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The report finds that private equity-backed fossil fuel facilities in the U.S. cause between $11.3 and $15.1 billion in annual human health damages, resulting in nearly 1,000 premature deaths and 1,500 emergency room visits per year. A small group of firms, specifically ArcLight, Energy Capital Partners, and Quantum Capital, are responsible for approximately 20% of these impacts. The General J.M. Gavin coal plant in Ohio is identified as the single most harmful facility, accounting for roughly 19% of all health impacts in the study. Regional analysis highlights disproportionate burdens in the Mid-Atlantic/New England area and the Permian Basin, with Texas ranking first in asthma onset and symptoms due to its large population and proximity to extraction sites.