Resource extraction projects and health: evidence from cross-national and national data sources

Implementation of resource extraction projects often triggers a series of complex environmental and social-ecological changes. These changes may include alterations in land use (i.e., from forestry and vegetation to infrastructure and mining), an increase in construction activities (new buildings such as houses, schools and hospitals), population increase (more people, more road traffic), urbanization, movement and installation of heavy machinery, increases in employment and business opportunities and household resettlements. These changes can positively or negatively affect health of the population living within mining areas and beyond. For instance, one common and most visible contribution of resource extraction projects is the impact on income generation. This has been widely studied in the economic literature, showing both positive and negative effects between natural resources activities and income generation. Positively, governments can benefit from the generated resource rents and royalties. Individually, people can earn income from employment and business opportunities. The revenue generated can help governments to re-invest in other sectors, including health, education and infrastructure. Negatively, the sharp increase in economic development in one sector can hamper growth in other sectors causing what is known as the Dutch disease. The presence of resource-income dependency can as well fuel local conflicts, political instability, weak institutions and corruption, and ultimately result in a slow development process causing the resource curse. One major aspect of resource extraction projects which is often under-represented is its implication on health. Health is influenced both directly and indirectly through activities involved in resource extraction projects. Evidence suggests that resource extraction projects can positively or negatively affect health and well-being of the population therein. This directly relates to the Sustainable Development Goal (SDG) number 3 (SDG3) of the SDGs 2030 agenda. SDG3 aims to ensure healthy lives and promote well-being for all at all ages. Health has a central place in SDG3, and it is also central to the three dimensions of sustainable development: environment, society and economy. Resource extract projects can act on determinants of health and ultimately contribute to improve lives and well-being. An increase in income can promote access to better care, construction of health care post and hospitals can contribute to improving healthcare delivery, constructions of water points can improve the availability of clean water, and lastly but not least, the provision of health education can contribute to knowledge and disease prevention. On the other hand, resource extraction projects can cause environmental disruption linked to air, water and land pollution. This can further result in disease outcomes. Combustion activities associated with the extraction process can result in the presence of small particulate matter (PM2.5) in the atmosphere and further lead to respiratory and cardiovascular diseases. Toxic substances often used in the extraction process can leak into the environment and result in cancer diseases. The presence of both positive and negative health outcomes in resource extraction areas present an opportunity to systematically study the contribution of resource extraction projects to health outcomes. This PhD thesis embarked on this particular opportunity and studied the association between resource extraction projects and population health indicators in three layered perspectives: global, national and subnational