Household energy use and health in low-income and middle-income countries

At the household level, energy powers human health and wellbeing, enabling essential services such as cooking, lighting, communications, heating, cooling, and ventilation. Despite the recognised need for reliable clean energy, access remains deeply unequal, with high-income households benefiting from modern energy sources while over 600 million people do not have access to electricity and 2-3 billion people rely on biomass fuels as an energy source to meet basic household needs. 2-3 million deaths annually are attributed to household air pollution (HAP) from the combustion of these fuels. HAP degrades ambient air quality and contributes to climate change. Studies of household energy and HAP largely focus on cooking-related emissions and might underestimate the true effect of energy use at home to meet a variety of needs, such as heating and lighting. This Series paper reviews the methods used to estimate the HAP disease burden, evaluates the current epidemiological evidence, and examines the health effects of interventions aimed at cleaner energy adoption. Despite differences in methodology, exposure assessment approaches, or the specific health outcomes considered, estimates of global deaths attributable to HAP exposure consistently remain in the millions each year. Thus, this Series paper also identifies areas for future research, emphasising the need for equitable access to clean energy, especially in low-income and middle-income countries.