<p>Energy Access and Ambient Air Pollution Mortality in Sub-Sahara Africa: Evidence from a Technology Transition</p>

This paper examines whether the relationship between energy access and ambient PM !.#-related mortality in sub-Saharan Africa varies across a period of rapid energy transition. Using a balanced panel of 23 countries from 2000 to 2021, we estimate two-way fixed effects models with a predetermined lag structure, complemented by difference-indifferences designs that exploit crosscountry variation in post-2010 energy expansion. We document a structural shift in the energy-mortality relationship. In the pre-2010 period, electricity access is positively associated with PM !.# mortality, with effects concentrated in rural areas. After 2010, this relationship attenuates and becomes statistically indistinguishable from zero. This transition is accompanied by a substantial narrowing of the rural-urban gap and the disappearance of institutional moderation. Difference-indifferences estimates show no differential increase in mortality in high-adoption countries after 2010, and event-study results confirm parallel pre-trends and gradual post-transition divergence. While generation technology is not directly observed, the convergence of evidence across empirical strategies and outcome patterns is consistent with a shift from diesel-based to cleaner energy systems. The results suggest that the health implications of electrification depend not only on access but on the technology used to deliver it, with implications for energy investment and policy in developing contexts