Stemming the Effects of Health Care on Climate Change

Anand Bhopal is a PhD research fellow at the University of Bergen and the former Takemi Associate in International Health at the Harvard T. H. Chan School of Public Health.

What do you say to health care professionals who feel overwhelmed by the problem of climate change? 

Start small. You know your area of practice and your patient population better than anyone. Look for your local specialty organization or regional group. Meet people incorporating environmental considerations into quality improvement. Look into reducing health care overuse where you work, promoting disease prevention, or shaping policy guidelines for your specialty.

What you do may not make a huge difference on the grand scale of climate change, but a transformational shift requires small steps a million times a day. Action inspires action.

You write about how climate change is shifting the way people think about health care. What does that look like?

We’ve been taught that patient care is the first concern, but that concern extends beyond the patient in front of you, and trying to improve care access and quality while reducing our carbon footprint requires new definitions of what quality means.

Not so long ago, economic costing was thought to be a vulgar conversation for medical professionals. Fast-forward to 2023 and it’s pretty normal to talk about cost and fairness.

We can extend that thinking to climate impacts. Is it fair to deliver extremely high-tech and polluting health care knowing it causes climate problems elsewhere?

How much of a concern is greenwashing — making claims about reducing emissions that aren’t matched by action?

Greenwashing is pervasive in climate policy. I think in health care, though, there is sincere desire to do something. An oil or gas company saying they have a net-zero plan seems at odds with their values, but for health care, we shouldn’t be cynical; we should be supportive of the people who are trying.

Greenwashing isn’t always intentional. You may invest your health care organization’s money in buying carbon offsets, but the long-term effectiveness of that approach is hotly disputed. Better to focus your energy on reducing emissions rather than paying to offset emissions elsewhere.

But the risk of greenwashing shouldn’t be a reason not to act. We don’t have time for that.

This year in Lancet Planet Health, you published a two-week module you developed on climate change for medical students. How important is education in the drive to reduce health care emissions?

When I was at medical school from 2008 to 2014, I remember going to my dean with some colleagues and saying we wanted education on climate change and health. Fifteen years later, there are lots of people demanding this and there are excellent courses at many universities, including Harvard. The challenge is arranging the course in the right way.

Some health care providers, educators, and students are interested in the issues and want to do their bit. I want to lift those people up. Those of us who’ve had the privilege of taking time away from clinical practice to work in the climate arena should see our role as peer educators.

What’s your ultimate hope?

My wish is that climate change is not seen as something for the enthusiasts but as everybody’s problem.

As I stated in a recent commentary I co-wrote for the Journal of Medical Ethics, I believe it’s an ethical imperative for health care to take climate change seriously. If we choose to act first and fast, that benefits us because we’re decarbonizing on our own terms.

We’re talking about a major global challenge. There’s no rulebook. We’ll be dealing with climate change for the duration of our careers, and we can do it well or we can do it badly. It’s up to us to create the future. 

Stephanie Dutchen is the manager of feature content and multimedia in the HMS Office of Communications and External Relations

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