The Interaction between U.S. Healthcare and the Environment
By Dylan Mai and Vivien Moritz
What words come to mind when hearing about healthcare? Healing, cures, medicine, expenses, or even death may come to mind. However, a topic that often goes unmentioned is the environmental impacts of the American healthcare system and how it affects not only the health of patients, but also the world that they live in.
Hospitals are open and operating 24 hours a day, 7 days a week, 365 days a year. They require constant use of lights, air conditioning and heating units, and the various technologies for diagnoses and treatments. To keep patients safe from infection, bed linens and towels are washed frequently, requiring large amounts of water and energy to do so. For the same reason, chemical cleaners are used to wipe down surfaces and equipment after every use. Healthcare professionals in the hospital are continually using gloves, masks, scrubs, and sterilized tools wrapped in plastic that contribute to the hospital’s production of solid waste. It is estimated that each day, U.S. hospitals produce 7000 tons of solid waste. [2]
Additionally, when considering all the energy needed to keep the hospital operating, it is estimated that healthcare is responsible for 10% of greenhouse gas emissions in the U.S., 10% of smog formation, and 9% of other harmful air pollutants. [1] The emissions and waste from hospitals are contributing to the pollution that causes diseases hospitals look to cure in the first place. Climate change has many consequences on human health, including temperature-related death and illnesses, poor air quality, disastrous weather events contributing to infection, and food and water insecurity. [5] The healthcare industry’s contribution to climate change and air pollution ultimately results in the death of around 7 million people per year. [4] The oath doctors take to ‘do no harm’ contradicts the environmental havoc caused by healthcare.
Luckily, there are hospitals and medical schools currently working to enact positive changes to reduce healthcare’s negative contribution to climate change. Institutions such as the Boston Medical Center, Kaiser Permanente, and the University of California Health committed to 100% renewable energy in September 2018. Harvard aims to end its use of fossil fuels completely by 2050 [5]. Aaron Bernstein, a Harvard Medical School instructor in pediatrics, emphasized how important climate change is in medicine, saying, “Climate change, as arguably the greatest health threat facing humanity and a major concern for the practice of medicine, is not an elective topic. Physicians must not only understand what is at stake for their patients’ health with climate change, but how climate change will affect our practice of medicine.” [5]
Further efforts have been taken to increase sustainability in powering hospitals, such as using biodigestion, also known as anaerobic digestion, for power generation. [4] Hospitals have been turning to wind power, wood chips, and even cow manure to save not only energy, but also money. Theda Clark Medical Center in Wisconsin has been saving $800,000 per year since making changes to become more energy efficient. [8]
Pollution and waste reduction do not only have to occur at the national or institutional level. Students at the University of California, Los Angeles (UCLA) have created a way to help local hospitals reduce waste while also assisting health and disaster relief organizations. The Medical Aid Initiative at UCLA helps prevent and reduce waste from UCLA Health medical centers by collecting unused, excess medical supplies from hospitals and distributing them to global health volunteer groups and disaster relief organizations. [7]
Possible solutions for used medical waste have been implemented in the past, such as the discontinued use of medical waste incinerators and mercury thermometers, which were poisoning bodies of water. Instead of incinerators, autoclaves, which use pressurized air and steam to sterilize items, are being used to degrade waste before shredding it and bringing it to landfills. While still taking up space, the reduction of smoke and smog from incinerator use has been a needed change. Some companies have taken further steps by using the shredded waste to create pellets for use in roads and construction. [6]
By taking the steps to save the environment, or at least lessen the damage done, hospitals and other healthcare providers also take steps to protect the lives they are sworn to serve. Many often view humans and the environment as two separate entities. However, upon seeing how affected we are by environmental change and how necessary it is to enact protections for our own health, it is clear we are a part of the environment and therefore face the consequences of its demise. Although many changes still need to be made, recent policies taken up within the realm of medicine provide hope for the future.
Sources:
[1] Environmental Impacts of the U.S. Health Care System and Effects on Public Health (Eckelman and Sherman)
[2] Waste Article (Sustainability Roadmap)
[3] The hidden harm of health care: air, water, and other pollution (Slutzman, STAT)
[4] Climate change is a medical emergency (Do No Harm)
[5] Environmental medicine brings climate change to forefront (Blackwell, The Harvard Gazette)
[6] Eco-Friendly Solutions to Medical Waste Disposal (Brenner, MedPro Disposal)
[7] Medical Aid Initiative at UCLA
[8] Energy-efficient hospitals are reaping some benefits in their budgets (Appleby, Med City News)
Dylan Mai is a fourth-year Physiological Sciences major at UCLA. Vivien Moritz is a second-year Biology major at UCLA. Dylan and Vivien are both THINQ 2020–2021 clinical fellows.
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