Health care is a major source of carbon emissions

Climate change presents an unprecedented public health emergency and the global health care sector is contributing to the worldwide climate change crisis in a big way, researchers argue

“The health care industry is responsible for responding to many of the most dangerous effects of pollution and climate change, and yet it is a significant source of greenhouse gases and other deadly environmental emissions itself,” says Jodi Sherman, an associate professor of anesthesiology at the Yale University School of Medicine who is also an associate professor of epidemiology in environmental health sciences at the School of Public Health.

“We must act to reduce waste and prevent pollution—work that is crucial to protecting public health and improving patient safety, which is at the heart of everything we do. ”

A plan to cut health care emissions

In a new commentary, Sherman and her coauthors—Andrea MacNeill of the University of British Columbia and Cassandra Thiel of New York University—lay out a multi-faceted approach to incorporate environmental sustainability into value assessments in health care, which includes quality, safety, and costs.

Their “green print” plan to improve sustainability would engage clinicians and hospital administrators, regulatory bodies, policymakers, and health care-related industries in minimizing the health care sector’s environmental impact.

The US health care system contributes 10% of the nation’s carbon emissions and 9% of harmful non-greenhouse air pollutants. (Air pollution was associated with an estimated 9 million premature deaths worldwide in 2015 or 16% of all deaths.) Its rate of greenhouse gas emissions increased 30% between 2006 and 2016, Sherman says.

The health care sectors of the United States, Australia, Canada, and England combined emit an estimated 748 million metric tons of greenhouse gases each year, an output greater than the carbon emissions of all but six nations worldwide, Sherman notes.

Sherman and her coauthors advocate applying the principles and tools of sustainability science—a multi-disciplinary field that addresses complex problems threatening the Earth’s systems—to the health care sector to critically examine how the current provision of health care depletes natural resources and produces toxic emissions that undermine public health.

Focusing on public health

Sherman says that patient safety regulations are frequently made in isolation without considering how they impact health systems and public health. That narrow view must change, she asserts.

“Everything we do must factor in public health considerations,” Sherman says. “Patient care and public health go hand in hand. We can no longer make patient care and regulatory decisions in silos without considering the implications on public health.”

The commentary piece highlights the need for international standards and metrics for measuring the energy and material use and environmental impact of health care facilities and practices. The coauthors urge consideration of the public health effects of pollution health care-related activity causes up and down the supply chain, including natural resource extraction, manufacture and packaging, transportation, utilization, and disposal.

They call on government funding bodies, such as the National Science Foundation, the Agency for Healthcare Research and Quality, and the National Institute for Environmental Health Sciences to create funding mechanisms to support health care sustainability science, and cite the need for policy-relevant research to facilitate innovation.

Sherman and her coauthors suggest establishing a “Global Commission for the Advancement of Sustainability in Healthcare” to stimulate scientific research into health care sustainability and guide policymaking.

The commentary appears in the Journal of the American Medical Association.

Source: Yale University

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