A surreal illustration depicting the divide in access to environmental health resources.

Bridging the Gap: How Wealth Affects Access to Basic Health Resources

Rhea Morgan in Health & Wellness August 2025 • 5 min read.

"Uncover the stark realities of environmental health access in developing countries and what can be done to level the playing field."

Imagine a world where access to clean water, safe sanitation, and clean energy isn't a given. For many in low- and middle-income countries (LMICs), this is the reality. Low access to environmental health assets (EHAs) like clean cookstoves, bed nets, piped water, and electricity contributes significantly to the global burden of disease. It's a persistent problem, especially among the poorest households, despite decades of efforts to promote affordable solutions.

The global community has made strides in recognizing the importance of EHAs, setting targets through the Millennium Development Goals and the Sustainable Development Goals (SDGs). These goals aim to ensure access to safe drinking water, improved sanitation, and modern energy for all. However, significant gaps remain. Millions still lack access to electricity and clean cooking options, highlighting the critical need to understand and address the barriers hindering progress.

This article explores the relationship between wealth and access to EHAs in 41 LMICs. By examining household-level data on access to essential resources, we uncover the disparities that exist across different wealth strata and shed light on the challenges of reaching the most vulnerable populations. Understanding these patterns is crucial for developing effective strategies to bridge the gap and improve environmental health outcomes for all.

The Wealth Divide: Unequal Access to Environmental Health

A surreal illustration depicting the divide in access to environmental health resources.

Access to EHAs is strikingly unequal across wealth quintiles. Households in the bottom three quintiles often face alarmingly low access to essential resources. For example, access to piped water, modern cooking fuels, electricity, and improved sanitation often falls below 50% for these households. While access to some EHAs, like improved water supply and bed nets, increases gradually with wealth, disparities in other areas, such as electricity and improved sanitation, are much more pronounced.

Urban-rural divides exacerbate these inequalities. Rural households consistently lag behind their urban counterparts in access to most EHAs, except for bed nets. This gap is particularly evident for capital-intensive infrastructure like piped water and electricity. In urban areas, even the poorest households fare relatively better than their rural counterparts, underscoring the unique challenges of reaching remote and underserved communities.

Piped Water: Below 40% access for the bottom three wealth quintiles.
Modern Cooking Fuels: Below 40% access for the bottom three wealth quintiles.
Electricity: Below 50% access for the bottom three wealth quintiles.
Improved Sanitation: Below 40% access for the bottom three wealth quintiles.
Bed Nets: More equitable distribution compared to other EHAs.

These findings challenge the assumption that certain technologies, like mobile phones, have successfully bypassed wealth-related barriers. While mobile phone coverage is relatively high, access to other essential EHAs remains significantly lower for the poorest households, highlighting the need for targeted interventions to address specific needs and challenges.

Moving Forward: Strategies for Equitable Access

Addressing the disparities in access to EHAs requires a multi-faceted approach that goes beyond simple market solutions. While market-based approaches can play a role, they often fail to reach the poorest and most vulnerable populations. Targeted subsidies, supply chain support, and information campaigns are essential to ensure equitable access.

Recognizing the unique challenges of rural communities is also crucial. Interventions in these areas must address issues such as remoteness, high costs, and lack of awareness. Community-based programs, tailored to local needs and circumstances, can be particularly effective in promoting the adoption and sustained use of EHAs.

Ultimately, achieving the SDGs and reducing the global burden of disease requires a commitment to equity and inclusion. By understanding the complex interplay between wealth, location, and access to EHAs, we can develop more effective strategies to bridge the gap and create a healthier, more sustainable future for all.

About this Article -

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This article is based on research published under:

DOI-LINK: 10.1371/journal.pone.0207339, Alternate LINK

Title: Access To Environmental Health Assets Across Wealth Strata: Evidence From 41 Low- And Middle-Income Countries

Subject: Multidisciplinary

Journal: PLOS ONE

Publisher: Public Library of Science (PLoS)

Authors: Jay P. Graham, Maneet Kaur, Marc A. Jeuland

Published: 2018-11-16

Everything You Need To Know

What are Environmental Health Assets, and why is their access so crucial in low- and middle-income countries?

Environmental Health Assets such as clean cookstoves, bed nets, piped water, and electricity are crucial for reducing the global disease burden, particularly in low- and middle-income countries (LMICs). Despite global efforts through the Millennium Development Goals and Sustainable Development Goals (SDGs), significant gaps persist, with millions lacking access to these essential resources. Wealth disparities significantly impact access to EHAs, highlighting the need for targeted interventions to reach vulnerable populations.

How does wealth impact access to essential resources like piped water, cooking fuels, electricity and sanitation?

Access to Piped water, modern cooking fuels, electricity, and improved sanitation is strikingly unequal across wealth quintiles in low- and middle-income countries (LMICs). Households in the bottom three wealth quintiles often experience alarmingly low access, frequently below 50%, to these resources. While bed nets show more equitable distribution, significant disparities persist, especially in electricity and improved sanitation access. Urban-rural divides exacerbate these inequalities, with rural households lagging behind in most EHAs, especially capital-intensive infrastructure.

What strategies can be implemented to ensure equitable access to Environmental Health Assets for the most vulnerable populations?

Addressing disparities in Environmental Health Assets access necessitates a multifaceted approach in low- and middle-income countries (LMICs). Market-based solutions alone are insufficient; targeted subsidies, supply chain support, and information campaigns are crucial. These strategies ensure equitable access by reaching the poorest and most vulnerable populations, bridging the wealth divide in access to essential resources.

How does access to Environmental Health Assets compare to mobile phone access, and what does this reveal about wealth disparities?

The data reveals that mobile phone coverage is relatively high in low- and middle-income countries (LMICs), but access to essential Environmental Health Assets remains significantly lower for the poorest households. This challenges the assumption that technology alone can bypass wealth-related barriers. Targeted interventions must address the specific needs and challenges that perpetuate unequal access to EHAs, even when other technologies are more widespread.

How do the findings relate to the Sustainable Development Goals (SDGs), and what are the implications for achieving these goals?

The Sustainable Development Goals set specific targets for universal access to safe drinking water, improved sanitation, and modern energy. However, progress towards these goals is uneven, particularly in low- and middle-income countries (LMICs). Wealth disparities, urban-rural divides, and the need for targeted interventions highlight the challenges of achieving these goals. Successfully achieving the SDGs requires focused efforts to address the underlying inequalities that hinder access to Environmental Health Assets, ensuring that no one is left behind.