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Environmental Impacts of the U.S. Health Care System and Effects on Public Health

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  • Matthew J Eckelman
  • Jodi Sherman

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.

Suggested Citation

  • Matthew J Eckelman & Jodi Sherman, 2016. "Environmental Impacts of the U.S. Health Care System and Effects on Public Health," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-14, June.
  • Handle: RePEc:plo:pone00:0157014
    DOI: 10.1371/journal.pone.0157014
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    1. Elinor Hallström & Quentin Gee & Peter Scarborough & David A. Cleveland, 2017. "A healthier US diet could reduce greenhouse gas emissions from both the food and health care systems," Climatic Change, Springer, vol. 142(1), pages 199-212, May.
    2. Alexander Cimprich & Steven B. Young, 2023. "Environmental footprinting of hospitals: Organizational life cycle assessment of a Canadian hospital," Journal of Industrial Ecology, Yale University, vol. 27(5), pages 1335-1353, October.
    3. Anastasios Sepetis & Paraskevi N. Zaza & Fotios Rizos & Pantelis G. Bagos, 2022. "Identifying and Predicting Healthcare Waste Management Costs for an Optimal Sustainable Management System: Evidence from the Greek Public Sector," IJERPH, MDPI, vol. 19(16), pages 1-20, August.
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    8. Włodzimierz Kanownik & Agnieszka Policht-Latawiec & Wioletta Fudała, 2019. "Nutrient Pollutants in Surface Water—Assessing Trends in Drinking Water Resource Quality for a Regional City in Central Europe," Sustainability, MDPI, vol. 11(7), pages 1-15, April.
    9. Masoumeh Vali & Khodakaram Salimifard & Amir H. Gandomi & Thierry J. Chaussalet, 2022. "Care process optimization in a cardiovascular hospital: an integration of simulation–optimization and data mining," Annals of Operations Research, Springer, vol. 318(1), pages 685-712, November.
    10. Or, Zeynep & Seppänen, Anna-Veera, 2024. "The role of the health sector in tackling climate change: A narrative review," Health Policy, Elsevier, vol. 143(C).
    11. Herman J. Friedericy & Cas W. van Egmond & Joost G. Vogtländer & Anne C. van der Eijk & Frank Willem Jansen, 2021. "Reducing the Environmental Impact of Sterilization Packaging for Surgical Instruments in the Operating Room: A Comparative Life Cycle Assessment of Disposable versus Reusable Systems," Sustainability, MDPI, vol. 14(1), pages 1-15, December.
    12. Miguel Gómez-Chaparro & Justo García-Sanz-Calcedo & Luis Armenta Márquez, 2018. "Analytical Determination of Medical Gases Consumption and Their Impact on Hospital Sustainability," Sustainability, MDPI, vol. 10(8), pages 1-17, August.
    13. Alfonso González González & Justo García-Sanz-Calcedo & David Rodríguez Salgado, 2018. "Evaluation of Energy Consumption in German Hospitals: Benchmarking in the Public Sector," Energies, MDPI, vol. 11(9), pages 1-14, August.
    14. Nala Alahmari & Sarah Alswedani & Ahmed Alzahrani & Iyad Katib & Aiiad Albeshri & Rashid Mehmood, 2022. "Musawah: A Data-Driven AI Approach and Tool to Co-Create Healthcare Services with a Case Study on Cancer Disease in Saudi Arabia," Sustainability, MDPI, vol. 14(6), pages 1-41, March.
    15. Qu, Weihua & Qu, Guohua & Zhang, Xindong & Robert, Dixon, 2021. "The impact of public participation in environmental behavior on haze pollution and public health in China," Economic Modelling, Elsevier, vol. 98(C), pages 319-335.
    16. Zini, Marco & Carcasci, Carlo, 2023. "Machine learning-based monitoring method for the electricity consumption of a healthcare facility in Italy," Energy, Elsevier, vol. 262(PB).
    17. Weiwei Mo & Darline Balen & Marianna Moura & Kevin H. Gardner, 2018. "A Regional Analysis of the Life Cycle Environmental and Economic Tradeoffs of Different Economic Growth Paths," Sustainability, MDPI, vol. 10(2), pages 1-16, February.
    18. Ying-Wei Wang & Shu-Li Chia & Chien-Ming Chou & Michael S. Chen & Jürgen M. Pelikan & Cordia Chu & Mei-Hsiu Wang & Chiachi Bonnie Lee, 2019. "Development and Validation of a Self-Assessment Tool for an Integrative Model of Health Promotion in Hospitals: Taiwan’s Experience," IJERPH, MDPI, vol. 16(11), pages 1-18, June.
    19. Peng Jiang & Jiří Jaromír Klemeš & Yee Van Fan & Xiuju Fu & Yong Mong Bee, 2021. "More Is Not Enough: A Deeper Understanding of the COVID-19 Impacts on Healthcare, Energy and Environment Is Crucial," IJERPH, MDPI, vol. 18(2), pages 1-22, January.
    20. Jean C. Bikomeye & Caitlin S. Rublee & Kirsten M. M. Beyer, 2021. "Positive Externalities of Climate Change Mitigation and Adaptation for Human Health: A Review and Conceptual Framework for Public Health Research," IJERPH, MDPI, vol. 18(5), pages 1-29, March.
    21. Amy Booth, 2022. "Carbon footprint modelling of national health systems: Opportunities, challenges and recommendations," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(4), pages 1885-1893, July.

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