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Nearly 47 Million Americans Face Elevated Health Risks from Fossil Fuel Infrastructure

November 17, 2025
in Medicine
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A groundbreaking new study from Boston University has unveiled the vast scale of human populations residing in close proximity to fossil fuel energy infrastructure throughout the entire supply chain across the contiguous United States. The investigation, recently published in the journal Environmental Research Letters, reveals that approximately 46.6 million people—representing 14.1% of the nation’s population—live within roughly one mile (1.6 km) of critical fossil fuel infrastructure components. This research marks one of the most comprehensive attempts to quantify exposure to fossil fuel-related environmental stressors beyond the commonly studied extraction and end-use phases.

Fossil fuel production and use involve a complex journey comprising five distinct stages: extraction, refining, storage, transportation, and end-use. Prior studies have largely focused on the environmental and health impacts at the beginning and end points of this process. However, the intervening steps, though equally vital, have remained largely underexplored, partly due to the diffuse and often concealed nature of infrastructure such as storage terminals and transportation pipelines. This study bridges that knowledge gap by integrating data from all five stages to provide a holistic picture of the spatial distribution of fossil fuel infrastructure and its intersection with population demographics.

The researchers leveraged the Energy Infrastructure Exposure Intensity and Equity Indices (EI3) database—a pioneering, centralized dataset aggregating publicly available information from local, state, and federal agencies nationwide. Before this effort, fossil fuel infrastructure data was highly fragmented, often locked behind paywalls or dispersed across numerous jurisdictions. The EI3 database harmonized this fractured knowledge into a cohesive tool, enabling unprecedented granularity in mapping infrastructure and adjacent populations.

One of the study’s revealing findings concerns the distribution of populations near different infrastructure types. Extraction sites, such as oil and gas wells, have a vast number of dispersed locations, typically situated in sparsely populated areas, with an average of only 17 residents living within a one-mile radius per site. Conversely, storage facilities—ranging from peak shaving installations to underground gas storage and petroleum terminals—are fewer but generally located in or near dense urban centers. This results in a far higher population density, averaging nearly 2,900 residents living close to each storage facility, heightening potential exposure risks in these urban localities.

End-use facilities, including power plants that combust fossil fuels for electricity generation, account for approximately 21 million residents living within a mile of these sites. Extraction areas attract a similar number of nearby residents, while storage sees over 6 million, with refining and transportation facilities situated near smaller but still significant populations. Around 9 million individuals reside near multiple infrastructure types, compounding potential exposure to a complex mixture of emissions over the supply chain.

Emerging evidence has linked proximity to extraction and end-use facilities with various adverse health outcomes, notably increased incidences of asthma, leukemia, and negative birth outcomes such as preterm births and low birth weights. Yet, the health impacts of mid-supply chain infrastructure have remained poorly understood. The study cited detections of volatile organic compounds (VOCs) and other hazardous pollutants near storage and transportation sites, flagging these areas as potential but under-recognized sources of community health risks.

The spatial concentration of fossil fuel infrastructure and nearby populations is not uniform across racial or geographic lines. The study highlights troubling environmental justice concerns, revealing that predominantly non-white communities consistently face higher exposure levels to fossil fuel facilities across all supply chain stages. Urban residents also bear a disproportionate burden, with almost 90% of those living near refining, transportation, storage, and end-use infrastructure situated in urbanized areas. This uneven distribution underscores the imperative for policymakers to consider equity in energy transition and urban planning.

Jonathan Buonocore, assistant professor of environmental health at Boston University and lead author of the paper, emphasized the importance of this integrated approach: “By mapping all stages of the fossil fuel supply chain, we are better positioned to understand who is affected and begin assessing the multifaceted hazards and stressors these communities face.” His colleague Mary Willis, assistant professor of epidemiology, added that the study is a vital first step: “Without understanding the baseline proximity and exposure, it is impossible to fully characterize the distinct health impacts or develop targeted, effective interventions.”

The technical innovation of the EI3 database has been a game-changer, enabling data scientists to employ detailed geographic information system (GIS) analyses coupled with demographic data to unveil the actual scale of fossil fuel exposure vulnerability. The database’s creation involved meticulous harmonization of data from underground gas storage permits, transportation pipeline routes, petroleum product terminal locations, oil and gas well inventories, and power plant coordinates. This comprehensive geospatial synthesis offers researchers and policymakers an invaluable tool for future health impact assessments and environmental justice evaluations.

Given the study’s findings, urban policymakers seeking high-impact interventions might prioritize regulation of storage infrastructure, where population densities near facilities are greatest. Contrastingly, mitigation strategies around extraction sites may require a different focus, emphasizing exposure risks over more dispersed, less densely populated regions but with unique hazards such as blowouts or uncontrolled leaks.

Looking ahead, the researchers advocate for intensified monitoring campaigns targeting air, water, noise, and light pollution associated with all fossil fuel infrastructure phases. Integrating environmental data with health records, including Medicaid claims and other medical datasets, offers a promising direction for further elucidating the complex environmental-health linkages. Unique populations, such as pregnant individuals or communities vulnerable to cumulative environmental stressors, represent critical groups for additional investigation.

This comprehensive and integrative view of fossil fuel infrastructure exposure challenges conventional paradigms that focus narrowly on extraction or combustion facilities alone. It underscores the necessity of a systemic perspective to fully appreciate the environmental and public health ramifications embedded across the fossil fuel supply chain. By clarifying population exposure patterns and highlighting stark inequalities, this research lays the foundation for more equitable, science-driven energy policy and sustainable urban planning in the transition towards cleaner energy futures.

As fossil fuel infrastructure continues to intertwine with the fabric of both rural and urban America, studies like this offer an essential lens to uncover hidden environmental injustices, enabling communities, scientists, and policymakers to collaboratively chart pathways to healthier, more equitable energy landscapes.


Subject of Research: Not applicable

Article Title: High populations near fossil fuel energy infrastructure across the supply chain and implications for an equitable energy transition

News Publication Date: 17-Nov-2025

Web References:

  • Environmental Research Letters Article
  • EI3 Database on Harvard Dataverse
  • BU Institute for Global Sustainability
  • SPH Energy and Health Lab

References:

  • Adverse birth outcomes: https://pubmed.ncbi.nlm.nih.gov/34287013/
  • Asthma studies: https://pubmed.ncbi.nlm.nih.gov/32879945/
  • Leukemia research: https://ehp.niehs.nih.gov/doi/10.1289/EHP11092
  • VOC exposure: https://pubmed.ncbi.nlm.nih.gov/36185588/
  • Environmental injustice review: https://pmc.ncbi.nlm.nih.gov/articles/PMC10568515/

Keywords: Fossil fuel infrastructure, environmental justice, population exposure, energy supply chain, health impacts, volatile organic compounds, air pollution, urban exposure, environmental equity, data integration, energy transition, public health

Tags: assessing fossil fuel production impactsBoston University study on fossil fuelscomprehensive fossil fuel supply chain analysiselevated health risks from fossil fuelsenvironmental research on energy impactsexposure to environmental stressorsfossil fuel infrastructure health risksinfrastructure and public health intersectionpopulation proximity to energy infrastructurestorage terminals and community riskstransportation pipelines and health effectsunderstanding fossil fuel exposure demographics
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