• Research and White Papers
  • May 2024
  • 6 minutes

Climate Change Mortality Risk

The impact of climate change on future mortality in South Africa

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In Brief
In this summary analysis, RGA's Chris Falkous assesses the possible impact climate change could have on future mortality in South Africa by 2050, providing a potential template for analyses in other markets. 

To a first-order approximation, the WEF/Oliver Wyman estimates imply that annual average global mortality rates could increase by around 1%. Vulnerability to these climate change risks varies by region, so it can be expected that if the average impact is 1%, some regions will see a significantly higher increase in mortality rates.

Africa is expected to be affected by most of the risks associated with climate change. The WEF analysis points to the vulnerability of middle Africa to floods, southwestern Africa to droughts, and southern and western Africa to heatwaves. 

Given the importance of the insurance market in South Africa, RGA reviewed the academic literature to assess the possible impact climate change could have on future mortality in South Africa by 2050 under the SSP2-4.5 “middle of the road” emissions scenario. This article provides a summary of that analysis.

Industrial smokestacks at dusk
As insurers struggle to assess mortality risks in a warming world, thoughtful analysis is essential. In a new report, RGA focuses on mortality impacts in South Africa and delivers timely insights applicable to all markets.

Summary of physical risk impacts

Table 1 summarizes RGA’s analysis of how, according to current academic literature, the mortality impact of physical risks related to climate change might change by 2050 in a “middle of the road” 1°C warming scenario in South Africa.

The analysis explores a range of climate-related factors, noting only slight increases in mortality risk from several of those factors and a decrease in mortality risk from at least one of them (air pollution from coal power stations – due to a planned transition to renewable energy). For a breakdown of how these figures were derived, view the full report.

For certain other climate-related factors, mortality risk in South Africa is relatively insignificant now and will remain so for the given climate change scenario. For example, consider this statistic as is relates to risks from storm surges and sea level rise: A 2010 assessment estimated that only around 0.16% of the population of South Africa (roughly 100,000 people), live within 5m of sea level.2 Contrast that with around 30% of the population of Florida in the United States (around 7.4 million people) living at less than 2m of sea level.3

Unfortunately, the lack of sufficient research prevents quantification of the potential change for the two risks with the largest estimated current population impact:

  • Sources of air pollution other than coal power stations and wildfires, which might be expected to reduce annual population deaths through general efforts to improve air quality

  • Food insecurity, which might be expected to increase annual population deaths through diminished crop yields due to increasing temperatures, droughts, floods, and storms
Based on around 500,000 annual population deaths currently experienced in South Africa, physical risks associated with climate change under this scenario would account for fewer than an additional 2,000 annual population deaths.

However, this does not capture anticipated population growth over the period to 2050 and, except for the impact on average temperatures, the anticipated aging of the population.

On the positive side, risks associated with the transition to a lower carbon economy have the potential to improve health:

  • According to Hamilton et al, sustainable food and agriculture policies may, if designed and implemented appropriately, encourage people to eat a calorie-balanced diet that is high in plant-based nutrition and could help prevent an estimated 150 deaths per 100,000 population in South Africa (90,000 for a population of 60 million) in a sustainable pathway scenario (SPS), which is broadly equivalent to the 2015 Paris agreement. 

  • Sustainable travel and transport policies may encourage people to walk or cycle instead of using their cars and may help prevent an estimated 30 deaths per 100,000 population in South Africa (18,000 for a population of 60 million) in an SPS scenario.

Market Survey: How do insurers view climate change risk?

RGA conducted an online survey over three weeks from January to February 2024 in the South Africa market. The survey sought to gauge life and health insurers’ current level of concern and strategic priorities around the emerging risks related to climate change. A total of 20 respondents provided answers with representation from 17 companies. Key takeaways include:

  • Life and health insurers in South Africa predominantly viewed climate change as a “moderate risk” (65%); while 15% rated it as a “high risk.”

  • Insurers have a mixed view on the level of priority to place on climate change: 55% rating it as a “low” or “no priority”; 45% rating it as a “moderate” or “high” priority.

  • 55% of respondents believe that climate change will have a material impact on their business in the next 5-10 years.

  • 58% of respondents either have implemented or plan to implement a sustainability program to manage the risks and opportunities from climate change.

  • 50% of respondents believe that environmentally conscious consumers will be willing to pay more for “green insurance products.”

View the full survey report.

Caveats and other considerations

Climate science has improved markedly over recent decades, but significant uncertainty remains. That said, even doubling or tripling the impacts of each risk to account for uncertainty would still lead to a relatively modest overall physical impact in South Africa in the given scenario. It is important to acknowledge, however, that considerations outside of the scope this paper could also play a significant role:

Future impact on mortality

This analysis focuses on the direct mortality impacts of physical risks, but these physical risks could cause new onset morbidity that may lead to negative mortality impacts further into the future. 

Severe weather

Severe weather events that do not have a significant direct mortality impact can still have significant negative economic impacts and severely damage infrastructure, both of which could lead to negative health consequences and, ultimately, higher mortality.

Migration from other countries

Other countries in southern Africa may see greater impacts, which may lead to inward migration into South Africa that could put strain on public services such as healthcare. 

Interactions between risk

This analysis considered each physical risk in isolation, but the reality is more complex and interactions between risks increase uncertainty. There is also the risk of reaching climate tipping points, which could lead to a self-reinforcing cycle of increased greenhouse gas emissions and warming. 

Animal interactions

Some of the actions that have led to climate change, such as deforestation, bring humans and animals closer into contact, which increases the risk of zoonotic disease transmission and increases the risk of future pandemics. 


This analysis set out to review the academic literature to assess the possible impact climate change could have on future mortality in South Africa by 2050 under the SSP2-4.5 “middle of the road” emissions scenario. Over longer periods and in higher emissions scenarios, the mortality impact could be greater.

For those physical risks where the change could be estimated, the overall impact was relatively modest, with annual population deaths potentially increasing by less than 0.4%. In addition, this impact would be reduced by adaptation measures taken to mitigate the mortality impact of these physical risks. This potentially surprising result may be counter to expectations of a more significant impact, although we need to recognize the uncertainties involved.  

The modest negative mortality impact from physical risks in South Africa outlined here does not absolve society from taking action – both in South Africa and globally – to limit greenhouse gas emissions and future climate change impacts.

Climate change remains a significant risk factor and a priority issue that must be addressed through collective action at the government, corporate, and individual levels. The insurance industry has an opportunity to play a leadership role in combating the climate crisis by promoting awareness, providing education, and inspiring, motivating, and incentivizing populations to modify behaviors in ways that will benefit their own health and the planet’s health.

RGA has made all reasonable efforts to ensure that the information provided in this publication is accurate at the time of inclusion and accepts no liability for any inaccuracies or omissions.


A woman in a red shirt leads a brainstorm
RGA's white paper and market survey report on climate change in South Africa are part of an ongoing commitment to helping insurers assess emerging risks. RGA experts combine global perspective with local knowledge to deliver actionable insights.

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Meet the Authors & Experts

Chris Falkous
Chris Falkous
Vice President, Senior Biometric Insights Actuary, Global Biometric Research


Note: This list contains all references used for the creation of the white paper, “The Impact of Climate Change on Future Mortality in South Africa,” which served as the source for all content contained in this article. 

  • Achebak et al (2018), Heat-related mortality trends under recent climate warming in Spain: A 36-year observational study, PLoS Med, 2018
  • Allison et al (2022), Projections of 21st century sea level rise for the coast of South Africa, Environmental Research Communications
  • Chen et al (2021), Mortality risk attributable to wildfire-related PM2.5 pollution: a global time series study in 749 locations, Lancet Planetary Health, 2021
  • Chen et al (2024), Impact of population aging on future temperature-related mortality at different global warming levels, Nature Communications, 2024
  • Colon-Gonzalez et al (2021), Projecting the risk of mosquito-borne diseases in a warmer and more populated world: a multi-model, multi-scenario intercomparison modelling study, Lancet Planet Health 2021
  • Gasparrini et al (2017), Projections of temperature-related excess mortality under climate change scenarios, Lancet Planetary Health, 2017
  • Hamilton, et al (2021), The public health implications of the Paris Agreement: a modelling study, Lancet Planetary Health, 2021
  • Holland (2017), Health impacts of coal fired power plants in South Africa
  • Ma et al (2024), Food insecurity and premature mortality and life expectancy in the US, JAMA Intern Med
  • Mbokodo et al (2023), Heatwave Variability and Structure in South Africa during Summer Drought, Climate, 2023
  • Mordecai et al (2020), Climate change could shift disease burden from malaria to arboviruses in Africa, Lancet Planetary Health, 2020
  • Myllyvirta and Kelly (2023), Health impacts of delaying coal power plant decommissioning in South Africa
  • Pascale et al (2020), Increasing risk of another Cape Town “Day Zero” drought in the 21st century, PNAS
  • Powis et al (2023), Observational and model evidence together support wide-spread exposure to noncompensable heat under continued global warming, Sci. Adv
  • Salvador et al (2020)1, Quantification of the effects of drought on daily mortality in Spain at different timescales at regional and national levels: a meta-analysis, International Journal of Environmental Research and Public Health, 2020
  • Salvador et al (2020)2, Short-term effects of drought on daily mortality in Spain from 2000 to 2009, Environmental Research, 2020
  • Scovronick et al (2018), The association between ambient temperature and mortality in South Africa: A time-series analysis, Environmental Research, 2018
  • Strydom and Savage (2016), A spatio-temporal analysis of fires in South Africa, South African Journal of Science
  • Trancoso et al (2024), Significantly wetter or drier future conditions for one to two thirds of the world’s population, Nature Communications, 2024
  • World Economic Forum, Quantifying the impact of climate change on human health, 2024
  • Yang et al (2023), Mortality risks associated with floods in 761 communities worldwide: time series study, BMJ