Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0207339
Title: Access to environmental health assets across wealth strata: Evidence from 41 low- and middle-income countries
Authors: Graham J.P.
Kaur M.
Jeuland M.A. 
Keywords: drinking water
Africa south of the Sahara
Article
bivariate analysis
controlled study
demography
electricity
environmental health
health care access
health care disparity
human
linear regression analysis
low income country
middle income country
organization and management
quality of life
sanitation
water supply
water treatment
adult
developing country
environment
family size
female
health status
income
male
middle aged
poverty
Adult
Developing Countries
Environment
Family Characteristics
Female
Health Status
Humans
Income
Male
Middle Aged
Poverty
Issue Date: 2018
Citation: Graham J.P., Kaur M., Jeuland M.A. (2018). Access to environmental health assets across wealth strata: Evidence from 41 low- and middle-income countries. PLoS ONE 13 (11) : e0207339. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0207339
Rights: Attribution 4.0 International
Abstract: Introduction Low levels of household access to basic environmental health assets (EHAs)–including technologies such as clean cookstoves and bed nets or infrastructure such as piped water and electricity–in low- and middle-income countries (LMICs) are known to contribute significantly to the global burden of disease. This low access persists despite decades of promotion of many low-cost, life-saving technologies, and is particularly pronounced among poor households. This study aims to characterize variation in access to EHAs among LMIC households as a function of wealth, as defined by ownership of various assets. Methods Demographic and Health Survey (DHS) data from 41 low- and middle-income countries were used to assess household-level access to the following EHAs: 1) improved water supply; 2) piped water supply; 3) improved sanitation; 4) modern cooking fuels; 5) electricity; and 6) bed nets. For comparison, we included access to mobile phones, which is considered a highly successful technology in terms of its penetration into poor households within LMICs. Ownership levels were compared across country-specific wealth quintiles constructed from household assets using bivariate analysis and multivariable linear regression models. Results Access to EHAs was low among the households in the bottom three quintiles of wealth. Access to piped water, modern cooking fuels, electricity and improved sanitation, for example, were all below 50% for households in the bottom three wealth quintiles. Access to certain EHAs such as improved water supply and bed nets increased only slowly with concomitant increases in wealth, while gaps in access to other EHAs varied to a greater degree by wealth quintile. For example, disparities in access between the richest and poorest quintiles were greatest for electricity and improved sanitation. Rural households in all wealth quintiles had much lower levels of access to EHAs, except for bed nets, relative to urban households. Conclusions The findings of this study provide a basis for understanding how EHAs are distributed among poor households in LMICs, elucidate where inequalities in access are particularly pronounced, and point to a need for strategies that better reach the poor, if the global environmental burden of disease is to be reduced. © 2018 Graham et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/161209
ISSN: 19326203
DOI: 10.1371/journal.pone.0207339
Rights: Attribution 4.0 International
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This item is licensed under a Creative Commons License Creative Commons