The intersection of fossil fuel emissions and public health: the anatomy of a polycrisis
1
Fossil Free South Africa, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A399
ABSTRACT
BACKGROUND:
Fossil fuels account for approximately 75% of global greenhouse gas emissions, yet their health impacts extend beyond climate change. In South Africa, the “cradle-to-grave” lifecycle of coal and gas—from extraction to combustion—drives a polycrisis of air pollution, energy poverty, and social inequity. This study draws on global evidence of fossil fuel–related health harms to examine how fossil fuel dependence functions as a driver of mortality and systemic health disparities.
METHODS:
A literature synthesis approach is used to assess fossil fuel impacts on South African public health, with a focus on Eskom and Sasol operations and their effects on surrounding communities. Sources include peer-reviewed academic literature and grey literature.
RESULTS:
Using the Global Climate and Health Alliance’s “Cradle to Grave” framework (Narayan & Kuhl, 2025), this research expects to show that fossil fuel pollution causes severe, systemic health harms across the human lifecycle. These impacts are anticipated to be persistent and unevenly distributed within South Africa’s “sacrifice zones,” compounding existing socio-economic health disparities. The study also aims to demonstrate how current climate and health policies inadequately account for these multidimensional harms. Findings are intended for submission to a peer-reviewed public health journal or publication as an independent policy report.
CONCLUSIONS:
Transitioning away from fossil fuels and halting capital flows to fossil fuel companies should be treated as a public health imperative, not merely an environmental objective. Integrating health-cost accounting into energy policy could prevent thousands of premature deaths annually in South Africa. By documenting the systemic nature of fossil fuel harms, this study contributes to the growing global case for urgent action, arguing that redirecting the $7 trillion in annual fossil fuel subsidies toward health-aligned energy systems is both a moral and economic necessity, offering a pathway to address historical health inequities and protect marginalised communities.
Fossil fuels account for approximately 75% of global greenhouse gas emissions, yet their health impacts extend beyond climate change. In South Africa, the “cradle-to-grave” lifecycle of coal and gas—from extraction to combustion—drives a polycrisis of air pollution, energy poverty, and social inequity. This study draws on global evidence of fossil fuel–related health harms to examine how fossil fuel dependence functions as a driver of mortality and systemic health disparities.
METHODS:
A literature synthesis approach is used to assess fossil fuel impacts on South African public health, with a focus on Eskom and Sasol operations and their effects on surrounding communities. Sources include peer-reviewed academic literature and grey literature.
RESULTS:
Using the Global Climate and Health Alliance’s “Cradle to Grave” framework (Narayan & Kuhl, 2025), this research expects to show that fossil fuel pollution causes severe, systemic health harms across the human lifecycle. These impacts are anticipated to be persistent and unevenly distributed within South Africa’s “sacrifice zones,” compounding existing socio-economic health disparities. The study also aims to demonstrate how current climate and health policies inadequately account for these multidimensional harms. Findings are intended for submission to a peer-reviewed public health journal or publication as an independent policy report.
CONCLUSIONS:
Transitioning away from fossil fuels and halting capital flows to fossil fuel companies should be treated as a public health imperative, not merely an environmental objective. Integrating health-cost accounting into energy policy could prevent thousands of premature deaths annually in South Africa. By documenting the systemic nature of fossil fuel harms, this study contributes to the growing global case for urgent action, arguing that redirecting the $7 trillion in annual fossil fuel subsidies toward health-aligned energy systems is both a moral and economic necessity, offering a pathway to address historical health inequities and protect marginalised communities.
| eISSN: | 2654-1459 |
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