Premature mortality from type 2 diabetes mellitus attributable to household air pollution from solid fuels among adults aged ≥55 years in Ethiopia, 1990 to 2023

Abstract

Background: Household air pollution is identified as one of the leading risk factors for mortalities from type 2 diabetes mellitus. However, there is limited epidemiological information to support decision-making in low-income countries. This study aimed to estimate the magnitude of years of life lost due to type 2 diabetes mellitus attributable to household air pollution from solid fuels among adults aged 55 years and above in Ethiopia from 1990 to 2023. Methods: The study used methods, tools, and estimates from the Global Burden of Diseases 2023 study. A Comparative Risk Assessment framework was applied to estimate the years of life lost. Results: There were an estimated 42,669 years of life lost (95% UI: 24,310-67,089) from type 2 diabetes mellitus attributable to household air pollution among adults aged 55 years and above in Ethiopia in 2023, with 26,183 years of life lost (95% UI: 13,213-44,070) among males and 16,486 years of life lost (95% UI: 8752-28,224) among females. The highest number of years of life lost was estimated in Oromia, Amhara, and Southern Nations, Nationalities, and Peoples, whereas the lowest was in Harari, Gambella, and Dire Dawa. The corresponding rate was 571 years of life lost per 100,000 adults (95% UI: 325-897), with 673 years of life lost per 100,000 males (95% UI: 340-1133) and 460 years of life lost per 100,000 females (95% UI: 244-787). The average estimated rate was higher among males, and increased with age. Between 1990 and 2023, the years of life lost rate remains stable across the country. However, the rate declined in Addis Ababa. Conclusion: This study revealed that there was a high burden of years of life lost from type 2 diabetes mellitus attributable to household air pollution among older adults in Ethiopia, with marked regional and male-predominant disparities. Priorities include scaling clean cooking fuel access in high-burden regions and adopting gender-sensitive strategies for older men. Integrating household air pollution reduction into Ethiopia's diabetes and aging-health frameworks is essential to reverse the stagnant trend and reduce preventable premature mortality.