Environmental Impacts of the U.S. Health Care System and Effects on Public Health
TLDR
Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA) modeling using National Health Expenditures (NHE) for the decade 2003–2013 and compared to national totals.Abstract:
The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation’s pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA) modeling using National Health Expenditures (NHE) for the decade 2003–2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%), greenhouse gas emissions (10%), smog formation (10%) criteria air pollutants (9%), stratospheric ozone depletion (1%), and carcinogenic and non-carcinogenic air toxics (1–2%). The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors) and demand side (NHE categories), as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000–98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.read more
Citations
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The 2019 Report of The Lancet Countdown on Health and Climate Change
Nick Watts,Markus Amann,Nigel W. Arnell,Sonja Ayeb-Karlsson,Kristine Belesova,Maxwell T. Boykoff,Peter Byass,Wenjia Cai,Diarmid Campbell-Lendrum,Stuart Capstick,Jonathan Chambers,Carole Dalin,Meaghan Daly,Niheer Dasandi,Michael Davies,Paul Drummond,Robert Dubrow,Kristie L. Ebi,Matthew J. Eckelman,Paul Ekins,Luis E. Escobar,Lucia Fernandez Montoya,Lucien Georgeson,Hilary Graham,Paul Haggar,Ian Hamilton,Stella M. Hartinger,Jeremy J. Hess,Ilan Helman,Gregor Kiesewetter,Tord Kjellstrom,Dominic Kniveton,Bruno Lemke,Yang Liu,Melissa C. Lott,Rachel Lowe,Maquins Odhiambo Sewe,Jaime Martinez-Urtaza,Mark A. Maslin,Lucy McAllister,Alice McGushin,Slava Mikhaylov,James Milner,Maziar Moradi-Lakeh,Karyn Morrissey,Kris A. Murray,Simon Munzert,Maria Nilsson,Tara Neville,Tadj Oreszczyn,Fereidoon Owfi,Olivia Pearman,David Pencheon,Dung Phung,Steve Pye,Ruth Quinn,Mahnaz Rabbaniha,Elizabeth J. Z. Robinson,Joacim Rocklöv,Jan C. Semenza,Jodi D. Sherman,Joy Shumake-Guillemot,Meisam Tabatabaei,Jonathon Taylor,Joaquin Trinanes,Paul Wilkinson,Anthony Costello,Peng Gong,Hugh Montgomery +68 more
TL;DR: The 2019 report of The Lancet Countdown on health and climate change : ensuring that the health of a child born today is not defined by a changing climate as mentioned in this paper, is the most relevant work to ours.
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The Lancet Countdown : tracking progress on health and climate change
Nick Watts,W. Neil Adger,Sonja Ayeb-Karlsson,Yuqi Bai,Peter Byass,Diarmid Campbell-Lendrum,Tim Colbourn,Peter M. Cox,Michael Davies,Michael H. Depledge,Anneliese Depoux,Paula Dominguez-Salas,Paul Drummond,Paul Ekins,Antoine Flahault,Delia Grace,Hilary Graham,Andy Haines,Ian Hamilton,Anne M Johnson,Ilan Kelman,Sari Kovats,Lu Liang,Melissa C. Lott,Robert Lowe,Yong Luo,Georgina M. Mace,Mark A. Maslin,Karyn Morrissey,Kris A. Murray,Tara Neville,Maria Nilsson,Tadj Oreszczyn,Christine Parthemore,David Pencheon,Elizabeth J. Z. Robinson,Stefanie Schütte,Joy Shumake-Guillemot,Paolo Vineis,Paul Wilkinson,Nicola Wheeler,Bing Xu,Jun Yang,Yongyuan Yin,Chaoqing Yu,Peng Gong,Hugh Montgomery,Anthony Costello +47 more
TL;DR: The proposed indicator domains require further refinement, and mark the beginning of an ongoing consultation process-from November, 2016 to early 2017-to develop these domains, identify key areas not currently covered, and change indicators where necessary.
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The impact of surgery on global climate: a carbon footprinting study of operating theatres in three health systems.
TL;DR: Emissions reduction strategies including avoidance of desflurane and occupancy-based ventilation have the potential to lessen the climate impact of surgical services without compromising patient safety.
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The environmental footprint of health care: a global assessment.
Manfred Lenzen,Arunima Malik,Mengyu Li,Jacob Fry,Helga Weisz,Helga Weisz,Peter-Paul Pichler,Leonardo Suveges Moreira Chaves,Leonardo Suveges Moreira Chaves,Anthony Capon,Anthony Capon,David Pencheon +11 more
TL;DR: This multiregional input-output analysis evaluated the contribution of health-care sectors in driving environmental damage that in turn puts human health at risk and quantified the direct and indirect supply-chain environmental damage driven by the demand for health care.
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International comparison of health care carbon footprints
TL;DR: In this article, the authors show that health care on average accounts for 5% of the national CO2 footprint making the sector comparable in importance to the food sector, and that the carbon intensity of the domestic energy system, the energy intensity of domestic economy and health care expenditure together explain half of the variance in per capita health carbon footprints.
References
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BookDOI
To Err Is Human Building a Safer Health System
TL;DR: Boken presenterer en helhetlig strategi for hvordan myndigheter, helsepersonell, industri og forbrukere kan redusere medisinske feil.
Journal ArticleDOI
Crossing the Quality Chasm: A New Health System for the 21st Century
TL;DR: Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Journal ArticleDOI
Book ReviewTo Err is Human: building a safer health system Kohn L T Corrigan J M Donaldson M S Washington DC USA: Institute of Medicine/National Academy Press ISBN 0 309 06837 1 $34.95
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