Connecting Climate Change, Public Health and Healthcare Systems

Connecting Climate Change, Public Health and Healthcare Systems

What comes to mind when we are asked to think about the connections between climate change and our health? For many, the first thoughts reflect media stories about the possibilities of infectious diseases now common in tropical countries “moving north” to threaten Europeans and North Americans. But, as with so many initial reactions, reality turns out to be much more complex – and more interesting. On November 17 and 18, I participated in a fascinating conference on “Health, Healthcare and Climate Change” in London, sponsored by the Salzburg Global Seminar and Goodenough College. I came away impressed with the unappreciated richness, complexity and immense importance of the many connections between climate change, sustainability, global public health and national healthcare systems.

First, let’s start with the emissions. Because healthcare constitutes between 5% and 15% of most OECD economies, the emissions for this growing sector are substantial. The electricity demands and transportation driven directly by heathcare systems are large and generally growing, while the indirect emissions from industries such as pharmaceutical companies, medical instruments and equipment, paper products and a host of business services and other procurement areas result in substantial domestic and international emissions for all national healthcare systems. More importantly, like other OECD emissions they amount to dumping risks and damages onto the poorest countries in the world, where climate change impacts are likely to be quite severe and where capacity to deal with them less developed. Furthermore, the negative effects of climate change on the public are not confined to the developing world, as they likely include increased deaths and economic and social costs from extreme heat and other extreme weather events, possible changes in insect, virus and bacteria reproduction rates and geographic distribution, and changes in ecogystems and allergen patterns and frequencies. In fact, substantial attention to climate change issues and their connections to public health is now paid by top medical journals, such as The British Medical Journal and The Lancet.

Certainly, the news is not all bad. Like increased attention to energy use and carbon emissions in various areas of the private sector, greater attention to energy use and the pollution produced by both public and private healthcare organizations and institutions can result in improved energy measurement and efficiency, the reduction of wastes and costs and improved incentives for innovation. The UK’s National Health Service and the Oxford based Centre for Sustainable Healthcare are leading the way, in terms of their attempts to gather and analyze data and case study information about the ways particular aspects of healthcare can simultaneously improve people’s health outcomes and reduced carbon emissions and greater ecological and community sustainability. Programs to facilitate sustainable action planning in medical practices, information based choices for patients and medical professionals and the distribution of best practice knowledge can all result in improved environmental and human health outcomes.

Perhaps the most radical notion under debate is the idea that more healthcare is not always the best answer for patients or the planet. Consuming more healthcare, particularly at the end of our lives, does not always improve our health. As we know, we can consume too much of most things. In other words, we should seek to find the “win-win” policies and institutions for individual health, public health, and the global ecosystem. For example, more exercise and better diets (with more vegetables, less meat and many fewer processed foods) for people in developed countries could improve health and longevity and reduce carbon emissions. In general, recommendations to help reduce obesity and the related diabetes epidemic in OECD countries dovetail nicely with strategies to lower carbon emissions. Better public transport (including more walking and biking), to get people out of thier cars is a likely win for both, as well. Like climate change policy actions, public health policies – and behavioral and attitude change – can and must happen at all levels of social organization, from our homes and workplaces to our national governments and international organizations. Climate change is certainly not “just” an environmental issue about the health of the planet. It is also about the health of humans, rich and poor alike. There is much to be done. It’s time to get busy.

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Comments

Consumption of healthcare

Stacy - the biggest opportunity is captured in your final paragraph. We can do a lot more to reduce the consumption of healthcare interventions that don't improve health. Thanks for writing this blog!

climate change

What a refreshing perspective on climate change discussions--impacts on health and health care utilization are rarely considered beyond the unimaginative "zombie-pocalypse" scenarios of Hollywood. Keep writing, Mr. Vandeveer! Jarrett Barrios