Promoting change to contain our health costs

This article by DEA Member Eugenie Kayak was published in Medical Observer 8th October 2013 and appears under a Creative Commons licence.

HEALTHCARE’S cost debate often tends to focus on elective surgery lists and more hospital beds.

Yet the billions of dollars directed to healthcare (Australia presently spends over $130 billion annually) is but a band-aid measure unless current rates of non-communicable diseases and environmental degradation are addressed comprehensively.

Sufficient prioritisation and resources are needed to keep patients well and away from hospitals – which tend to be associated with high levels of energy consumption and waste production. Hence, adequate preventive and primary healthcare are paramount in addressing both healthcare’s environmental footprint and escalating cost burden.

Our healthcare system, as a major fossil fuel consumer, contributes significantly to greenhouse gas and local pollution emissions and therefore also to illness and poor health. Air pollution from fossil fuel combustion is linked to conditions including cardiovascular disease, stroke, cancer, asthma and chronic lower respiratory tract disease. A reduction in healthcare’s greenhouse gas and pollution emissions would both decrease ill health and save money.

By improving the environmental footprint of the health system and our surrounds we can help mitigate rising costs.

US audits have shown that billions of dollars can be saved by improving the energy efficiency of health services and waste reduction while also decreasing CO2 and local air pollutant emissions from power generation.1 EU health organisations have also estimated that a target of 30% reduction in greenhouse gas emissions compared to a 20% target (from1990 levels) by 2020 would provide additional health savings to the EU of between €10.5 billion and €30.5 billion per year.2

As doctors, we can instigate or promote practices both at work and in daily life to achieve significant reductions in waste, carbon emissions and localised pollution.

Using the waste hierarchy ethos of ‘Reduce, Reuse, Recycle’ and taking steps to ‘Rethink’ to further decrease our environmental impact and help maintain the health of others, we can promote changes at work and among the wider community. (See www.greenpractice.org.au for further details on GP clinics).

An integrated ‘whole of government response’ for improved environmental practices for both health and fiscal benefits would enable people to engage more readily in general environmentally-sustainable practices – while reaping health co-benefits. Increasing rates of obesity, diabetes, heart and lung disease can all be partly attributed to our built environment, reliance on cars, physical inactivity and eating habits. Annual direct gross costs to our economy from physical inactivity are estimated at over $1 billion.

Policies, communities, infrastructure and health systems that promote and maintain physical and mental health are desperately needed. Can we afford to continue ignoring the predicted co-benefits to human health and health budgets through improved environmental sustainability across multiple sectors?

What’s good for the environment can also be good for health and good for addressing healthcare’s rising costs.

References:
1. Kaplan et al. Can Sustainable Hospitals Help Bend the health Care Cost Curve? The Commonwealth Fund, 2012; November Vol 29.
2. Health Care Without Harm (HCWH) and Health and Environment Alliance (HEAL). Acting Now for Better Health; A 30% reduction target for EU climate policy. 2010.

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