A quantile regression analysis of mediating impacts of institutions in environmental quality‐health outcomes nexus in sub‐Saharan Africa

• Published date: 01 June 2022
• Author: Olorunfemi Yasiru Alimi,Kazeem Bello Ajide,Folorunso Sunday Ayadi
• Date: 01 June 2022
• DOI: http://doi.org/10.1111/opec.12226

A quantile regression analysis of mediating

impacts of institutions in environmental

quality-health outcomes nexus in

sub-Saharan Africa

Olorunfemi Yasiru Alimi*,** , Kazeem Bello Ajide* and

Folorunso Sunday Ayadi*

*Department of Economics, University of Lagos, Akoka, Yaba, Lagos, Nigeria. Email:

haleemphemy480@gmail.com Email: alimi.olorunfemi@lcu.edu.ng Email: kazeemajide@gmail.com Email:

fayadi@unilag.edu.ng

**Department of Economics, Lead City University, Toll-Gate Area, Off Oba Otudeko Ave, Ibadan, Oyo,

200255, Nigeria.

Abstract

This study examines the role of institutions in reducing a presumably negative impact of poor

environmental quality on health outcomes, using a panel of 45 sub-Saharan African countries over

the period, 1996–2016. The empirical estimation is based on the panel quantile regression

estimator. The study established inter alia: first, the declining health status occasioned by

environmental degradation resulted in low life expectancy, high child mortality and increasing

health expenditure. Second, strong institutional settings are needed to reverse the adverse effects of

poor environmental quality on health outcomes. Thus, the minimum thresholds of control of

corruption, government effectiveness, regulatory quality and overall institutions that restore human

age expectancy are −0.37, −0.59, −0.40 and −0.40, respectively. In the same order, 0.08, −0.18,

−0.41 and −0.15 are needed for health spending, whereas 0.24 of control of corruption and −0.21

of regulatory quality are needed to minimise child mortality. Third, the net effects of interactions

do not align with the hypothesised relationships. Finally, we acknowledged the importance of

some auxiliary indicators specific to each measure of health outcomes. On the policy front, setting-

up an innovative and sustainable agenda of green environment and clean growth seems critical to

realising improved health conditions.

1. Introduction

An inquiry into the role of institutions in environmental quality-health outcomes nexus

for sub-Saharan Africa (SSA) is motivated by at least four important strands in health

and environment literature: being a global concern, threat to the national healthcare

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174

system, reaching a threatening dimension among the SSA countries and gaps in

literature. These highlighted points are discussed in a sequential order.

First, the problem of environmental degradation has become a pressurised concern

that has drawn attention of the international agencies like the World Green Economy

Summit (WGES), Global Green Growth Institute (GGGI), World Bank Environmental

Regulations and Standard (WBERS), the United Nations and the African Union.

Interestingly, they have all come up with policies and programmes to combat the

deteriorating environments across the world. However, the average global climate

temperature still remains high despite the agreement signed by the United Nations

member states

1

to reduce it below 2°C (United Nations, 2016). Nonetheless, the increase

in global climate temperature is projected to remain high in the next decades despite the

global effort to combat it. Meanwhile, the impact is mostly pronounced in low-income

countries, living in less developed like SSA, Asia and Latin America (World Bank,

2014).

Second, benefits from the national healthcare system over the last decades are

presently threatened by the increasing global climate change, with infants, pregnant

women and the aged people in the less developed countries likely to be disproportion-

ately affected. The improvement made towards achieving reduction in maternal and

child mortality under the Millennium Development Goals (MDGs) is low in SSA

countries compared to the developed countries. According to the World Health

Organization (2015), the lifetime risk of having a woman dying during pregnancy and

childbirth is 1–3700 in developed world while the risk is still high for SSA countries

standing at 1 in every 38. However, a total worldwide reduction of 47 per cent was

recorded for under-five mortality rate from 78 to 41 deaths per 1000 live births between

2000 and 2016 (United Nations Children’s Fund, 2018). Nonetheless, progress on the

goal of reducing child and maternal mortality and increasing life expectancy are still not

impressive even after intervention from the international bodies. The unpredictable and

uncoordinated action of the SSA countries towards protecting child and maternal health

may undermine the effort of the 2030 Agenda through deteriorating environment, poor

institutional settings, falling education of female child, social inequality, and low

income. All these factors have irreversible consequences on the ability of an individual

and an economy to stop the child mortality rate and lower life expectancy.

Third, as earlier noted, environmental pollution is one of the greatest challenges

facing every economy of the World. It has continued to increase on a yearly basis

thereby causing permanent damages to the floral, human and ecosystem most especially

in the developing countries like SSA. Evidence from the World Bank (2018) showed

that about 99.81 per cent, 100 per cent, 95.9 per cent and 99.49 per cent of people living

in Eastern, Central, Western and Southern regions of Africa during the period 1990–

2015 are exposed to particulate matters 2.5 (PM2.5) exceeding the WHO guideline value

©2022 Organization of the Petroleum Exporting Countries OPEC Energy Review June 2022

Environment, institution and health 175

respectively.

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The problem of deteriorating environmental quality is more severe in SSA

countries because of the following reasons: (i) the region has attracted industries with

high level of crude activities in the absence of regulations. Africa is characterised as the

hub of industrial estates for manufacturing of toxic materials and chemicals owned and

operated by international corporations. According to Brautigam and Xiaoyang (2011),

Africa has attracted attention for housing industrial zones by developed and emerging

countries; (ii) her richness in resources has attracted mining industries to explore mineral

resources which have come with high environmental damages. Review of the mining

industry in Africa by African Development Bank (AfDB, 2012) indicated that the

continent as hosting about 30 per cent of the world’s total mineral reserves. Similarly, it

has a higher share of deposits of diamonds, vanadium, manganese, platinum, cobalt and

gold (iii) the existing weak institutional frameworks in SSA countries have also led to

high record of air pollution in the region. For instance, the growth in industrial estates in

SSA is attributed to the less strict regulations and codes of establishment and operations

against the World Bank Multilateral Investment Guarantee Agency recommendations.

3

Available evidence from the World Governance Indicators (2018) indicate that between

1996 and 2016, countries located in the Central African region have the least

institutional quality with an average value of −1.0558, followed by East Africa

(−0.7312), West Africa (−0.6028) and Southern African countries (0.1214) and (iv) that

many low and middle income countries with large industrial parks are characterised by

prevalence of poverty rates have little to no waste treatment and disposal infrastructure,

as well as poor pollution control mechanisms. However, where these waste infrastruc-

tures exist, they are located near populated areas

4

(Blacksmith Institute, 2011).

Fourth, this study deviates from the existing studies, which mainly centers on either

examining the relationship between environmental quality and health outcomes or

institutions (see Neidell, 2004; Fayissa and Gutema, 2005; Currie et al., 2009; Issaoui

et al., 2015; Balan, 2016) and human health status (Kaufmann et al., 1999; Filmer and

Pritchett, 1999; Gupta et al., 2000; Rajkumar and Swaroop, 2008; Olafsdottir et al.,

2011; Farag et al., 2012; Hu and Mendoza, 2013; etc.). This study complements the

existing studies by investigating the marginal thresholds at which institutions mediate in

environmental quality-health outcomes nexus in sub-Saharan Africa (SSA). This is

considered imperative as less attention is devoted to less-developed region like SSA. In

addition, unveiling institutional thresholds seem salient because the adverse effects of

environmental damages on human health outcomes (in regards to human longevity, child

mortality and health expenses) are more severe in developing countries than developed

countries (World Bank, 2014) amid the high emitting rates of greenhouse gas (World

Bank, 2018). This can be attributed to the institutional dysfunctions. Hence, the study

deploys a panel data analysis to investigate the threshold

5

at which institutions mitigate

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176 Olorunfemi Yasiru Alimi, Kazeem Bello Ajide and Folorunso Sunday Ayadi