Air pollution, socioeconomic development, and ischaemic heart disease mortality in Asia

Abstract

Ischaemic Heart Disease (IHD) remains one of the leading causes of global mortality. Recent evidence indicates a persistent upward trend in IHD mortality in Asia, despite declines in many other regions. Increasing exposure to ambient air pollution, together with socioeconomic and behavioural transitions, suggests that environmental and social determinants may play an important role in shaping regional cardiovascular outcomes. This study investigates the combined influence of air pollution, socioeconomic development, behavioural factors, and pathological conditions on IHD mortality across 31 Asian countries from 2000 to 2021. Panel regression techniques were employed to capture temporal dynamics and cross-country heterogeneity. These were complemented by country-specific linear regressions to identify differential national-level effects. The analysis focuses on ambient particulate matter (PM2.5), alcohol consumption, anaemia prevalence, and the Human Development Index (HDI). The results show that a one-litre increase in per-capita alcohol consumption is associated with approximately eight additional IHD deaths per 100,000 population. Higher anaemia prevalence also significantly increases mortality risk. In addition, a 1% increase in PM2.5 exposure associated with approximately 0.4 additional IHD deaths per 100,000 population, highlighting the cardiovascular burden of poor air quality. In contrast, higher levels of socioeconomic development, reflected by improvements in HDI, are associated with a substantial reduction in IHD mortality. These findings highlight the need for integrated policy responses that combine air quality regulation with health, nutrition, and socioeconomic development strategies. Strengthening air pollution control, together with broader socioeconomic interventions, is essential for reducing the growing cardiovascular burden in Asia.