Imma Perfetto
Cosmos science journalist
A public health physician and planetary health expert says that healthcare workers now have a “duty of care to both their patients and the planet”.
“We have to change our mindset in healthcare, because climate change is harming health,” says Professor Tony Capon, director of the Monash Sustainable Development Institute in Australia, whose work has focused on population health and the connection between health and the environment.
“It’s actually part of the responsibility of healthcare workers, not only to think about the patient who they are providing care for, but the broader context of the care they’re providing.”
Capon suggests that achieving these ambitions will require a change of clinical culture and mindset.
“This is a shift in thinking for people, and it will take time. There’s no doubt about that.
“It’s the young professionals who are super concerned about these issues, and they’re really pushing hard inside the system to help us get the attention that’s needed.”
“We’re talking about, not only, doctors, nurses, others in health systems, but also engineers, lawyers, teachers, no matter who we are, if we’re a plumber or an electrician or a builder, we all have to think differently about our responsibilities in our working lives.”
Capon spoke to Cosmos ahead of an expert talk on driving a more environmentally conscious future for health and medical research at the Annual Meeting of the Australian Academy of Health and Medical Sciences, to be held today in Adelaide.
He argues that, in the face of accelerating climate change and environmental decline, urgent and transformative action is needed to lessen the healthcare system’s substantial environmental footprint.
Climate change directly impacts our health
According to Capon, climate change affects health in 3 broad categories: direct, indirect, and flow-on impacts.
The direct health impacts are the most straightforward. They include the effects of extreme weather events like bushfires, floods, cyclones, and heatwaves.
“Health impacts of heat waves are a bit more hidden, but perhaps the most important of those extreme weather events in our country,” he says.
Indirect health impacts of climate change can include the changing distribution and abundance of vectors of disease, such as mosquitoes, and the impacts of climate on the availability, quality, and price of food.
Flow-on impacts sit in the intersection between climate change and other social determinants of health. They may include the mental health impacts from loss of livelihoods due to climate change, such as farmers experiencing prolonged drought and eco-anxiety among young people.
Capon co-authored the first global assessment of the whole environmental footprint of health care in 2020, which, in addition to greenhouse gas emissions, assessed factors such as water scarcity, air pollution, and reactive nitrogen in water. They found that health care causes between 1% and 5% of global environmental impacts and can be responsible more than 5% of some national impacts.
A 2018 study estimates that 7% of Australia’s carbon emissions come from the healthcare system.
“This ranges from carbon emissions from the burning of gas in hospitals, carbon emissions from the energy that is purchased in hospitals, a lot of that still coal-fired in parts of Australia, and importantly, the carbon emissions in the supply chains of healthcare, including pharmaceuticals and medical supplies, which accounts for around half of all the emissions of the healthcare system,” says Capon.
Capon says investment in the prevention of disease and the promotion of health, will reduce the demand for healthcare.
“If people are healthy, then they’re not needing to use hospitals,” he says.
“The second is to reduce what we call low value care, and indeed harmful care, because it’s estimated that about 30% of all the health care that is provided in Australia is low value … and indeed, 10% of healthcare could be harming our patients.
“The third area is to reduce emissions from the higher value care, the care that we absolutely need to provide, and that’s where we have to do things like electrify our hospitals and purchase renewable energy.”
This also includes decarbonising hospital transport and supply chains.
“We have to work with the manufacturers to decarbonise those supply chains, put this into the purchasing agreements for our pharmaceuticals and medical supplies, and make sure that there’s a level playing field so that anybody who is providing those supplies to health care in our country, and indeed around the world, is required to reduce carbon emissions.”
Capon points to the carbon emissions associated with single use plastics and metal wear and the sustainability issues associated with disposing those items. He suggests single use items be used when necessary, rather than being the standard.
“For many more simple medical procedures, using a cloth gown and laundering it and perhaps using it 50 or 100 times is much more sustainable than putting a gown on and throwing it away after one use.” he says.
“If you are reducing waste, you are also going to save money at the same time. So many of the things we need to do will mean we save money that can be reinvested in healthcare.”
Transforming healthcare also requires changing mindsets
“We fully appreciate that healthcare organisations in Australia, and indeed around the world, are under enormous financial pressure,” he says.
“People who work in healthcare are tired, exhausted from the pandemic … but the approach we’re taking is to strive to integrate this into the routine work of healthcare systems.
He suggests integrating carbon accounting into existing financial, safety, and quality systems to make sustainability just another part of the business of healthcare.
There’s been some progress so far in Australia, with the first National Health and Climate Strategy launched last year which outlines priorities for the next 5 years to address the challenges of decarbonisation and building a climate-resilient health system.
The Australian Commission on Safety and Quality in Healthcare has also released a framework of actions that health services can use to ensure their services are improving the safety and quality of care while addressing the health impacts of climate change and healthcare’s contribution to it.
Cosmos is an official media partner of the AAHMS Annual Meeting. You can read other preview articles on digital health transformation and responsible AI integration in healthcare.
