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Medical Team

Fossil Free for Health: Policy Action Agenda

A Call for Action

As individuals and organizations, we represent US health professionals, health workers, health organizations and systems, and health education institutions working on public health, environmental health, mental health, and health care. We have dedicated our lives to
improving and protecting health, and we believe that all people have the right to a healthy environment and a stable climate, now and in the future. Climate change and fossil fuel pollution have created a public health crisis that is already affecting our patients and
communities, with much worse to come.

Air pollution from fossil fuel combustion kills an estimated 5 to 8.7 million people globally each year, including 350,000 premature deaths in the US. Fossil fuel pollution is associated with respiratory disease, heart disease and strokes, lung and other cancers, effects on brain function and children’s ability to learn, childhood asthma, and premature births and low birth weight. In addition to their direct harm, fossil fuels are the primary cause of climate change, the greatest threat to human health in the 21st century. As the dominant contributor to global climate change, fossil fuels account for more than 75 percent of greenhouse gas emissions. Climate change causes extreme heat events, storms, flooding, droughts, and wildfires, resulting in deaths, injuries, and a myriad of serious illnesses including heart, lung, and kidney disease, vector and water-borne illnesses, harm to pregnant people and babies, mental health impacts in youth and adults, and forced displacement, shortages of food and water, and related exacerbation of war and conflict. While threatening people broadly, fossil fuel pollution and climate change disproportionately harm certain groups due to historical and ongoing structural inequalities, economic injustice, and racism: people with low incomes, communities of color, Indigenous people and tribal communities, immigrants, communities heavily burdened by pollution, unsheltered people, and fossil fuel and outdoor workers. Children, pregnant people, older adults, and people with disabilities and chronic illnesses are also at high risk of harms from climate change. The good news is that we have an unprecedented opportunity to reap immediate and ongoing health and equity benefits and save countless lives, by moving as rapidly as possible away from dirty, polluting fossil fuels to pollution-free, renewable energy. Limiting fossil fuel combustion could save roughly 1.4 million lives over the next 20 years from improved air quality, with estimated health benefits in the trillions of dollars this century. To realize these benefits, we must accelerate our investments in healthy, non-combustion energy, restrict extraction and use of fossil fuels, and support the health of people and communities in this transition. The faster we act, the better off humanity will be. The fossil fuel industry is actively working to block progress on each of these fronts. To move forward with necessary speed, it is essential that we take policy actions to limit the power and influence of the fossil fuel industry, as was done with the tobacco industry.

We call for immediate and comprehensive action to protect people from fossil fuels by every elected official and policymaker at every level of government, working with communities, non-profit organizations, the health sector, and businesses, adopting and implementing the policies in this US Fossil Free for Health Policy Action Agenda.

Explore the Policy Agenda By Topic

  1. Counter Fossil Fuel Industry Disinformation and Tell the Truth about the Harms of Fossil Fuels. 

Public health campaigns such as the tobacco control campaign demonstrated the power of counter-marketing and media advocacy in effectively eroding public approval of health-harming industries. These proven public health strategies will proactively counter fossil fuel industry disinformation, building demand for health action. 


Key policies include:

  1. Fund, develop, and implement a large-scale coordinated public health counter-marketing and media advocacy campaign. 

  2. Issue a Surgeon General’s public advisory on the health harms of fossil fuels.

  3. Enforce and expand rules on misleading fossil fuel industry advertising.

  4. Provide health warning labels on gas stoves and other consumer products that expose people to pollution from methane gas and nitrogen oxides.

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Tell the Truth

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Tell the Truth

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Tell the truth about fossil fuels, make polluters pay, and hold the fossil fuel industry accountable for its inequitable harms

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Stop Making the Problem Worse

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Stop making the problem worse and accelerate a just transition to an equitable pollution-free, renewable energy economy

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Protect People

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Protect people and advance healthy, equitable, resilient communities

We call on local, state, and national leaders to act now to stop fossil fuel pollution and accelerating climate harms, for the health of today’s communities, our children, and future generations. The Fossil Free for Health policy agenda provides a roadmap to protect and promote health in the face of the interconnected fossil fuel and climate health crises:

2. Make Polluters Pay: Hold fossil fuel companies accountable for the health harms caused by their products. 

Fossil fuel companies should pay the immense costs of the health, environmental, and climate harms caused by fossil fuel pollution and climate change, costs that are now borne by households, government, and businesses. Holding fossil fuel companies accountable will provide financial resources for climate adaptation, pollution harms, and renewable energy investments. 


Key policies include:

  1. Require the parties responsible for pollution to pay for the full remediation of environmental and health harms from all stages of the coal, oil, and gas chain, including pollution from operating, abandoned, and orphaned infrastructure.

  2. Require fossil fuel corporations to pay into a US climate fund to support climate mitigation, resilience, and emergency response efforts, especially in environmental justice communities.

  3. Ensure that the US meets its pledges to the Green Climate Fund to enable developing nations to accelerate the energy transition and build climate resilience.

  4. Incorporate the full cost of health and environmental harms from fossil fuels, plastic and petrochemical products, and climate change into the social cost of carbon, used to quantify the benefits and costs of climate policies.

  5. Use litigation to hold fossil fuel companies accountable by bringing public lawsuits on behalf of governments at all levels and supporting legal efforts to hold the fossil fuel industry accountable for the costs to the public for its health, environmental, and climate damages.

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Stop Making the Problem Worse


3. Prohibit New and Expanded Fossil Fuel Infrastructure to Stop Making the Problem Worse. 

The Intergovernmental Panel on Climate Change (IPCC) is clear that new fossil fuel infrastructure is incompatible with limiting global warming to 1.5℃, the “danger line” above which the risk of catastrophic impacts increases. Yet plans of the US, governments globally, and fossil fuel companies would by 2030 generate double the amount of fossil fuels consistent with limiting warming to 1.5°C. Avoiding new fossil fuel infrastructure will bring innumerable health and climate benefits. We must stop making the problem worse. 


Key policies include:

  1. Halt new and expanded fossil fuel infrastructure, through policy tools including leasing, permitting, lawsuits, and prohibition and discontinuation of public funding or incentives, including:

    1. Production and related facilities such as oil and gas exploration and drilling; coal mining; pipelines; export terminals; oil and gas fracking and related infrastructure; and petroleum and petrochemical processing and refining facilities; 

    2. Coal, oil, and gas power plants; 

    3. Gas transmission and distribution pipelines; and 

    4. Carbon capture and sequestration (CCS) and related infrastructure (except in the most hard-to-decarbonize industries).

  2. Prohibit new leases for fossil fuel exploration and extraction on public lands and waters.

  3. Establish requirements for all-electric new buildings.

  4. Sign the call for a Fossil Fuel Non-Proliferation Treaty.

4. Equitably Phase Out Fossil Fuel Extraction, Export, Refining, and Use. 

By engaging in a rapid, managed, and people-centered process to phase out the production, refining, and use of fossil fuels, we can reduce air pollution deaths and avert the worst impacts of climate change, centering equity for affected workers and frontline communities, minimizing economic disruption, and optimizing equitable benefits. 


Key policies include:

  1. Develop a national plan for fossil fuel phase out complemented by worker- and community-led planning and engagement processes to set timelines, determine phase-out prioritization, and provide investments and support for communities and workers. 

  2. Decommission and remediate all coal power plants as rapidly as possible, followed by a rapid decommissioning and remediation of other fossil fuel power plants.

  3. Reinstate ban on crude oil exports and phase out other fossil fuel exports, including liquefied natural gas (LNG). 

  4. Rapidly phase out existing fossil fuel extraction, refining, production, and transportation on public lands and waters.

  5. Rapidly phase out sales of fossil fuel vehicles and appliances.

5. Avoid Approaches that Perpetuate the Extraction and Use of Fossil Fuels. 

The fossil fuel industry is investing heavily in strategies to maintain its profits, including false solutions that are costly, unproven, and continue to impose fossil fuel pollution on communities, as well as harmful pivots that maintain a robust market for oil and gas, such as increasing production of fossil-fuel based plastics and petrochemicals. We must focus investment and policy support on approaches that limit oil and gas use and bring climate and health co-benefits. 


Key policies include:

  1. Use governmental policy and investments to prioritize direct greenhouse gas and toxics emissions reductions, rather than false solutions.

  2. End subsidies and support for technologies that prolong the use of fossil fuels, such as carbon capture and sequestration (CCS), and “blue” hydrogen.

  3. Commit to a robust Global Plastics Treaty.

  4. Rapidly phase down the production and use of single-use plastics, including through plastic bag bans and packaging restrictions.

  5. Restrict expansion of plastics production facilities and infrastructure.

  6. Make plastic and petrochemical producers responsible for lifecycle impacts through extended producer responsibility laws.

6. End Public Investments and Tax Breaks for Fossil Fuels. 

US taxpayers pay tens to hundreds of billions per year to subsidize the fossil fuel industry, while the health costs of air pollution and climate change have surged past $800 billion per year. Subsidizing fossil fuels contradicts and undermines our health and climate goals. 


Key policies include:

  1. End tax breaks that support the fossil fuel industry, including for new technologies that enhance or prolong fossil fuel extraction and use.

  2. Support public sector pension fund divestment from the fossil fuel industry.

  3. End policies that enable fossil fuel distributors to levy mandatory fees on customers to fund industry organizations to advocate against the clean energy transition.

7. Accelerate Adoption of Pollution-Free, Renewable Energy. 

Pollution-free, renewable energy has plummeted in cost. We can redirect fossil fuel subsidies from fossil fuels to renewable energy, investing in research and development, planning for grid transformation, and prioritizing equity and frontline communities, moving us rapidly toward the health and health equity benefits of reducing air pollution and lessening the impacts of climate change. 


Key policies include:

  1. Redirect existing fossil fuel subsidies to invest in pollution-free, renewable energy and related storage and infrastructure.

  2. Support adequate financing and planning for the technologies and infrastructure needed to transition away from fossil fuels in the energy sector, including resilient transmission and electrical grid infrastructure, large scale and distributed renewables, microgrids, and battery and other energy storage, with an emphasis on community-owned renewable energy projects.

  3. Establish timelines for implementation of fossil-free public procurement and operations policies, including fossil-free energy and vehicles and electrification of publicly owned buildings. 

  4. Establish or strengthen ambitious binding state and federal standards for pollution-free, renewable electricity aligned with achieving the 1.5℃ goal.

8. Accelerate the Transformation of Transportation and Land Use, Buildings and Housing, Industry, Agriculture, and Other Sectors to Reduce Dependence on Fossil Fuels. 

Actions to reduce fossil fuel pollution will bring immediate health and economic benefits to families and communities, by reducing diseases caused by air and water pollution and increasing access to healthier transportation and housing options. 


Key policies include:

  1. Support transportation pollution reduction through healthy community design, affordable housing, safe and accessible bicycling and walking networks, convenient and affordable public transportation, electric vehicle (EV) adoption, affordable, accessible EV charging facilities, and non-polluting trucks and ships.

  2. Strengthen energy efficiency standards and zero emissions targets across sectors, including for vehicles, appliances, boilers, and other industrial equipment.

  3. Support zero emission new and existing buildings through strong building standards and codes and fully funded energy efficiency and weatherization assistance programs. Fund or incentivize replacement of gas appliances with electric appliances, particularly for retrofitting existing homes and buildings.

  4. Support the transition to sustainable, regenerative agricultural and forestry practices.

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Protect People


9. Protect People from Exposure to Toxic Fossil Fuel Pollution. 

The best way to protect people from fossil fuel pollution is to rapidly phase out the extraction and use of fossil fuels. In the meantime, we must limit exposures to existing fossil fuel pollution and rebuild healthy community environments and rebuild healthy community environments. 


Key policies include:

  1. Reduce exposures to toxic fossil fuel pollution and safety risks across the fossil fuel life cycle, through stricter standards, buffers, and other interventions. 

  2. Prioritize actions to reduce exposures to fossil fuel pollution in pollution-burdened communities and prohibit further exacerbation of cumulative impacts in these communities, particularly those near industry, refining, and ports.

  3. Strengthen requirements for monitoring pollution emissions across the fossil fuel lifecycle. Require pollution monitors on the fence line of major sources of air pollution and ensure public access to monitoring data. Require automatic shutoff devices on indoor gas appliances to prevent dangerous pollution levels. 

  4. Invest in reclamation of land from fossil fuel infrastructure and in restoration and expansion of green space and tree canopy in pollution-burdened communities.

10. Support Workers in the Transition to a Fossil-Free Economy. 

A sustainable and equitable transition to a fossil-free economy requires high quality jobs and inclusive pathways to opportunity and economic mobility for workers who have been left out of today’s economy, while protecting workers from major losses in living standards resulting from the energy transition. 


Key policies include:

  1. Invest in a just transition for workers and communities adversely impacted by job loss related to the phase out of fossil fuel use, including through workforce development and local hiring, community investment, income replacement, and maintenance of pension and health benefits for displaced workers.

  2. Ensure that jobs created in a fossil-free economy pay a living wage and provide family-sustaining benefits and that employers in the new economy comply with labor and environmental laws, including support for collective bargaining rights and unionization.

  3. Provide education, training, and economic opportunities to low-wage workers to ensure family-sustaining jobs in the new energy economy.

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11. Support Community Health, Redress Health and Racial Inequities, and Protect the Most Vulnerable. 

While people in every community experience the health harms of fossil fuel pollution and climate change, the opportunity for improved health is greatest in communities with high pollution and health inequity burdens and limited resources to build healthy communities. 


Key policies include:

  1. Prioritize investments in environmental justice communities through implementation of the Justice 40 initiative and community-directed economic development. 

  2. Invest in community-led climate adaptation and resilience, including protections from disconnections and access to clean air shelters, cooling and heating, and electricity and health care during climate-related extreme events, especially for sensitive groups.

  3. Ensure the costs of transition and of climate change are equitably distributed and prevent imposition of financial burdens of adaptation and mitigation upon low-income households.

  4. Protect communities from experiencing the harms of new systems and technologies through regulation of design and operations; comprehensive health, equity, and cumulative impact assessments; siting restrictions; and strict pollution control and monitoring.

Citations and details are available in the Fossil Free for Health Policy Brief.

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The Signers




Center for Climate Change and Health

Central California Asthma Collaborative

Chesapeake Physicians for Social Responsibility

Climate Code Blue

Climate Equity Policy Center

Climate Health Now

Concerned Health Professionals of New York

Healthy Climate Wisconsin

George Mason University Center for Climate Change Communication

Greater Boston Physicians for Social Responsibility

Maine Physicians for Social Responsibility

Michigan Clinicians for Climate Action

Montana Health Professionals for a Healthy Climate

New York Physicians for Social Responsibility

Oregon Physicians for Social Responsibility

Physicians for Social Responsibility National

San Francisco Bay Physicians for Social Responsibility

Science and Environmental Health Network

Texas Physicians for Social Responsibility

Virginia Clinicians for Climate Action

Utah Physicians for a Healthy Environment

Washington Physicians for Social Responsibility


Organization Logos


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mthphc-logo-color-circle-raster_900x900px - Lori Byron.png
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Abby Novinska-Lois, MPH

Alison Schnick, MD

Alison Siefka

Amanda Millstein, MD 

Ann Turner, MD

Brian Moench, MD

Caren Solomon, MD, MPH

Carol Blenning, MD

Christine Guerrini, MD

Douglas Johnson, MD

Edward Maibach, MPH, PhD

Elizabeth Brown, CPA

Elizabeth DeBuono, MD

Jeffrey Kunkel

Jenny Pompilio, MD, MPH

Jerome Paulson, MD, FAAP

Joel Charles, MD, MPH

Joseph McCabe, MD

Howard Frumkin, MD, MPH

Kathleen Nolan, MD

Larry Junck, MD

Linda Rudolph, MD, MPH

Lisa Doggett, MD, MPH

Lori Byron, MD, MS

Mark Vossler, MD

Marjaneh Moini, MD

Marj Plumb, DrPH

Nadine Winocur, PsyD

Nova Tebbe, MPH, MPA

Patricia Kullberg, MD, MPH

Peter Wilk, MD

Rachel Wormer, MPH

Regna Merritt, PA

Ryan Adams

Robert Gould, MD

Sara Zimmerman, JD

Susan Lendvay

Theodora Tsongas, PhD, MS

Vijai Bhola, MD

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