Environmental Accounting and Planetary Health: How Adjusted Net Savings and Governance Quality Moderate Air-Pollution Deaths and Climate-Sensitive Malaria across Countries
DOI:
https://doi.org/10.35898/ghmj-931371Keywords:
green accounting, Adjusted Net Savings, environmental governance, air pollution mortality, ESG ratings, planetary healthAbstract
Background: Climate degradation and air pollution are escalating threats to global health. Unregulated emissions and ecosystem damage may function as hidden, un-audited liabilities on a nation's balance sheet, crystallizing as excess mortality and disease where governments may lack the capacity to recognize and manage them.
Aims: This study tests whether Adjusted Net Savings (ANS) and a governance-quality index moderate the cross-country association between PM2.5 exposure and air-pollution-attributable mortality, and the sensitivity of malaria incidence to temperature and precipitation anomalies.
Methods: Cross-sectional data for a purposively selected sample of 56 countries were compiled from World Bank and WHO sources. PM2.5, ANS, and a governance index (Government Effectiveness/Regulatory Quality), averaged over 2015–2021, were related to 2021 air-pollution mortality (age-standardized; n = 54) and malaria incidence (n = 31) using moderated OLS with HC3 standard errors, controlling for income, health expenditure, and urbanization. A 2000–2021 country–year panel of 22 malaria-endemic countries, with country and year fixed effects, tested whether governance and ANS moderate malaria's response to climate anomalies, with permutation and wild-bootstrap checks.
Results: PM2.5 was positively associated with mortality in most specifications. The PM2.5 × ANS interaction was negative but did not reach conventional significance (β = −0.025, 95% CI [−0.05, 0.00], p = 0.056) and was not robust to log or income-group specifications; the governance interaction was null. In the panel, warm anomalies raised malaria incidence where governance was weak but not where it was strong (temperature × governance β = −0.33, 95% CI [−0.48, −0.17], permutation p < 0.001); ANS did not moderate this response.
Conclusion: Evidence that ANS flattens the PM2.5–mortality association is weak and suggestive. Governance quality, however, was associated with a weaker malaria response to warm anomalies in endemic countries. These are associations, not confirmed causal protection; larger longitudinal studies are needed.
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