Sustainability in Health Care

The academic public health and biomedical communities have a long history of researching and documenting the adverse impacts of pollution on human health. However, the healthcare industry itself is a major contributor to pollution as well as the greenhouse gas (GHG) emissions responsible for global warming. For example, the health sectors of the United States, Australia, England, and Canada are estimated to emit a combined 748 million metric tons of carbon dioxide equivalents annually, equivalent to a nation that would rank seventh in the world for GHG emissions. Moreover, the healthcare sector is a major consumer of natural resources, thereby contributing to the imbalances characteristic of what is increasingly being referred to as the Anthropocene and a threat to planetary health. In this article, we summarize current information on the healthcare industry's environmental footprint and the potential for markedly reducing that footprint by applying the principles and tools of sustainability science. We discuss some of the industry's special challenges, including those associated with new construction (which have undergone relatively little examination in relation to sustainability, despite predictions of accelerated growth). We examine current ideas and efforts to advance sustainability solutions in the healthcare industry, in high-, middle-, and low-income countries alike, where the healthcare industry can be expected to grow the fastest. Finally, we review case studies and discuss research needs.