Abstract
BACKGROUND: Despite the efforts of policymakers to provide universal access to clean and affordable energy as outlined in Sustainable Development Goal 7 (SDG7), billions of people worldwide lack access to clean fuels, leading to major public health concerns. This study investigates the impact of lack of access to clean energy on cardiovascular disease (CVD) mortality among children across multiple age groups. METHODS: Using a panel dataset from 66 countries over the period from 2000 to 2021, we apply System Generalized Method of Moments (GMM) method. To explore how the effects vary across the distribution of mortality rates, we utilized quantile regression analysis, capturing heterogeneity and the influence of outliers. RESULTS: The empirical results reveal that lack of access to clean fuels and technology is a significant and consistent predictor of higher CVD mortality in children across all age groups. Specifically, on average, a 10-percentage point increase in the share of the population without access to clean fuels is associated with an increase in CVD infant deaths of approximately 2 per 100,000 people. The estimates from the quantile regression results reveal a heterogeneous impact where the effect is pronounced at higher quantiles of the mortality distribution. CONCLUSION: Lack of access to clean energy fuels or technology and insufficient public health investment are key contributors to child CVD mortality, particularly among those already at higher risk. The findings highlight the need for targeted policy interventions that prioritize clean energy access through accelerated transition to net zero, especially for high-mortality regions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-24242-6.