Growing demand for health services could impact climate action, scientist warns



John Ji, assistant professor of environmental health science at Duke Kunshan, introduces research on longevity during a TEDx talk at the university in April 2019

China’s climate action plan should be expanded to target greenhouse gas (GHG) emissions from the health care sector, as the growing demands of an aging society threatens to send levels soaring, according to John Ji, assistant professor of environmental health science at Duke Kunshan.

Research suggests that the health care sector accounts for 5 percent of the total carbon footprint in developing countries, around the same as the food, aviation and shipping industries.

In the United States, the sector contributes an estimated 8 to 9.9 percent of total national GHG emissions, while the National Health Service accounts for 39 percent of public sector emissions in the United Kingdom.

‘With China’s aging population and the rising epidemic of non-communicable diseases, the health care sector emissions trajectory will only increase,’ Ji wrote in a commentary published on Sept. 4 by The Lancet Public Health, the international journal.

Since adopting the Paris Agreement on climate change in 2015, China has issued policies to reduce its reliance on fossil fuels, such as promoting the use of electric-powered vehicles, and introduced mandatory waste-recycling systems in some cities.

However, Ji pointed out that the immediate and long-term co-benefits for population health remain a ‘crucial and under-recognized externality’ in the country’s climate action plan.

Fossil fuels are a common source of GHGs and air pollution, and in many regions of China, levels of PM2.5 (tiny airborne particles that can harm the lungs) are much higher than the level recommended by the World Health Organization.

Reducing air pollution by limiting GHGs can reduce premature death due to non-communicable diseases, such as stroke, heart disease and lung cancer, said Ji, whose research has shown that forests and other green coverage, which soak up carbon dioxide, can improve people’s physical and mental health.

However, health can be a double-edged sword, he said.

‘Although climate change mitigation has positive effects on health, achieving and maintaining a healthier population will require more health care services,’ Ji said. ‘The health care sector generates GHGs from care delivery, product procurement, technological equipment use, and from a carbon-intensive supply chain of manufacturing, transportation and waste disposal.’

With each signatory of the Paris Agreement set to communicate their updated climate commitments by 2020, he urged all parties, and in particular China, to recognize the co-benefits of GHG mitigation and to target the health care sector.

‘The question of whether China will lead in climate action will soon be answered,’ he added.

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