The environmental footprint of health care: a global assessment

Lenzen, Manfred; Malik, Arunima; Li, Mengyu; Fry, Jacob; Weisz, Helga; Pichler, Peter-Paul; Chaves, Leonardo Suveges Moreira; Capon, Anthony; Pencheon, David

doi:10.1016/s2542-5196(20)30121-2

Cited by 434 publications

(336 citation statements)

References 46 publications

(73 reference statements)

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“…For the MRIO-based results, previous work can provide context: an uncertainty analysis done for an earlier version of the UK MRIO model found that total UK consumer greenhouse gas emissions carried a relative SE of approximately 4-6%; previous health-care footprinting analyses found an SD of less than 5% globally and relative SEs of approximately 15% for China and 28% for Australia. 5,6,30 Qualitative sources of uncertainty are elaborated on in the Discussion.…”

Section: Uncertaintymentioning

confidence: 99%

Health care's response to climate change: a carbon footprint assessment of the NHS in England

Tennison¹,

Roschnik²,

Ashby

et al. 2021

The Lancet Planetary Health

413

268

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Background Climate change threatens to undermine the past 50 years of gains in public health. In response, the National Health Service (NHS) in England has been working since 2008 to quantify and reduce its carbon footprint. This Article presents the latest update to its greenhouse gas accounting, identifying interventions for mitigation efforts and describing an approach applicable to other health systems across the world. Methods A hybrid model was used to quantify emissions within Scopes 1, 2, and 3 of the Greenhouse Gas Protocol, as well as patient and visitor travel emissions, from 1990 to 2019. This approach complements the broad coverage of top-down economic modelling with the high accuracy of bottom-up data wherever available. Available data were backcasted or forecasted to cover all years. To enable the identification of measures to reduce carbon emissions, results were disaggregated by organisation type. Findings In 2019, the health service's emissions totalled 25 megatonnes of carbon dioxide equivalent, a reduction of 26% since 1990, and a decrease of 64% in the emissions per inpatient finished admission episode. Of the 2019 footprint, 62% came from the supply chain, 24% from the direct delivery of care, 10% from staff commute and patient and visitor travel, and 4% from private health and care services commissioned by the NHS. Interpretation This work represents the longest and most comprehensive accounting of national health-care emissions globally, and underscores the importance of incorporating bottom-up data to improve the accuracy of top-down modelling and enabling detailed monitoring of progress as health systems act to reduce emissions. Funding Wellcome Trust.

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Section: Uncertaintymentioning

confidence: 99%

Health care's response to climate change: a carbon footprint assessment of the NHS in England

Tennison¹,

Roschnik²,

Ashby

et al. 2021

The Lancet Planetary Health

413

268

View full text Add to dashboard Cite

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“…Health systems are responsible for about 4.4% of the world's greenhouse gas emissions (Health Care Without Harm 2019). Healthcare is also responsible for a broader environmental impact of between 1% and 5% of the total global impact and more than 5% for some national impacts (Lenzen et al 2020). Healthcare thus contributes to illhealth through emissions, which cause climate change and other environmental impacts including air pollution (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Healthcare thus contributes to illhealth through emissions, which cause climate change and other environmental impacts including air pollution (e.g. through waste incineration) and water pollution (e.g., through pharmaceutical waste) (Eckelman and Sherman 2018;Health Care Without Harm 2019;Lenzen et al 2020). The health professions therefore have a moral obligation to take action to reduce the environmental impacts of healthcare provision.…”

Section: Introductionmentioning

confidence: 99%

AMEE Consensus Statement: Planetary health and education for sustainable healthcare

et al. 2021

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The purpose of this Consensus Statement is to provide a global, collaborative, representative and inclusive vision for educating an interprofessional healthcare workforce that can deliver sustainable healthcare and promote planetary health. It is intended to inform national and global accreditation standards, planning and action at the institutional level as well as highlight the role of individuals in transforming health professions education. Many countries have agreed to 'rapid, far-reaching and unprecedented changes' to reduce greenhouse gas emissions by 45% within 10 years and achieve carbon neutrality by 2050, including in healthcare. Currently, however, health professions graduates are not prepared for their roles in achieving these changes. Thus, to reduce emissions and meet the 2030 Sustainable Development Goals (SDGs), health professions education must equip undergraduates, and those already qualified, with the knowledge, skills, values, competence and confidence they need to sustainably promote the health, human rights and well-being of current and future generations, while protecting the health of the planet. The current imperative for action on environmental issues such as climate change requires health professionals to mobilize politically as they have before, becoming strong advocates for major environmental, social and economic change. A truly ethical relationship with people and the planet that we inhabit so precariously, and to guarantee a future for the generations which follow, demands nothing less of all health professionals. This Consensus Statement outlines the changes required in health professions education, approaches to achieve these changes and a timeline for action linked to the internationally agreed SDGs. It represents the collective vision of health professionals, educators and students from various health professions, geographic locations and cultures. 'Consensus' implies broad agreement amongst all individuals engaged in discussion on a specific issue, which in this instance, is agreement by all signatories of this Statement developed under the auspices of the Association for Medical Education in Europe (AMEE). To ensure a shared understanding and to accurately convey information, we outline key terms in a glossary which accompanies this Consensus Statement (Supplementary Appendix 1). We acknowledge, however, that terms evolve and that different terms resonate variably depending on factors such as setting and audience. We define education for sustainable healthcare as the process of equipping current and

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“…The ratio in Germany is 11.45% [78]. The healthcare causes global environmental impact ranges between 1% and 5% of the total global impacts and more than 5% for some national impacts based on Eora multiregional global supply-chain database contain detailed information on healthcare sectors that use to quantified the direct and indirect supply-chain environmental damage driven by demand for healthcare [79]. Similarly, obesity is associated with 20% greater GHG emissions relative to normal weight and 700 megatons per year of CO 2 equivalent which is about 1.6% of global GHG emission because of increase in oxidative metabolism, food intake, and fossil fuel use for transportation [80].…”

Section: Methodsmentioning

confidence: 99%

Waste Food not Eat: Food Waste Treatment or Obesity - Selection of Sustainable Strategies for Dealing with Food Waste and Obesity

Smetana¹,

Profeta²,

Bhatia³

et al. 2021

Preprint

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This theoretical model-based study is aimed to answer an applied but system-related question, relevant to multiple current studies and general audience: Is it better for human health and the environment to consume extra portion of food or throw it in the garbage (for further treatment)? The question has deep conceptual roots and requires a holistic approach to assessing a few complex systems: food production, food waste treatment and medical treatment activities. According to estimations, there are around 3.05-7.2 Mtonnes of avoidable food waste generated by German consumers at the household level. Simultaneously, high levels of food overconsumption are also observed at the household level. Thus, more than half of all Germans are overweight and obese and a high share of them require additional medical treatment resources. The study compared the environmental impact of treating potentially avoidable food waste with current waste management system in Germany to the hypothetical scenario of consuming such amount of food by the existing population. The results indicated that current waste management system is more beneficial for the environment than consuming excessive food by German population and requesting related medical services in categories of global warming potential (0.128 versus 0.6-2.4 Mtonnes CO 2 eq.), energy demand (-21 versus 16-66 PJ) and water footprint (-1607 versus 13.2-53 million m 3).However, land use impact allocated to other healthcare due to food consumed by humans is 13-80% lower than current waste treatment. Another danger of consuming excessive food relates to accumulated risks and further increased demand for health services. Following years would worsen the situation, making a choice for “food waste avoided” diet unfeasible. The results received do not allow for a simple Sergiy Smetana 1 et al. answer on selecting more sustainable strategies of dealing with an excessive amount of food in every specific case. However, they allow to indicate preferable conditions for dealing with excessive food in model conditions, which account for health status of household members or group of people (population), nutrient density and amount of food, and time frame. Time factor is one of the key factors defining preferences for food-wasting or consumption.

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The environmental footprint of health care: a global assessment

Cited by 434 publications

References 46 publications

Health care's response to climate change: a carbon footprint assessment of the NHS in England

Health care's response to climate change: a carbon footprint assessment of the NHS in England

AMEE Consensus Statement: Planetary health and education for sustainable healthcare

Waste Food not Eat: Food Waste Treatment or Obesity - Selection of Sustainable Strategies for Dealing with Food Waste and Obesity

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