Public Health

U.S. health system must come to terms with its environmental impact


The U.S. health care sector is the second-largest industry contributing to landfill waste worldwide, and if it were its own country, it would be the 13th largest global greenhouse-gas emitter. This doesn’t just contribute to climate change; it also negatively affects the health of communities through solid, liquid and gas waste emissions—especially in historically marginalized communities where processing is concentrated.

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The AMA helps physicians build a better future for medicine, advocating in the courts and on the Hill to remove obstacles to patient care and confront today’s greatest health crises.

The October issue of AMA Journal of Ethics® (@JournalofEthics) explores how segregating waste and reducing overall volume are key to curbing emissions that contaminate air and water. It also investigates why moving to net-zero emissions is a measure of the health care sector’s sincerity about achieving health equity.

The issue includes the following articles.

  1. How Should Clinicians and Health Care Organizations Respond When Civic Planning Concentrates Waste Processing in Minoritized Communities?

    1. Communities are not affected equally by the volume and location of U.S. health care waste.
  2. How Should We Respond to Health Sector Emissions That Exacerbate Climate Change and Inequity?

    1. The health sector has obligations and ample opportunities to protect health by decreasing waste and motivating more system-wide sustainable clinical practices.
  3. How Should Health Systems Science Promote Health Systems’ Sustainability?

    1. Health system function, resilience and sustainability are needed to help prepare trainees to lead, innovate and prioritize a circular supply chain with low emissions.
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  4. How Should We Respond to Health Care Generating Environmental Harm?

    1. Health sector actions exacerbate climate warming and iatrogenically harm the global public.

Read this Q&A with AMA member Jerry Abraham, MD, MPH, CMQ, who says that when fighting climate change, health equity shouldn’t be overlooked.

The journal’s October issue also features two “Ethics Talk” podcasts. The first is a discussion with Shawn G. Gibbs, PhD, CIH, dean of the Texas A&M University School of Public Health and professor in in its Department of Environmental and Occupational Health. Gibbs discusses industrial hygiene, biocontainment and how to build more sustainable health systems. 

The second is an interview with Natasha Sood, MPH, a fourth-year year medical student at Pennsylvania State University College of Medicine, co-founder of Medical Students for a Sustainable Future, and project director of Climate Resources for Health Education. Sood co-edited this month’s issue of AMA Journal of Ethics with Gaurab Basu, MD, MPH, and joined “Ethics Talk” to discuss their article, “Why Health Care Needs Sustainable Waste Stream Management.”

The October issue also features seven author-interview podcasts. Listen to previous episodes of the “Ethics Talk” podcast or subscribe in Apple Podcasts or other services.

Also, CME modules drawn from this month’s issue are collected at the AMA Ed Hub™ AMA Journal of Ethics webpage.

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Upcoming issues of the journal will focus on price transparency and economic decision-making in health care, stillness and solidarity as orientations to health care practice and professionalism, and segregation in academic health centers. Sign up to receive email alerts when new issues are published.

Table of Contents

  1. Listen and learn
  2. A look ahead