Healthcare workers take immense pride in addressing global societal challenges. Their motivation is two-fold. Firstly, as professionals guided by science and data, they take action based on evidence. Secondly, for years, healthcare workers have addressed social issues such as homelessness, gender-based violence and food security, which often manifest as emergencies in healthcare facilities. Research shows that rising temperatures increase emergency department visits, wildfire smoke exacerbates asthma cases among children and the risk of contracting Lyme disease is now five times higher than it was 10 years ago.

A recent Ipsos survey indicates that healthcare professionals are among the most trusted groups, surpassing business leaders, politicians and lawmakers. They interact daily with ordinary citizens and have significant power to advocate for local change. However, healthcare professionals are growing weary. Despite Canada's commitment to reducing greenhouse gas (GHG) emissions, there is a lack of direction at the health system level to navigate this issue. Groups work in isolation, which is inefficient given that Canada is warming twice as fast as the rest of the world and faces challenges with aging infrastructure. It may be time to declare the climate crisis a healthcare crisis.

The estimated cost of inaction on climate change is in the billions, and every dollar invested today saves between $13-$15 and could prevent thousands of premature deaths. A study in The New England Journal of Medicine has provided conclusive evidence that microplastics contribute to cardiological distress, with as many as 20% of patients participating in the study experiencing complications. As healthcare demands grow, costs will inevitably rise just to maintain services, while climate change could reduce Canada's gross domestic product, putting further strain on funding for essential services such as healthcare, social services and education.

It is time for introspection. Healthcare is the fifth largest producer of GHG emissions in Canada, more than aviation and maritime transport. Despite having access to clean hydro power, health facilities are second only to the food and beverage industry in emissions. There is a significant opportunity to adopt alternative delivery models, such as clinics, virtual care or home-based care, which can dramatically reduce emissions. The average virtual care consultation reduces emissions by 333000 metric tonnes equivalent to powering 60000 homes in a year. 

About 60% of healthcare emissions come from the supply chain. The increase in disposable products, sourcing from regions with emission intensive operations and stockpiling has created significant waste and driven up costs. Scientific studies have debunked many claims that single-use plastics improve care or result in infection prevention. This underscores the importance of initiatives such as ChooseWisely, which advocate for appropriate care. For instance, greening operating theatres can reduce waste and save approximately $20,500 per operating theatre annually.

There is an expectation that the current Canadian Sustainability Disclosure Standards that are available for comment will also be required of hospitals and other non-profit entities in the near future. Similar to other markets such as the US and the UK, Canadian authorities may also opt to include specific sustainability outcomes in order to qualify for funding and licensing. The climate crisis offers a unique opportunity to adopt more cost-effective and potentially more clinically effective practices in the long term, such as prescribing walks in parks for mental health or using food as medicine.

The need for healthcare to act now is clear, with numerous resources available, including the Sustainability Accelerator Tool*. This tool assesses a hospital's performance across three domains – environment; well-being and health equity; and leadership and governance –and proposes plans to address development areas with minimal effort. Healthcare leaders can take three actions to advance this agenda: (1) advocate for planetary health in all strategic investments, (2) start with sustainability in mind for new infrastructure and upgrades and (3) follow the science and investigate where gaps exist. Crises are a catalyst for innovation and change, and we must seize this opportunity to build a more resilient and equitable healthcare system that Canadians can be proud of.

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