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December 23, 2021

What you can do to cut health care's carbon footprint

Daily Briefing

    Writing for the International Travel & Health Insurance Journal, Lauren Haigh talks to frontline experts about how the health care industry "significantly contributes to environmental damage"—and how the industry can do better.  

    How health systems can fight climate change at the grassroots level

    A moral obligation to 'do no harm'

    According to Haigh, research has found that that "[h]ealth care causes global environmental impacts that, depending on which indicator is considered, range between 1% and 5% of total global impacts, and are more than 5% for some national impacts." But despite how the "health care sector significantly contributes to environmental damage," she questions whether there is sufficient "awareness of this"—and whether enough is being done to address the issue.  

    For instance, in conversation with Haigh, the Australian Healthcare & Hospitals Association's Emma Hoban and Kylie Woolcock pointed out that "'First, do no harm' is considered one of the defining ethical principles underpinning the provision of health care." However, Haigh notes that the "health sector [globally] contributes 4.4% of net global carbon emissions, an amount equivalent to the fifth-largest carbon emitter on the planet."

    Similarly, Jon Utech, senior director of sustainability strategy at Cleveland Clinic, said health care organizations have a "moral imperative to do no harm and prioritize the health and wellbeing of patients and communities"—an imperative that he said extends to taking an active role in addressing climate change.

    "The health of our planet and public health are intrinsically linked, and we know that exposure to environmental pollutants and chemicals of concern harm human health," Utech said. He added that "[t]he health care sector has a significant environmental footprint, and many health care organizations are anchor institutions in their communities. To this end, the health care sector has an important and influential role in modelling and advocating for environmental health."

    How can the health care industry reduce its carbon footprint?

    Beyond the health care industry's own contribution to climate change, experts highlighted for Haigh "the concerning relationship between climate change and human health."

    For instance, Alex Perry, CEO of Bupa UK Insurance, told Haigh that "the impact of climate change on health outcomes is undeniable," citing as examples the relationship between declining air quality and increased rates of respiratory illness and between a warming planet and infectious disease rates.

    As a result, Perry said health care providers and insurers must develop a better understanding of the relationship between human health and planet health so they can "better support their customers, manage related costs and mitigate risks." He added, "We can't undo the damage that has already been done, but we can play our part in making the future healthier for humans and all life on our planet."

    To do so, Haigh cited experts' recommendations on how health care organizations seeking to reduce their carbon footprint can foster innovative solutions, collaborate against climate change, use digital platforms, and learn to recognize the impacts of climate change.

    For instance, Hoban and Woolcock suggested that health systems and services set net zero emission goal along with interim targets that align with the Paris Agreement. "Strategies and plans must then be developed, embedded into core business, and continuously monitored to facilitate collective decarbonization action," they said.

    Separately, Utech urged hospitals to tap into the creativity, expertise, and passion of their caregivers. As an example, Ulrich cited how Cleveland Clinic's "green teams and committees that champion resource efficiency at their facilities and in their functional areas" have—among other accomplishments—generated "significant energy savings" by "implement[ing] air exchange setbacks in our operating rooms" and "promote[d] recycling and waste reduction, water conservation, and the expansion of green space by planting and maintaining gardens on site."

    Perry also highlighted the benefit of using digital technology within an organization. "Innovation is being driven by huge investments in digital technology, which is having a direct impact on carbon footprint." Perry said. "At Bupa, our digital appointments and a digital membership portal have supported our commitment to reduce carbon emissions."

    Ultimately, Hoban and Woodcock told Haigh that "[t]he health care sector must use its trusted position in society to demonstrate innovation and leadership through the creation of a sustainable health care system that respects and protects the environment, while continuing to improve the health and wellbeing of individuals and communities."

    "Although the planet is in a critical condition, it could be argued that never has there been more awareness and understanding about climate change and sustainability, and all of the links across the health care sector are actively advocating for and working towards positive change and a greener tomorrow," Haigh writes. (Haigh, International Travel & Health Insurance Journal, 12/2)

    Advisory Board's take

    The Hippocratic Oath stops at climate change—let's change that.

    By Alex Polyak and Miles Cottier

    When I first started researching the relationship between climate change and health care, I was both surprised and disheartened to see how significantly the sector's emissions impact climate change.

    The global health sector's carbon emissions account for 4.4% of the world's total emissions. As Health Care Without Harm put it, "if the global health sector were a country, it would be the fifth-largest emitter on the planet." Health care is an active enabler of climate change, not merely a passive bystander. And climate change makes people sicker. This means greater usage of health care which at existing emissions rates, means greater emissions and sicker people. That is the cyclical nature of the problem.

    This, for me, goes against the very principles that health care is grounded on. "First, do no harm" are the words spoken by clinicians the world over that form the foundation of modern bioethics. Health care practitioners are bound by this commitment, even at those difficult moments when the only way to honor the oath is through doing nothing. But when it comes to climate change, it is precisely health care's inaction that is causing it to break this golden principle. 

    Health care must break out of the cycle—and soon. In the last year alone, health systems across Germany, BelgiumCanada, and Spain have had to respond to unprecedented natural disasters. Health care organizations need to find ways to reduce emissions and waste, build partnerships that enable both national and community-led sustainability efforts, and develop a culture that incentivizes and encourages sustainability from the ground up. If we don't become part of the solution, inevitably, we will end up as victims to the problem.

    To help assist in your important efforts, review our guidance on how health systems can fight climate change at the grassroots level.

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