Health Journal Editors and the Pope Call for Action on the Climate Crisis

Kenny Lin, MD, MPH
Posted on October 30, 2023

This month, two major documents—one by a coalition of more than 200 health journal editors and the other from the leader of the Roman Catholic Church—invoked science and faith to advocate for aggressive action to address the climate crisis. On October 25, 2023, an editorial simultaneously published in participating journals declared that “climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe.” As previous group editorials have outlined, climate change poses ongoing threats to human health by creating “shortages of land, shelter, food, and water,” particularly in lower income countries that generate far fewer greenhouse gas emissions per person than the United States. Further, the authors argued that the climate and nature crisis meets World Health Organization criteria to be designated a global health emergency.

Three weeks earlier, on October 4, 2023, Pope Francis issued an apostolic exhortation “to all people of good will on the climate crisis,” warning that “the world in which we live is collapsing and may be nearing the breaking point.” After refuting disinformation that human activities are not responsible for our warming planet, he declared that “the world … is not an object of exploitation, unbridled use and unlimited ambition.” Reviewing the limited progress in reducing emissions following past global climate conferences and looking ahead to the 28^th United Nations Conference of the Parties (COP28) in Dubai occurring at the end of November, Francis acknowledged that “the most effective solutions will not come from individual efforts alone, but above all from major political decisions on the national and international level.”

An International Energy Agency report released last month projected that worldwide demand for fossil fuels will peak before 2030 because of the accelerating transition to solar and wind energy. This movement creates a narrow path to achieve the international goals of net-zero emissions by 2050 and limiting global warming to 1.5°C (2.7°F). Remaining below this temperature threshold reduces the risk of catastrophic climate events such as this summer’s Canadian wildfires, which not only burned more than 45 million acres (the country’s previous single-year record was 19 million), but also released an estimated two billion tons of carbon dioxide into the atmosphere.

The U.S. health care industry remains one of the world’s largest climate culprits, producing one-fourth of global health care emissions and 8.5% of all U.S. emissions in 2018. U.S. hospitals are half as efficient as European hospitals and cause air pollution that leads to an estimated 77,000 excess deaths annually. Overuse of single-use disposable plastic devices is an important part of the problem, a recent JAMA Viewpoint observed:

In addition to personal protective equipment (masks, protective gowns, and gloves), everyday items such as blood pressure cuffs, catheters, complex surgical instruments, and even bed linens, pillows, and patient gowns are laden with plastic and commonly discarded after a single patient encounter. … However, there is a dearth of evidence of benefit from most single-use devices—especially for infection prevention—and dependency on them increases supply chain vulnerabilities.

Aligning infection control guidelines with evidence and prioritizing reusables in medical device regulation could incentivize health care organizations to purchase more durable, reusable patient care products.

More broadly, overdiagnosis and unnecessary medical treatment not only waste money and energy and expose patients to harm, but they also increase the carbon footprint of health care. The scientific committee of this year’s Preventing Overdiagnosis conference called on decision makers to embrace sustainable health care approaches and acknowledge that “our global medical culture has driven excessive diagnostic testing, overmedicalisation, and overtreatment across many conditions that may harm patients, exhaust health care resources, and harm the planet.”