alongside the growing burden of chronic diseases.