To Stay Healthy, We're Making Our Planet Sick: The Climate Impact Of Health Care

Someone, somewhere, is using a metered-dose inhaler right now. As they press down on its canister and take a deep breath, the inhaler is emitting a teeny bit of propellant into the air. That propellant, necessary to deliver the life-giving medicine inside, contains hydrofluoroalkane (HFA)—a potent greenhouse gas that contributes to climate change.

This is one small example of a larger issue: The tools we all rely on to stay healthy are making our planet sick. The health care industry is now responsible for around 5% of global greenhouse gas emissions1—and that number is likely closer to 10% in the United States2. If health care sectors in Australia, England, Canada, and the U.S. formed an independent nation, it would be the seventh most polluting3 in the world.

Climate change doesn't just harm the planet; it harms human health. As Shweta Narayan, an India-based environmental health advocate with Healthcare Without Harm, said in her talk at the recent TED Countdown conference, "The climate crisis is a health crisis. It threatens our air, water, food, shelter, security—all of the basics on which human life depends." This makes the high climate impact of health care all the more concerning.

As we treat one person for one disease, we might predispose someone else, worlds away, to another. The fossil fuels burned to create, transport, and administer medical care ultimately end up in our atmosphere as air pollution—which is responsible for 7 million premature deaths a year5, mostly in low- and middle-income countries. They also contribute to a warmer planet and all the threats that come with it: longer and more intense allergy seasons, wider spreads of infectious vector-borne disease6, heat stress, deadly storms7, and the mental distress of a planet in flux.

Clearly, as we're solving problems in the short term, we're creating new ones in the long run. But a growing coalition of environmentalists and health care professionals are saying it doesn't have to be this way.

Doctors are, rightfully so, some of the most trusted and respected professionals in the world. They also have a unique view on climate change, as they're seeing how it affects patients firsthand. This expertise makes them valuable voices to invite to the climate policy table.

If you're wondering why the health care industry is such a heavy emitter in the first place, consider your last visit to the doctor: You probably sat on disposable exam paper, had your temperature taken using an individually wrapped thermometer, and walked away with a prescription to a plastic tube filled mostly with air and some medication.

Sherman explains that 70 to 80% of the health care industry's emissions come from the supply chain, with the top offenders being pharmaceuticals, medical devices, food, inhaled anesthetics, and metered dose inhalers. None of these heavy hitters are incentivized to make their products more sustainable or reusable because, like any other industry, they operate off a consumption-based model: The more products they sell, the more money they make.

Sherman gives single-use medical equipment and arbitrary best-by dates on pharmaceuticals as examples. "A lot of focus is on why so much is single-use disposable," she says. "Obviously, we need to prevent infection; that's fundamental to what we do. But a lot of what has become disposable is not evidence-based, and industries are making it harder and harder to reuse things. Our regulatory policies are supporting industry manufactured obsolescence."

The WHO now considers air pollution one of the biggest threats to human life—so why do we seldom hear about it in the doctor's office? It's largely a matter of causality. It's often impossible to directly attribute a medical condition to pollution or climate change.

Even so, encouraging conversations about climate and health in the checkup room is essential. For starters, Narayan says, they can make people feel more supported by their health professionals. They can also help validate patients' concerns about how their environment is affecting their health.

Another problem happens when health care services are doled out unnecessarily. Sherman notes that "globally, a quarter of care is deemed low-value or inappropriate—meaning it's not needed, it's not wanted, or it's ineffective."

As scary as it is to think about, most experts are predicting that life-threatening weather events will only become more common in the years ahead. This means we'll be relying on doctors, nurses, first responders, and other caregivers even more. To set them up for success, we need to ensure that their infrastructure is resilient.