Now the effects of climate change are manifested more clearly than on human health. Although many people view climate change as an imminent threat, the health problems derived from it already kill millions of people each year.1 It is well established that rising levels of greenhouse gas emissions, which cause climate change, also cause or exacerbate myriad health problems associated with air pollution, severe weather, wildfires, extreme temperatures, changes in the ecology of vectors and alterations in the food supply, among others. other stressors. Furthermore, these health threats are not uniformly distributed or experienced across geographies or populations: they disproportionately affect the most vulnerable and disadvantaged groups. The climate crisis is thus a public health and equity crisis that, in the absence of concerted action, will continue to pose significant threats to human health.
The Biden administration is committed to focusing on environmental justice to help address these disparities. We believe that those of us who are privileged to serve in healthcare also have an obligation to address this great threat. Specifically, we can mobilize to reduce our own carbon footprint and take actions to improve the resilience and adaptability of our system to climate change.
The US healthcare sector is responsible for approximately 8.5% of national carbon emissions. These emissions come directly from healthcare facility operations (Scope 1) and indirectly from purchased sources of energy, heating and cooling (Scope 2) and the supply chain of healthcare goods and services (Scope 3) . Between 2010 and 2018, greenhouse gas emissions from our sector increased by 6%, reaching 1,692 kg per capita, the highest rate among industrialized countries.2 In fact, the US healthcare sector accounts for 25% of global healthcare emissions, the highest proportion attributable to the healthcare sector of any individual country.
Improving the sector’s environmental effects and reducing greenhouse gas emissions could not only improve everyone’s health, but also reduce the costs of care. The World Health Organization estimates that the costs of direct climate change damage to health (not including the costs of damage mediated by effects on agriculture, water and sanitation) will reach $ 2 billion to $ 4 billion million per year by 2030.3 Additionally, climate change is affecting our ability to provide safe, effective and efficient care. Extreme weather and other weather-sensitive events lead to hospital evacuations, power outages, infrastructure damage, shortages of medical products and supplies, and other disruptions. This strain on the system worsens the quality of care and patient outcomes, and exacerbates existing inequities in health care.
Dramatically reducing the carbon footprint of the healthcare ecosystem would have immense health, social and economic benefits. Although there is growing momentum in this direction, much more must be done to urgently activate all parts of the sector for decarbonisation. Progress in four areas will be essential to decarbonize and respond to climate change: the healthcare supply chain, healthcare delivery, healthcare professional education, and policies, financing and metrics.
The US healthcare supply chain is a complex global system that encompasses the production, transportation, use, and disposal of goods and services. Because it is responsible for approximately 80% of the sector’s carbon footprint,1 Addressing its carbon emissions is critical to decarbonizing the sector. Some companies in the biopharmaceutical, biotechnology and medical device industries are expanding their environmental, social and corporate governance initiatives with the goal of reducing emissions and waste. Accelerating your progress will require rapid innovation to create more sustainable products, packaging, and distribution methods; incentive systems that encourage such innovation; and more consistent and transparent reporting structures and emissions metrics.
Health service delivery is the second main area of opportunity for decarbonization. Although some U.S. hospitals and health systems are leading environmental initiatives to reduce their carbon footprint, we need commitment and system-wide change to reduce emissions from national hospitals to more sustainable levels. Such a change will require a clearer business case to support decarbonization, along with financial and payment incentives and greater consistency in the measurement and reporting of emissions.
Additionally, educating healthcare professionals more thoroughly about the effects of climate change could lead to more sustainable clinical practices and better patient outcomes. In particular, physicians and healthcare administrators will be better positioned to “green” their practices, counseling patients with climate-sensitive health conditions, caring for people experiencing weather-related health effects, and mitigating disruptions in health. care during extreme weather events and disasters. Doctors are well positioned to communicate the importance of the health effects of climate change. However, most doctors have been taught little about the links between climate change and health; Few health professional education programs include curricula in this area, and those that do tend to make participation voluntary.
Finally, and fundamentally, substantial progress will require equity-driven policies and supportive funding, as well as common metrics. Decarbonizing the U.S. supply chain will require policies and incentives that support sustainable innovation, and delivering health care that is environmentally friendly and resilient will require rethinking how we prevent disease, provide and pay for care, and educate. to our doctors. Transparency and accountability in this process will be paramount, so we must develop standardized sets of sustainability metrics with clear expectations for reporting.
Given the urgency of this effort, the National Academy of Medicine (NAM) is launching, and we are co-chairing, a collaborative action to decarbonize the U.S. healthcare sector.This public-private partnership of federal government leaders, industries biomedical and pharmaceutical, hospital systems, private payers and the health professions aims to develop and implement a shared action plan to decarbonize the health sector and strengthen its sustainability and resilience.
The collaboration will focus its decarbonization efforts in four areas. We will seek to work with industry to reduce scope 3 emissions, as well as facilitate coordination with the federal government to better accelerate and enable low-carbon innovations. To accelerate the delivery and practice of climate-sensitive healthcare, beyond highlighting direct mechanisms to reduce scope 1 and scope 2 emissions, the collaboration will identify opportunities to link performance on sustainability metrics with payment and value-based reimbursement and to expand health professional curricula and curricula. climate change programming. Finally, we will develop sustainability metrics and indicators for industry and healthcare systems, along with shared plans for public reporting.
The health impacts of climate change are real and happening today, and the US healthcare sector faces immense opportunities for leadership and action. As a critical first step, the collaboration will leverage NAM’s independence and authority to mobilize the industry to set shared goals for decarbonization and commit to equitable and sustainable transformation. We hope that by highlighting the effects of climate change on human health and the capacities of public-private collaboration, collaborative efforts will reverberate beyond the health sector and mobilize other sectors to take action against climate change to achieve the broader systemic transformation that is needed. The time for leadership, commitment and action is now: our health and the future are at stake.