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New Research: Air Pollution Hinders Childhood Development in up to 90% of Children

May 28, 2021 (New York) – In 2019, 144 million children globally were stunted— too short for their age—which causes negative health implications in physical and cognitive development. New research from Vital Strategies offers evidence that air pollution is often overlooked as a contributor to the global scale of the problem, with 90% of children and teens under 15 exposed to harmful pollution. The new study in Environmental Science and Pollution Research builds on previous associations between air pollution and stunting with updated evidence on the extent of the issue in low- and middle-income countries which have both higher levels of air pollution exposure and higher levels of stunting.

Air Pollution and Stunting: Key Findings


Vital Strategies’ new research on air pollution and stunting reviewed 45 previous studies from 1999-2000.


Air pollution can cause stunting in children, which can permanently harm cognitive and physical development.


144 million children were stunted in 2019.


90% of children and teens are exposed to harmful air pollution with higher rates in low-, middle-income countries.


Air pollution exposure includes outdoor and indoor sources, such as dirty cookstoves.


Exposure to air pollution is the second leading cause of death in children under 5.


If India could meet its own air pollution standards, 3 million fewer children would be stunted.

“Globally, 1 in 5 children under 5 suffer from stunted growth,” said Sumi Mehta, Senior Epidemiologist, Vital Strategies. “Stunting is largely irreversible. Our findings are a call to action for those who care about childhood development. With air pollution rates rising in low-and-middle income countries, clean air action is critical to preventing stunting and improving the health and life course of children, especially children who face higher exposure to pollutants.”

The Vital Strategies paper integrates new evidence from more recent studies in low- and middle-income countries over the last two decades, evaluating a much greater range of articles than previous reviews, making results particularly relevant for countries where air pollution levels, poverty, and prevalence of stunting are higher.

Unlike previous reviews, ambient and household air pollution on early-life determinants of stunting includes studies that assessed outdoor air pollution and household air pollution, investigating both prenatal and postnatal exposure. The assessment of 45 studies from 29 countries found significant associations between children small for their age, and an increase in exposure to air pollutants over the entire pregnancy. The analysis also showed a 19% increased risk of postnatal stunting was associated with postnatal exposure to household air pollution from using solid fuels. Women and children living in low-and-middle income countries are disproportionately affected by indoor air pollution, often a result of their proximity to solid fuels in cooking and heating.

 “Global progress on air pollution would have an immediate effect on women and children leading them to live healthier lives,” said Vivian Pun, Epidemiologist, Vital Strategies. “Cooking, heating, or lighting with traditional stoves and dirty fuels is a leading source of health-damaging air pollutants resulting in air pollutant concentrations several times higher than World Health Organization’s air quality guidelines, posing significant health threats to women and children in these households.”

According to the researchers, the analysis shows the need for faster progress on reducing air pollution as part of an integrated approach to prevent childhood stunting. Governments must prioritize air pollution control efforts through:

  • Identifying leading sources of air pollution;
  • Investing in clean fuels and best available emission-reduction technologies;
  • Implementing evidenced-based clean air policies to reduce emissions; and
  • Enacting equitable policies that consider which communities are most likely to be exposed and impacted by air pollution, such as children and families who still use solid fuels for cooking and heating.

Exposure to air pollution was the second leading risk factor for premature death among children under 5 in 2019. In India, a country with one of the highest stunting prevalence (38%) among children under 5, 3 million fewer children would be stunted if air quality could be improved to meet the country’s National Ambient Air Quality Standards.  

Air pollution is preventable in most cases and effective policy and solutions are available to reduce the root causes of air pollution. Improvement in air quality through effective policy and action can ultimately reduce the likelihood of childhood stunting and its related impacts, protect thousands of children around the world from both physical and cognitive developmental concerns, and promote child health and well-being.

To read the full report, please click here.

For more information about Vital Strategies’ work on air pollution and health, visit:

About Vital Strategies

Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. We work with governments and civil society in 73 countries to design and implement evidence-based strategies that tackle their most pressing public health problems. Our goal is to see governments adopt promising interventions at scale as rapidly as possible.

To find out more, please visit or Twitter @VitalStrat.

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