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<p>Air pollution remains one of the leading global threats to population health, yet its burden is unevenly distributed across countries. This study examines the association between age-standardised mortality attributable to household and ambient air pollution and the strength of the rule of law across 137 countries. We obtained mortality data from the World Health Organization and governance indicators from the World Justice Project Rule of Law Index. Given the non-normal distribution of variables, we used Spearman’s rank correlation to assess associations. We observed strong to very strong negative correlations between air pollution mortality and the overall rule of law score, as well as all eight sub-dimensions, including open government, absence of corruption, regulatory enforcement, and access to justice (all <i>P</i> &lt; 0.01). Countries with weaker legal and institutional frameworks experienced substantially higher mortality rates related to pollution. These findings highlight the rule of law as a critical, yet under-recognised, determinant of environmental health and suggest that strengthening legal and governance systems should be considered a core public health intervention.</p>

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Weak rule of law and high age standardised mortality from air pollution

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月20日

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  • Jitendra Kumar

摘要

Air pollution remains one of the leading global threats to population health, yet its burden is unevenly distributed across countries. This study examines the association between age-standardised mortality attributable to household and ambient air pollution and the strength of the rule of law across 137 countries. We obtained mortality data from the World Health Organization and governance indicators from the World Justice Project Rule of Law Index. Given the non-normal distribution of variables, we used Spearman’s rank correlation to assess associations. We observed strong to very strong negative correlations between air pollution mortality and the overall rule of law score, as well as all eight sub-dimensions, including open government, absence of corruption, regulatory enforcement, and access to justice (all P < 0.01). Countries with weaker legal and institutional frameworks experienced substantially higher mortality rates related to pollution. These findings highlight the rule of law as a critical, yet under-recognised, determinant of environmental health and suggest that strengthening legal and governance systems should be considered a core public health intervention.