Healthcare sustainability: factors impacting performance

There is a growing global interest in environmentally, socially, and economically viable health systems. It is becoming clear that this is needed for resilience of care delivery. At COP28 in Dubai, 148 countries endorsed the importance of recognizing the relationship between climate change and human health.(1) Various countries are implementing policies and strategies to support the transition towards sustainable healthcare. Successful achievement of objectives is influenced by various factors such as scope of environmental programs, governance structure of health systems, mandatory versus optional sustainability standards, and incentive frameworks.

Canada’s first commitment to a climate-resilient health system was made in 2021 at COP26. In 2004, some large hospitals were eligible to report on their greenhouse gas emissions and in 2018, the Greenhouse Gas Pollution Pricing Act was introduced. Most federal efforts are limited by their high thresholds, which include only the largest emitters.(2) Moreover, with the historical focus on directly controlled emissions, that excludes most of the environmental impacts of healthcare, which arise from the supply chain (or better yet, constellation chain). Health system governance also has an impact on consistency in environmental performance; for example, British Columbia is most advanced in their environmental sustainability strategy whereas other jurisdictions are catching up.(2) With sustainability disclosures playing a role in environmental performance, Canada has yet to adapt the IFRS sustainability standards to the Canadian context. Even then, not all hospitals, which are mostly publicly funded, will need to disclose their sustainability performance. Finally, while the healthcare sector would benefit from a sustainability incentive framework, current incentives are lacking or non-existent. With healthcare’s limited capabilities and resources, incentives should be considered by governments trying to transition their economies to a more sustainable future.(3)

Sources:

1. COP28 UAE, COP28 Declaration on Climate and Health, 2024.

2. World Economic Forum, Partnership for Health System Sustainability and Resilience, Sustainability and Resilience in the Canadian Health System, 2022.

3. MIT Sloan Management Review, Economic Incentives Are Key to Driving Sustainability at Scale, 2023.