Guest post by Katie Leach-Kemon, a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation, on indoor air pollution and child mortality.
Indian leaders from the public health, environmental, and security sectors have been urging government action to reduce household or indoor air pollution from solid fuels as a major contributor to death early in life.
Household air pollution caused 3.5 million deaths worldwide in 2010, many of which were in young children. In India, an estimated 100, 411 children died as a result of household air pollution that same year.
Burning solid fuels such as wood and dung for cooking is a leading risk factor for lower respiratory infections. Lower respiratory infections include deaths caused by influenza, haemophilus influenzae type B, pneumonia, respiratory syncytial virus, and other respiratory infections. A detailed breakdown of deaths caused by these different viruses and bacteria can be found in the published Global Burden of Disease studies.
Household air pollution is attributable to more than 50% of deaths from lower respiratory infections among children under five globally.
The following graphic comes from the Institute for Health Metrics and Evaluation’s GBD (Global Burden of Disease) visualization tool and shows how lower respiratory infections cause many more deaths in children than in most other age groups, underscoring the potential to save a large number of lives by prioritizing interventions that reduce exposure to household air pollution.
In India, policymakers could potentially prevent nearly 51% of all deaths from lower respiratory infections in children under five, as indicated in the screenshot shown below from IHME’s online data visualization tool. The screenshot shows a square pie chart where the size of each box represents the fraction of total deaths caused by a certain disease or injury. The darker shading shows the proportion of deaths from lower respiratory infections that are related to household air pollution.
In addition to household air pollution, another major risk factor for lower respiratory infections is suboptimal breastfeeding, which is classified as non-exclusive or lack of breastfeeding in the first six months of life and failure to continue breastfeeding after six months until age 2.
At the global level, 30% of deaths from lower respiratory infections can be attributed to suboptimal breastfeeding. Another risk factor, childhood underweight, which is an indicator of malnutrition, contributed to an estimated 23% of deaths due to lower respiratory infections. These statistics can be found in the data visualization tools on IHME’s website here and here. It is important to note that risk factors should not be added up due to the methods used to calculate them.
When GBD measured the impact of risk factors on health over time, they found encouraging signs of progress.
Worldwide, deaths among under fives from childhood underweight, suboptimal breastfeeding, and household air pollution decreased over time by more than 50% each as shown in the screen grab of the GBD Arrow Diagram tool below. This tool shows both the ranking and the percent change in deaths from different risk factors between 1990 and 2010. Despite substantial decreases in deaths from childhood underweight, suboptimal breastfeeding, and household air pollution, their ranking relative to other risk factors among children under five remained first, second, and third, respectively during this period.
Reduced exposure of children under five to household air pollution, suboptimal breastfeeding, and childhood underweight has contributed to declines in deaths from lower respiratory infections in this age group. As shown in the example below, deaths from lower respiratory infections dropped by nearly 60% between 1990 and 2010 among children under five at the global level.