19 January 2022
Climate change and health conditions are inextricably linked. Worsening air pollution and extreme heat increase the risk of non-communicable diseases (NCDs), such as respiratory and cardiovascular disease. Paradoxically, the health systems treating us for those diseases are strong contributors to greenhouse gases, which further facilitate climate change.
In a bid to limit global warming to 1.5°C (as described in the Paris Agreement) and move towards net-zero emissions, COP26 saw countries strengthen their emission-cutting targets with several new pledges. In response to growing evidence for the impact of climate change on health, countries have begun to prioritise cutting emissions from the health sector, with 50 pledging to develop climate-resilient and low-carbon health systems. It appears that governments are beginning to realise the link between protecting global health and tackling climate change.
Air pollution has been linked to myriad conditions, including asthma and heart disease. In 2015, an estimated nine million premature deaths globally were attributed to diseases caused by air pollution – three times the number of deaths from AIDS, tuberculosis and malaria combined. Long-term exposure to air pollutants has also been associated with depression.
Vulnerable people, such as children, older adults and those with underlying medical conditions, may be particularly susceptible to the effects of climate change. In 2020, nine-year-old Ella Adoo-Kissi-Debrah became the first person in the UK to have air pollution listed as a cause of death, following a severe asthma attack in 2013. At the inquest into her death, a coroner stated that the nitrogen dioxide levels where she lived – only 25 metres from London’s South Circular Road – exceeded guidelines from both the World Health Organization and the European Union.
In 2015, an estimated nine million premature deaths globally were attributed to diseases caused by air pollution – three times the number of deaths from AIDS, tuberculosis and malaria combined.
The healthcare sector is responsible for almost 5% of global greenhouse gas emissions, and has a carbon footprint equivalent to 514 coal-fired power plants. If the sector were a country, it would be the fifth largest polluter on Earth. Under a ‘business as usual’ scenario, emissions from healthcare could triple between now and 2050.
Health systems contribute to climate change primarily through greenhouse gas emissions. These fall largely under three categories: scope 1, which are emissions under direct control of the healthcare facility (such as fleet vehicles); scope 2, derived from electricity purchased by the facility; and scope 3, the majority (71%), comprising all other indirect emissions, such as those from supply chains. Emissions from supply chains include the production, transport and disposal of medications, food, medical devices and hospital equipment.
As the burden of disease increases, more pressure will be placed on health systems worldwide to provide a greater number of hospital stays and medical appointments. Increasing demand and inefficiencies (such as overprescribing, preventable medical errors and delivery of low-value care) will further increase emissions from health systems.
If the healthcare sector were a country, it would be the fifth largest polluter on Earth.
In 2020, NHS England became the world’s first national health service to announce a plan to become a net-zero health system. This means striving for ‘net zero’ greenhouse gas emissions when accounting for all contributions and offsetting. The following year, all four UK health services committed to this change at COP26. Plans aim to decarbonise care in a number of ways, including construction of net-zero hospitals, adding zero-emission vehicles to the NHS’s fleet, installing LED light bulbs, and optimising the location of care (e.g. moving care closer to home, reducing hospital visits and travel emissions).
If emissions continue to rise, climate change and poor health will follow. Reducing the carbon footprint of health systems will not only contribute to efforts to mitigate climate change, but also protect and improve the health of people the world over.
This is the first in a series of HPP blogs around healthcare and climate change – so keep an eye on our news & blog page for further instalments on this topic.
