Moreover, this study estimates that 716 million poor people (living on under $1.90 per day) live in areas with unsafe air pollution. At least 405 million people in Sub-Saharan Africa are estimated to live in both extreme poverty (using a $1.90 a day definition) and unsafe air pollution – thus making them particularly vulnerable to prolonged adverse impacts on livelihoods and well-being. For them, the same air pollution level is likely to imply more severe health risks than for higher income households. Among low-income population groups, high proportions of physical and outdoor labor mean that they are faced with heightened exposure and intake of pollutants. Constraints in terms of the accessibility, availability and quality of health care provision further increase air pollution related mortality among poor people. For instance, a study on air pollution and infant mortality suggests that mortality risks are 2 to 3 times as large in India compared to high-income countries. Moreover, exposure to indoor air pollution – not covered in this study – also affects poor people disproportionately, as they are more dependent on the use of polluting low-cost fuels such as charcoal, kerosene, or firewood for cooking and lighting.

Air pollution is one of the leading causes of death worldwide, especially affecting poorer people who tend to be more exposed and vulnerable. The estimates provided in this study affirm the case for implementing targeted measures to reduce the pollution intensity of economic growth – for instance, supporting the uptake of less polluting technologies in industry and infrastructure, or facilitating the transition towards cleaner fuels (in particular electrification). In addition, measures are warranted to directly address the disproportionate exposure of poor people highlighted in this study. Expanding the provision of affordable and adequate health care in large urban centers in low- and middle-income countries can help reduce mortality, bringing it closer to the levels experienced in higher income countries. Mandating transparent accounting for environmental and health externalities in planning decisions can help to steer pollution sources (e.g. industrial zones or power plants) away from low-income communities. Finally, removing incentives that perpetuate the over-consumption of fossil fuels can yield a double dividend for poor people; e.g. fossil fuel subsidies are well documented to confer disproportionate monetary benefits to richer households, but the air pollution externalities associated with subsidized fossil fuel consumption are also a burden that is borne disproportionately by poorer households. Addressing these policy distortions can be pro-poor both in terms of fiscal and health benefits.

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