As the world grapples with the escalating climate crisis, healthcare systems have a unique opportunity and responsibility to lead the way in transitioning to a more sustainable future. Healthcare’s carbon footprint, estimated at over 4.4% of global greenhouse gas (GHG) emissions, underscores the urgency for the sector to enact meaningful change.1 2 3 4 5 6 7 8
Confronting this challenge requires a comprehensive, multi-faceted approach that addresses the healthcare system’s far-reaching impact on the environment. Through strategic policies, innovative practices, and targeted interventions, healthcare can chart a course towards net-zero emissions by 2050, while simultaneously strengthening its resilience to climate-driven demands.9 10 11 12 13 14 15 16 17 18 19 20
This article presents a framework of overarching strategies and specific tactics that healthcare systems can employ to reduce their environmental impact and contribute to a healthier planet. Drawing upon a rigorous systematic review of the international literature, we explore evidence-based solutions across various levels of the healthcare ecosystem.
Overarching Strategies for Decarbonizing Healthcare
Effective Policies and Governance
A key lever for driving sustainable change is the implementation of robust policies and governance structures that prioritize environmental stewardship within healthcare systems. This includes integrating sustainability goals into national and international healthcare policies, mandating carbon footprint reporting and benchmarking, and utilizing financial incentives to encourage sustainable practices.6 7 11 19 24 25 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70
Fostering multi-stakeholder collaboration and a whole-of-government approach is also crucial, as it enables coordinated efforts to address the complex, system-wide challenge of healthcare decarbonization.7 23 35 66 73 96 103 112 117 162 191 192 201 203 205 210 217 220 221 233
Organizational Transformation and Workforce Development
Cultivating a future-ready workforce equipped to champion sustainability is another vital component of healthcare’s green transition. This involves integrating environmental literacy and sustainable practices into the training and continuing education of healthcare professionals, as well as empowering employees at all levels to become agents of change within their organizations.24 25 27 46 48 49 50 57 58 63 65 66 68 69 70 71 73 75 77 78 80 81 82 83 86 91 93 99 102 103 105 110 112 114 116 127 130 133 135 136 137 138 142 143 150 151 152 154 165 166 171 172 174 178 179 180 181 182 185 187 191 192 195 196 202 205 206 207 210 212 216 220 221 228 233 234 235
Individual and Community Engagement
Harnessing the power of individuals and local communities is crucial for driving sustainable transformation within healthcare. This includes advocating for policy changes, championing eco-friendly practices, and educating patients and the public on the benefits of a greener healthcare system.7 19 28 43 48 49 50 51 53 56 57 58 59 61 63 64 65 66 67 69 71 73 81 85 86 88 89 90 91 96 98 102 103 107 108 112 114 116 117 127 130 133 134 135 139 142 143 151 160 162 168 171 177 180 181 183 184 192 195 196 210 212 215 216 218 219 220 221 226 229 232 233 236
Decarbonization Tactics for Healthcare Systems
Changing Clinical and Surgical Practices
One of the most impactful ways to reduce healthcare’s carbon footprint is by modifying clinical and surgical practices to prioritize lower-emission alternatives. This includes selecting anesthetic gases, rescue inhalers, and other medical supplies with a smaller environmental impact, as well as minimizing unnecessary procedures and promoting preventative care.1 12 23 24 25 27 28 42 43 48 50 51 52 54 55 57 61 63 66 68 69 71 73 74 75 77 78 79 81 82 83 84 85 86 87 90 91 93 94 96 97 99 100 101 102 103 106 107 108 112 113 114 120 126 128 129 133 135 138 139 142 143 148 149 151 152 159 161 163 165 166 167 168 169 170 171 173 174 175 177 178 179 183 185 186 189 190 191 192 196 205 212 214 217 224 227 229 230 232 233 234 236
Waste Management and Reduction
Tackling the issue of physical waste, including medical equipment, supplies, and packaging, is another crucial tactic for healthcare decarbonization. Strategies range from reducing, reusing, and recycling to implementing effective waste segregation and disposal methods that minimize emissions.1 12 25 43 47 48 49 50 51 54 55 57 60 61 63 67 72 73 77 78 80 81 82 84 85 86 88 89 91 93 95 96 97 98 100 101 102 104 105 107 110 112 114 116 135 138 142 143 144 149 150 151 152 153 154 155 157 159 160 169 171 177 183 189 190 191 192 198 199 206 210 211 217 218 219 222 223 224 228 229 232 233 234 236
Minimizing Travel and Transportation
Reducing the carbon footprint of patient, clinician, and staff travel and transportation is another critical lever for healthcare decarbonization. This includes promoting telehealth and virtual care models, optimizing transportation networks, and incentivizing low-emission modes of travel.6 7 24 43 47 48 51 55 59 61 63 69 71 73 74 75 84 85 93 94 95 96 105 109 114 117 119 120 121 122 124 125 126 127 128 131 132 135 137 140 142 148 152 156 161 163 165 166 171 172 174 176 188 190 191 192 193 195 196 197 201 202 217 224 226 228 229 232 233
Decarbonizing Infrastructure and Supply Chains
Improving the energy efficiency of healthcare facilities and transitioning to renewable energy sources can significantly reduce emissions. Simultaneously, decarbonizing the supply chains that support healthcare, including food, medical equipment, and other materials, is crucial for addressing indirect emissions.26 27 43 47 50 55 57 58 59 61 63 69 72 73 80 84 88 89 92 93 96 98 108 109 112 114 117 118 135 141 142 143 145 146 147 151 152 160 161 171 174 175 184 192 193 194 195 202 206 207 210 211 212 218 221 224 226 228 229 232 234 235
A Comprehensive Framework for Healthcare Decarbonization
The strategies and tactics outlined in this review provide a comprehensive framework for healthcare systems to navigate the complex path towards decarbonization (Figure 5). At the macro level, policymakers and healthcare leaders must establish effective governance structures, metrics, and financial incentives to drive sustainable change. At the organizational level, healthcare institutions must cultivate a workforce equipped with the knowledge and skills to champion eco-friendly practices, while empowering individuals and communities to participate in the transition.
At the micro level, clinicians and frontline staff can implement a range of decarbonization tactics, from modifying clinical procedures to optimizing waste management and transportation. By integrating these strategies and tactics, healthcare systems can make substantial progress towards net-zero emissions, while simultaneously enhancing their resilience to the growing impacts of climate change.
While the evidence presented in this review is primarily drawn from high-income countries, the fundamental principles and approaches are widely applicable. Healthcare systems in low- and middle-income settings can adapt and localize these strategies to address their unique contexts and resource constraints. Collaboration, knowledge-sharing, and a collective commitment to environmental stewardship will be crucial for the global healthcare sector to lead the way in the fight against climate change.
As the world grapples with the escalating climate crisis, healthcare systems have a moral imperative to reduce their environmental impact and serve as responsible stewards of the planet. By embracing the strategies and tactics outlined in this review, the healthcare sector can pave the way towards a more sustainable future, ensuring that its vital services and expertise are available to support communities in the face of a changing climate.
