R. Martins1, W. Ahmed2, M. Mahar2, A. Çelik3, J. Luo1, K. Poulikidis1, S. Razi1, M. Latif1, K. Tafuri1, F. Bhora1 1Hackensack Meridian Health, Thoracic Surgery, Edison, NEW JERSEY, USA 2Aga Khan University Medical College, Medical College, Karachi, Sindh, Pakistan 3Medical University – Pleven, Medical College, Pleven, PLEVEN PROVINCE, Bulgaria
Introduction:
The healthcare industry is a serious contributor towards climate change, with surgical care being responsible for the majority of its environmental footprint. High-income countries (HICs) are responsible for the bulk of global carbon emissions, with the health systems of the United States, Australia, Canada, and England accounting for more emissions than all but six entire countries worldwide. However, the health repercussions of climate change are disproportionately experienced by low-and-middle-income countries (LMICs).
We compared perceptions regarding the environmental impact and responsibility of health systems between surgeons in LMICs and HICs.
Methods:
This international survey of surgeons was conducted between January-July 2023 by the Global Eco-Health Collaborative, a trainee-led initiative exploring the intersection between climate change and healthcare. Respondents’ countries were classified as HICs or LMICs (including low, lower-middle-, or upper-middle-income countries) as per the World Bank categories.
Results:
A total of 1321 surgeons from 43 countries responded to the survey, with 1079 (81.7%) respondents from LMICs. Over 70% of surgeons from both HICs and LMICs recognized that the healthcare industry contributes towards climate change, and over 45% correctly identified that health systems in HICs contributed more to climate change than those in LMICs.
Comparisons of surgeons from HICs vs. LMICs revealed several statistically significant differences. Surgeons from LMICs were more likely to believe that climate change would have serious adverse effects on the health of their patients (51.8% vs. 36%). Surgeons from HICs were more likely to believe that HICs and LMICs shared equal responsibility towards making healthcare greener. Surgeons from HICs were also more likely to believe that it was more cost-effective for health systems to go green. A greater percentage of surgeons from LMICs were willing to dedicate their time to help their hospitals to go green.
Perceptions differed regarding the most important healthcare-related sources of pollution, with surgeons from LMICs reporting infectious medical waste and hospital emissions, while surgeons from HICs reporting single-use equipment and rubber/plastic products.
Conclusion:
While surgeons from LMICs and HICs recognize the detrimental climate impact of health systems, there is an urgent need to emphasize the importance of collaborative, shared responsibility in making healthcare greener globally. Given the perceived differences in sources of healthcare-associated pollution between HICs and LMICs, health systems must tailor climate change mitigation strategies to best suit local needs.
