Healthcare Sector Major Contributor to Global Climate Crisis: Study

Neha Pathak, MD

September 11, 2019

If the global healthcare sector were a country, it would be the fifth largest greenhouse gas emitter on the planet, a new international report shows.

This is one of the major findings from the 48-page report by the nongovernmental organization Health Care Without Harm in collaboration with technical advisor Arup.

According to the study, healthcare's climate footprint accounts for 4.4% of health-harming global emissions.

This is the first comprehensive global assessment of healthcare's climate footprint and serves as a baseline to monitor the trajectory of emissions from the healthcare sector, according to a release from the group. 

The report is unique also because it looks at the entire healthcare sector, in every country with available data, and accounts for greenhouse gases besides CO2, including methane and nitrous oxide.

The authors looked at global healthcare sector emissions, from healthcare facilities themselves all the way to global supply chains, to help identify and target key areas to reduce future emissions. In total, the authors obtained climate footprint estimates for 43 countries using detailed information from the World Input-Output Database.

The report shows that 71% of the health sector's climate footprint is attributable to the supply chain, which includes the production, packaging, transportation, and disposal of goods like pharmaceuticals, medical devices, food, and hospital equipment.

Not surprisingly, energy and fossil fuel combustion made up a key piece of the sector's climate footprint. The authors note that that would be the equivalent of the yearly greenhouse gas emissions from 514 coal-fired power plants.

The health systems and related supply chains for the United States, China, and the European Union are the largest emitters, accounting for more than half of the health sector's worldwide emissions, at 56% of the global health sector climate footprint.

This study is just the start, though, explains Josh Karliner, international director of Program and Strategy for Health Care Without Harm and one of the authors of the report.

"Our goal as an organization is to help move hospitals, and the health sector in general, toward a 'climate smart' future where healthcare is not contributing to the problem, but is part of the solution," he told Medscape Medical News.

Healthcare's Role

Gary Cohen, founder of Health Care Without Harm, stressed in a prepared statement for Medscape Medical News that the healthcare sector needs to "heal itself from its reliance on fossil fuels and toxic chemicals as part of its mission to 'first, do no harm.' "

There is abundant research  showing the interplay between climate change, pollution, and poor health and mortality. Air pollution from fossil fuel combustion plays a role in millions of deaths worldwide, in addition to the health-related costs for caring for more people with asthma, heart disease, and cancers. Just recently, 74 medical and public health groups were compelled to put out a statement labeling climate change a public health emergency in the United States.

But beyond harming human health, fossil fuel combustion propagates further climate change. That  puts health professionals on the front lines fighting the health repercussions on a daily basis.

From wildfires, to hurricanes, to the spread of infectious diseases in new regions, Jerry Paulson, professor emeritus, George Washington University, told Medscape Medical News in a statement that "clinicians are already seeing the impacts of climate change on the health of their patients."

Paulson, not affiliated with Health Care without Harm, believes that clinicians should be "using that information, [and] should work with their hospitals and clinics to create climate smart strategies to reduce the carbon footprint."

Taking the Lead

Under  the multinational Paris Agreement — from which President Donald J. Trump announced intentions to withdraw the United States in 2017 — every signatory country proposed a path to curtailing its greenhouse gas emissions by 2030.

But data from the independent Climate Action Tracker shows that only a few nations are on track to meet their goals, including the European Union, China, and India, though these governments still have room to substantially increase their emissions goals to meet the spirit of the climate agreement.

According to the study authors, at 10% of the world's gross domestic product, the global health sector is uniquely positioned to use its scale and purchasing power to make a significant impact on the supply chain by choosing what it buys. If the sector looks at procurement and new building construction through a climate impact and sustainability lens, Karliner believes the impact on emissions could be felt more broadly than in just the healthcare sector.

The report ends with a call for the healthcare sector to align with goals of the Paris Agreement and achieve net zero greenhouse gas emissions before 2050. The authors recommend that the global healthcare sector invest in renewable energy and move away from fossil fuels to create facilities that are more resilient to climate change while at the same time protecting the health of millions of people.

The report emphasizes that a global roadmap for "climate smart" healthcare is essential, with the healthcare sector working in conjunction with banks, governments, and investors to decarbonize and build resilient health systems that can improve health outcomes.

Jessica Wolff, US director of Climate and Health for Health Care Without Harm and Practice Greenhealth told Medscape Medical News that she believes we can build on the success of programs like the Health Care Climate Challenge supported by her groups.

Through this initiative, she said, thousands of hospitals are already engaged in greenhouse gas reduction goals though investments in renewable energy, energy efficiency upgrades, transportation initiatives for healthcare staff, and use of less potent anesthetic gases, to name a few interventions.

Wolff said that one third of US hospital systems are engaged with the Health Care Without Harm network, and hundreds of other hospital networks are engaged throughout the globe. She has hope that the "health sector takes its place as primary messengers and motivators to not only shift the sector but to shift society."

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