Why Canada needs a net-zero health system

The commitment for physicians to “do no harm” extends to the planet.

Right now, however, Canadian health care systems contribute 4.6 per cent of greenhouse gas (GHG) emissions from lighting, cooling and heating hospitals, single-use medical items such as syringes, transportation in the medical supply chain and a host of other standard practices across the continuum of care.

Recent data shows that from 2018 to 2019 alone, our per capita GHG emissions increased by 1.3% – the equivalent of more than nine million passenger vehicles on the road.

These emissions play a part in devastating ecosystems everywhere and directly impact human health.

Fossil fuel air pollution is believed to be responsible for one in five deaths worldwide. Heat waves can increase emergency room visits and ambulance transports by 10 to 15%, which can exceed healthcare system capacity and reduce quality of care.

Underserved populations and patients whose health is already compromised are particularly at risk.

BUT THE CANADIAN MEDICAL ASSOCIATION BELIEVES URGENT ACTION TO CREATE A NET-ZERO HEALTH SYSTEM CAN MAKE A DIFFERENCE

In 2021, Canada was one of more than 50 countries at COP26 to sign on to the World Health Organization’s initiative to develop climate resilient and low-carbon sustainable health systems.

The CMA is now calling on the federal government to establish a national secretariat to ensure cross-country coordination, and on all levels of

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The CMA is also committed to partnering with and being guided by First Nations, Inuit and Métis communities to advance and promote health care equity.

“Physicians witness the impact of climate change on patient health,” says CMA President Dr. Alika Lafontaine, “whether it’s smoke inhalation from wildfires, the spread of infectious diseases, heat stroke, or a host of other preventable issues. We have a duty to act in the best interests of our patients, and our planet.”

Strategies for net-zero health care

1. Expand virtual care

2. Create a robust primary health care system to alleviate pressure on hospitals

3. Support healthy living, including addressing the determinants of health, encouraging healthy eating and active living

4. Use energy efficiently, shifting to renewable energy sources and reducing the need for fossil fueled generators in hospitals

5. Practice sustainable prescribing, including reusable packaging when appropriate

6. Focus on community care to ensure health promotion and disease prevention, especially in rural and remote communities

7. Reduce waste through recycling and medical device reprocessing programs

8. Prepare for future climate emergencies with training and preparedness plans

9. Implement climate resilient infrastructure, such as flood doors and improved ventilation

What Clinicians Can Do

Choose sustainable procurement and health supplies. The majority of health sector emissions are embedded in the supply chain, including pharmaceuticals and medical devices. Clinicians can reduce waste and preferentially use lower-emission supplies. For example, by following appropriate prescribing guidelines to reduce unnecessary testing and treatments, and choosing reusable rather than single use medical devices, when possible.

Consider appropriate use of health services. The CMA is advocating for the implementation of robust primary care systems in Canada that everyone can access. Where appropriate, clinicians can help mitigate unnecessary use of hospital services by facilitating access to primary and community care service.

Reduce overall demand for health care. Integrative and comprehensive health care includes focusing on the determinants of health, chronic disease management, disease prevention and health promotion. Keeping people healthy will reduce the demand for energy intensive health services

The CMA is pressing for action as a partial response to the climate crisis as well as ongoing health inequities. A net-zero health system will lead to a healthier planet and a healthier population.

Learn more about the CMA’s work at www.cma.ca/our-focus. n H