Fossil Fuels, Clean Cooking Energy, and Health Inequality in Sub‐Saharan Africa: Distribution‐Sensitive Evidence for SDG ‐Linked Transitions

ABSTRACT This study investigates the asymmetric health impacts of fossil fuel dependence in Sub‐Saharan Africa (SSA) using the method of moments quantile regression (MMQR), Driscoll–Kraay robustness checks, and interaction models with clean cooking energy (CCE). Unlike conventional analyses focused on mortality, we examine chronic outcomes—respiratory illness, disability, and out‐of‐pocket health expenditure—across 48 SSA countries from 1990 to 2022. Results show that oil, gas, and coal consumption significantly increase health and financial burdens, with stronger effects in upper quantiles, indicating disproportionate harm among already vulnerable populations. Public health expenditure and CCE consistently mitigate these effects, while Granger quantile causality confirms fossil shocks precede worsening outcomes. Findings highlight a persistent “fossil fuel–health trap” in SSA that undermines SDGs 3 (health), 7 (clean energy), and 13 (climate action). Expanding access to clean energy and strengthening health systems are critical to reducing inequities and supporting sustainable development.