December 14th, 2024

Common Sense Health: Decarbonizing health care

By DR. W. GIFFORD-JONES & DIANA GIFFORD-JONES on March 4, 2022.

Last week we wrote about the environmental disaster of plastics choking the world’s oceans and the consequences for human health through the food chain. This week let’s look through a different lens at another environmental disaster of our own making – the carbon footprint of health care itself.

Here’s something you may not know. If the global health-care sector were a country, it would be the fifth-largest greenhouse gas emitter!

A report from Health Care Without Harm calculated that the environmental impact of health care amounts to 4.4 per cent of global net emissions – the equivalent of 514 coal-fired power plants.

So far, North Americans are among the main culprits. By way of example, the report notes, “The United States health sector, the world’s number one emitter in both absolute and per capita terms, produces 57 times more emissions per person than does India.”

What exactly is causing all these emissions? Primarily, it is the energy consumption of health-care facilities, health-care transportation, and health product manufacturing, use and disposal.

It’s not easy for individuals to have clout with the health-care industry and its complex global supply chains. But there are things everyone can do to share a sense of responsibility.

First and foremost, stay healthy. If you need yet another reason to do it, this is it. Staying healthy means not using health-care products. This will reduce your own contribution to health sector emissions. As it happens, the things that keep people healthy are the same things that protect the environment – e.g., reducing red meat consumption and walking in place of driving.

Second, make use of telehealth. There are times when seeing a doctor in person is an imperative. But telehealth is proving to be a valuable component of the system. It can offer convenience, speed, ease of access, low cost, quality care, safety and a low-carbon footprint. This is one of the great lessons of the pandemic.

Third, advocate for health-care providers to decarbonize and be environmentally responsible. The more people make this an issue, the more the pressure and incentives build for environmental accountability in health care.

Here’s an example. People suffering from respiratory conditions may use metered-dose inhalers (MDIs) that work based on a pressurized propellant in an aerosol chamber. Unfortunately, these propellant gases are up to 3,350 times more potent than carbon dioxide in trapping the sun’s heat! A single inhaler can release as much emissions as a small car driven for 180 miles. A typical patient may use 12 inhalers a year. Dry powder inhalers are a good alternative that can be used by the vast majority of patients.

But here are the big conundrums that need innovative solutions. It’s not just older people who inevitably need more health care – and therein add to the emissions of the sector. It’s those who fall ill too early in life from avoidable problems. Plus, there are many people around the world who desperately need better health care and for whom health-care spending must increase. To offset the impact of these deserving consumers, there’s an urgent need for a global transition to clean, renewable energy.

In addition, instead of learning from the errors of developed countries where people are eating too much meat and not getting enough exercise, developing countries that achieve higher income levels are making the same mistakes. The epidemic of diabetes in North America is now a worldwide pandemic.

Finally, doctors must think differently. The Hippocratic Oath implores “First, do no harm.” It’s time to include the planet, not just the patient, in the thinking.

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