What’s Healthcare’s Role in Combating the Climate Crisis?

Amid the U.N.’s climate summit in Glasgow this week, global leaders have made commitments to slash greenhouse gas emissions in an effort to combat the climate crisis.

Officials have pledged to support a few green initiatives at the COP26 conference, such as ending deforestation by 2030 and phasing out the use of coal power.

But some argue that mobilizing the healthcare sector is a vital measure to fight climate change. Extreme heat, natural disasters, and climate-induced infectious diseases all pose an immense threat to human health — yet, global health systems are responsible for 4.4% of worldwide greenhouse gas emissions.

MedPage Today spoke with Gary Cohen, president and founder of Health Care Without Harm, about healthcare’s unique role in the climate crisis and the organization’s goals for COP26, ahead of the 2021 Conference on Health and Climate Change. The following is an edited transcript of the conversation.

Tell me a bit about how you founded Health Care Without Harm. Why do you believe that the healthcare industry has a responsibility to fight climate change?

Cohen: I’ve been involved in environmental health issues since the mid-1980s. Around the mid-1990s, new science came out that said the way we thought about the health impacts of toxic chemicals was not accurate. At the same time that science was emerging, EPA [the Environmental Protection Agency] reported that medical waste incinerators were the largest source of dioxin emissions in the United States.

The healthcare sector, whose mission is to heal, was contributing a huge amount of pollution, which had links to cancer, birth defects, neurological problems, and so many other health issues. The irony was that the very sector of our economy that had healing as its mission was an enormous polluter.

So basically, myself and others said, how are we ever going to create a healthy society for our families, our children, our communities, if the very sector of our economy that is supposed to be focused on healing is completely ignorant of their environmental health problems?

That was the impetus to start Health Care Without Harm. We thought we needed to bring the latest science around chemicals, climate, food systems, and health to the sector that could actually do something about it, that had this Hippocratic Oath to first do no harm. And to get them to first do no harm, they had to clean up in house.

How do you think healthcare’s role in the fight against climate change has evolved?

Cohen: Dramatically. I mean, it’s been a complete sea change, really.

Ten years ago, we got together with the World Health Organization and said, we’ve got to start bringing the health sector to this climate struggle. And now there is a health program that we developed with the World Health Organization [WHO] and the COP presidency. Our hope is that more than 20 countries will commit to this health program.

That health program commits national governments and their health systems to do two things that are crucial here. One is to design climate resilient health systems, so they can operate in the face of extreme weather events. And then the other is to decarbonize their healthcare system.

I think the narrative around climate when we started in particular was, ‘isn’t that a problem that’s sort of about future generations and something about polar bears and melting ice caps?’ And what we’re seeing now is people recognizing more and more that fundamentally, it’s a health issue. It’s an equity issue, it’s a justice issue, it’s a survival issue.

Extreme weather events associated with the climate crisis are an increasing threat to human health. How do you think healthcare systems should be thinking about climate resiliency?

Cohen: Healthcare infrastructure should anchor resilience within their communities. Understanding supply chains, designing for the climate disasters, that’s a crucial piece of what they need to do to anchor.

They also have to understand the changing burden of disease. What does it mean for a community if it’s 100°F for 2 weeks in a row? Who is the most vulnerable? People who live along diesel truck routes, or in heavily polluted neighborhoods are going to be more affected. Children, communities of color are going to be more affected.

Understanding the vulnerabilities of your community and anchoring your own infrastructure is one of the fundamental goals.

The U.S. healthcare system is responsible for about 10% of our country’s total carbon emissions. How can healthcare reduce its emissions?

Cohen: Well, 75% of it is in the supply chain. The biggest share is in the stuff they buy. So it’s in the petro plastics, in the anesthetic gases, in the food. It’s in single-use devices that get thrown away. It’s in pharmaceuticals.

What if health systems had more proximate supply chains that did not rely on getting products from China, but getting them from within 50 miles or 100 miles from their facilities? We are doing a lot of work around that with food. Health systems buy billions of dollars of food, why not use that money to support a local, healthy food system.

There’s also opportunities in healthcare delivery. Does everybody need to go to a health facility for their visit? We can use telehealth. We don’t need everybody showing up in the emergency room. We can do visits, but not emergency visits, on the phone through diagnostics. There’s a huge amount of opportunity there.

U.S. healthcare is over 25% of global healthcare emissions. So the United States healthcare system has more responsibility than anybody else to decarbonize.

What are Health Care Without Harm’s goals coming out of the COP26 meetings?

Cohen: We’re hopeful that the U.S. government will join this health program that we’ve established with the WHO, and that we can work closely with the government to decarbonize the U.S. healthcare system in ways that support community health and racial equity.

And second is to build a movement inside of the health sector. Mobilizing millions of doctors and nurses and other healthcare workers, we hope to build an army of advocates for global survival. That’s what’s at stake here. And not just in this country, but around the world.

How can individual healthcare workers become involved in the fight against climate change?

Cohen: Doctors and nurses are some of the most trusted professions in any country. So educating, mobilizing, and equipping nurses, doctors, and health systems to use their political clout and their moral suasion to advocate for the acceleration away from fossil fuels, toxic chemicals, and industrial agriculture, that’s a really big goal.