{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:02:20Z","timestamp":1779951740517,"version":"3.53.1"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Over the last decade, South Africa has prioritized infrastructure development, focusing on an energy transition and resource efficiency as key areas of reform. However, while the country has reported some socio-economic benefits, it continues to deal with significant health issues, which impose a substantial cost in terms of DALYs and quality of life. This study therefore examines the asymmetric effects of access to clean energy, natural resource endowment, and institutional quality on sustainable, healthy living outcomes (DALYs and quality of life) in South Africa. The study also considers the moderating role of institutional quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study employed quantile regression and non-parametric Granger causality in quantiles on quarterly data covering the period from Q1 2000 to Q4 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and discussion<\/jats:title>\n                    <jats:p>The findings suggest that access to clean energy is the most significant factor in reducing DALYs from all causes and improving quality of life, with the greatest benefits realized by population groups with relatively low DALYs. Natural resource endowment has no direct effect on DALYs or quality of life, indicating the difficulty of converting resource riches into welfare advantages. Institutional quality has an important, albeit asymmetric, direct effect. Furthermore, the results confirm the moderating role of institutional quality in reducing DALYs among moderately to highly vulnerable population groups. These findings are corroborated by the robustness tests. They suggest that the South African government and its partners should accelerate the transition to clean energy by increasing investment in clean energy resources and\/or providing incentives and subsidies. They also show the importance of effective institutions to ensure the health and environmental benefits of energy systems and natural resource management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1800799","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:15:30Z","timestamp":1779948930000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Toward sustainable healthy living in South Africa: the asymmetric effects of clean energy, natural resources and institutional quality"],"prefix":"10.3389","volume":"14","author":[{"given":"Paul Terhemba","family":"Iorember","sequence":"first","affiliation":[{"name":"Institute for Social and Health Sciences, University of South Africa","place":["Johannesburg, South Africa"]},{"name":"Violence, Injury and Social Asymmetries Research Unit, South African Medical Research Council and University of South 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