Blog By: Sallie Sutton
Greenhouse gas emissions are gases, primarily from fossil fuel combustion, that cause heat to become trapped in the earth’s atmosphere.[i] The healthcare industry contributes to roughly 4.6% of global greenhouse gas emissions annually; about a quarter of which is from the United States alone, resulting in nearly 77,000 deaths.[ii] Additionally, the vast majority of persons negatively affected are low-income, minorities, and the elderly.[iii] Despite this, the United States federal government has yet to take a substantial legislative step toward curbing emissions.[iv] Instead, the government solely relies on the actions of the private healthcare sector to pick up its slack.[v] The United States needs to follow the lead of other countries, like the United Kingdom, by implementing statutory requirements for transitioning to a more sustainable healthcare industry.[vi] Without these actions, as the largest contributor to healthcare-related emissions, the United States remains responsible for the serious health issues, inequalities, and deaths caused by global warming.[vii]
In 2020, the United Kingdom’s National Health Service (NHS) pledged to emit net zero healthcare emissions by 2045.[viii] Later, in 2022, the United Kingdom passed the 2022 Health and Care Act (HCA), authorizing the NHS to issue statutory instruction to achieve this goal.[ix] So far this includes requiring hospitals to report their emissions, teaching more sustainable preventative curriculum, moving to zero emission emergency vehicles, moving to carbon-conscious inhalers and anesthetic gases, requiring suppliers to meet certain emissions standards for the seven greenhouse gases listed in the Kyoto Protocol international climate treaty, and more.[x]
Other nations including Fiji and those within the European Union planned or have plans to implement similar programs to curb their own emissions.[xi] Both Spain and the Netherlands are already in the process of establishing hospital emissions baselines and requiring hospitals to generate roadmaps showing steps each hospital will take to achieve decarbonization.[xii] With the execution of these measures, carbon emissions will decrease and with it the adverse health effects.[xiii] These measures will not only save but it will extend thousands of lives, particularly the aforementioned negatively affected population.[xiv]
If the United Kingdom, a country five times smaller than the United States, recognized the healthcare system’s burden on the environment and enacted a reasonable plan to lessen said burden, then the United States can surely do the same.[xv] By not enacting similar legislation to cut healthcare emissions to net zero, the United States will not only continue contributions to the loss of lives, but it will only further burden the federal government. Specifically, Medicare and Medicaid, two federal health insurance and coverage programs, serve the elderly and low-income, both of which are major populations adversely affected by the healthcare industry emissions.[xvi] Further, they are statistically more likely to be exposed to high emissions.[xvii] As emissions increase, so do occurrences of illnesses like lung or heart disease.[xviii] Therefore, one can infer that, as emissions increase and with it the occurrence of illnesses, the more reliant these populations become on Medicare and Medicaid to fund treatment caused by the industry they are seeking help from: the healthcare industry. By implementing measures to decarbonize the healthcare industry like those already in progress in the United Kingdom, Fiji, and other countries, the United States will prevent deaths, help curb climate change and the inequities it causes, and lighten the burden felt by the Medicare and Medicaid system.
[i] Overview of Greenhouse Gases, EPA, https://www.epa.gov/ghgemissions/overview-greenhouse-gases (last updated Oct 10, 2023) [https://perma.cc/59KW-AV9E].
[ii] See Matthew J. Eckelman et al., Health Care Pollution And Public Health Damage In The United States: An Update, 39 Health Affairs 2071, 2079 (2020); David Introcaso, How U.S. Hospitals Undercut Public Health, Time (Oct. 6, 2023 10:47 AM), https://time.com/6321357/how-us-hospitals-undercut-public-health/ [https://perma.cc/GYU9-JANU].
[iii] Disparities in the Impact of Air Pollution, Am. Lung Ass’n (Nov. 2, 2023), https://www.lung.org/clean-air/outdoors/who-is-at-risk/disparities [https://perma.cc/689U-56K7].
[iv] Delivering a ‘Net Zero’ National Health Service, 7 (NHS England and NHS Improvement), https://www.england.nhs.uk/greenernhs/wp-content/uploads/sites/51/2022/07/B1728-delivering-a-net-zero-nhs-july-2022.pdf [https://perma.cc/PP8Q-CGAU] (last visited Feb. 7, 2024).
[v] FACT SHEET: Health Sector Leaders Join Biden Administration’s Pledge to Reduce Greenhouse Gas Emissions 50% by 2030, White House (June 30, 2022), https://www.whitehouse.gov/briefing-room/statements-releases/2022/06/30/fact-sheet-health-sector-leaders-join-biden-administrations-pledge-to-reduce-greenhouse-gas-emissions-50-by-2030/#:~:text=Today%2C%20the%20Biden%2DHarris%20Administration,gas%20emissions%2050%25%20by%202030 [https://perma.cc/T9LT-8QJL].
[vi] Supra note iv.
[vii] Shanoor Seervai, et al., How the U.S. Health Care System Contributes to Climate Change, The Commonwealth Fund (Apr. 19, 2022), https://www.commonwealthfund.org/publications/explainer/2022/apr/how-us-health-care-system-contributes-climate-change [https://perma.cc/2GMC-R5T2].
[viii] Supra note iv.
[ix] Id.
[x] Id.
[xi] Michael R. Littenberg, An Overview of the New UK National Health Service Carbon Reduction Compliance Requirements, Ropes & Gray (Aug. 2, 2023), https://www.ropesgray.com/en/insights/alerts/2023/08/an-overview-of-the-new-uk-national-health-service-carbon-reduction-compliance-requirements [https://perma.cc/RB8E-M5TF].
[xii] Health will develop the first Carbon Footprint Reduction Plan for the health sector in Spain, Web Oficial del president del Govern I del Consell de Ministres (Sept. 14, 2023), https://www.lamoncloa.gob.es/lang/en/gobierno/news/paginas/2023/20230914_carbon-footprint.aspx [https://perma.cc/LY68-ZAHF]; Sustainable Healthcare, Gov. of the Neth. https://www.government.nl/topics/sustainable-healthcare/more-sustainability-in-the-care-sector#:~:text=health%20and%20care%20organisations%20will,through%20local%20and%20other%20measures [https://perma.cc/69NG-6DJU ](last visited Feb. 15, 2024).
[xiii] Ava Ferguson Bryan, MD, et al., How Should We Respond To Health Sector Emissions That Exacerbate Climate Change and Inequity?, 24 AMA J. Ethics (2022); Seervai, supra note v.
[xiv] Id.
[xv] Eckelmen, et al., supra note i.
xvi Id.
[xvii] Disparities, supra note iii.
[xviii] Research on Health Effects from Air Pollution, EPA (Dec. 5, 2023), https://www.epa.gov/air-research/research-health-effects-air-pollution [https://perma.cc/XA97-MRFR].