Gold with grief: Exploring the evolving health perceptions and psychosocial lived experiences of galamsey deaths in northern Ghana

Illegal small-scale gold mining (Galamsey) remains a dominant livelihood source for Ghanaian youth from rural areas with limited economic opportunities. While most of northern Ghana lacks mining activity, it has served as a source of labor for mining sites in southern Ghana, following colonial legacies. Many young men migrate from the north to the south to take on hazardous roles, particularly underground blasting at galamsey sites. Anecdotal data suggest an increased rate of mortality among youth engaged in these mining roles. Yet, limited studies have explored the downstream psychosocial and health impacts on migrant-sending communities. This study employed a qualitative research approach to explore the evolving health perceptions and psychosocial lived experiences of families (n = 36) who have lost relatives to galamsey -related respiratory illnesses and complications. Thematic analysis, guided by the Health Belief Model, helped examine how perceptions of causation, susceptibility, and risk evolved over time in contexts of poverty and limited institutional support. Four key themes emerged: initial spiritual interpretations of death; a gradual shift toward biomedical explanations; economic dependency as a barrier to preventive action; and an emerging demand for health education, emotional support, and alternative livelihoods. Despite increased awareness of mining-related risks, families remain trapped in cycles of loss and poverty, often sending new members to replace the deceased. This study expands prevailing understandings of the human costs of informal extraction and contributes to international debates on informal labor, occupational risk, and extractive economies.