This week’s blog is brought to you by: Managing Director, Dr Tim Wilson

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Full reference and title from the journal:

International comparison of health care carbon footprints, Peter-Paul Pichler et al 2019 Environ. Res. Lett. 14 064004.

Web Link to Paper:

Authors conclusion:

The health care sectors of the 36 countries studied were responsible for 1.6 Gt of CO2 emissions or 4.4% of the global total in 2014 (35.7 Gt). The health carbon footprints of China, the US, Japan, India and Germany were similar to the total national footprints of Canada, Italy, Greece, Finland, and Hungary respectively. In an international ranking of total national carbon footprints, the health carbon footprints of China and the US would rank 10th and 14th respectively. The health care sector in most countries is the largest service sector in terms of its carbon footprint and it is comparable in size to the food sector. In most countries it is only surpassed by sectors related to energy, transport, and construction.

3V bottom line:

Healthcare is a large consumer of carbon and as a result is a major contributor to carbon emissions. Therefore, carbon should be one of the resources we take into consideration for investment when optimising value (not just money).

3VH – Implications for value:

As the NEJM of medicine starts to consider the impact of climate change on health, like The Lancet before it, so we should consider the impact of healthcare on climate change. This week’s paper of the week outlines the impact of healthcare systems on climate change It makes for sober reading. If the Chinese and US healthcare systems were counted as a country, they would be the 10th and 14th largest national emitters of carbon.

The authors outline how healthcare is responsible for around 4.7% of all carbon emissions globally. In some countries, mainly those with developing economies, healthcare has a far smaller impact. For instance, the emissions in the US are 1.51 tCO2/capita compared to 0.06 tCO2/capita in India. So, as health system grow in these developing economies, CO2 emissions will rise.

Work has been done in the NHS on sustainability. The NHS Sustainability Unit calculated that 59 per cent of NHS carbon emissions are linked to procured goods, 24 per cent to direct energy use in buildings and 17 per cent to patient and staff travel. Pharmaceutical production alone accounts for 22 per cent of NHS emissions.[1] Not only might a medicine cost more than social prescribing, the chances are it also has a greater environmental cost.

Importantly, CO2 emissions are often a motivating factor for clinicians to engage in debates about value. Whereas some clinicians might be less inclined to debate how to prioritise the use of finite monies, those same people are willing to debate better use of carbon as a resource.

Time, therefore, to include CO2 in our calculations about value.

[1] NHS Sustainable Development Unit (2012). Report. NHS England Carbon Footprint Update