Signatories included twelve national health-professional organizations - the Canadian College of Health Service Executives, the Canadian Medical Association, the Canadian Dental Association, and the Canadian Nurses Association, among others - joined by the David Suzuki Foundation. Their joint position statement expresses a shared vision of the health sector as a leader in integrating environmentally responsible practices and in advocating action to protect the environment.

There are three compelling reasons why this kind of leadership from Canada’s health professionals is significant – and sorely needed. First, the health sector is a major player in the Canadian economy. It accounts for approximately 10 percent of gross domestic product (GDP).¹ According to 2006 census data, health care and social assistance together employ close to 1.7 million Canadians, making it the country’s second-largest service industry after retail trade.² As such, the sector consumes large amounts of energy and other resources and generates considerable waste. University of Chicago researchers recently calculated that health care in the United States accounts for a full 8 percent of the country’s greenhouse gas emissions.³ By comparison, this is roughly equivalent to the emissions of the entire American agricultural sector and only slightly less than half of all emissions associated with residential energy use in the US.⁴

This challenge is also an opportunity. Greening health operations will have a significant impact on our ecological footprint over all. Moreover, because the sector controls such a large piece of the economic pie, it can leverage its purchasing power to develop the market for ecologically preferable alternative products and services. Shifting the Canadian economy onto the path of environmental sustainability will require broad participation from all sectors, but in particular large players like the health sector.

The second reason for environmental leadership from the health sector is that health professionals are widely respected and influential in the wider community. A Nanos Research poll released in September found that Canadians consider doctors and pharmacists more honest and ethical than other professionals.⁵ Participants in a Reader’s Digest Canada poll this past spring likewise ranked doctors, nurses, pharmacists, and dentists among the top ten most trusted professions.⁶ When health professionals demonstrate a concern for the environment, they set an example for others to follow. Integrating environmentally responsible practices in health care can therefore serve both a practical and an educational function.

This is particularly true given the frequent and personal nature of health professionals’ interactions with their patients (i.e. the public). Four out of five Canadians report consulting a physician at least once in the past 12 months ⁷ - more than the number attending religious services over the same period! ⁸ Few patients are likely to read the Joint Position Statement Towards an Environmentally Responsible Canadian Health Sector. However, each trip to the doctor’s office can affirm the importance of environmental action, whether implicitly by modelling environmentally responsible practices, or explicitly by providing information about environmental health.

Earlier this fall, the David Suzuki Foundation launched David Suzuki at Work , a program to support environmental practices in the workplace. An online toolkit and a team of volunteer peer ambassadors are available to help green leaders get started. This program is designed to be adaptable across a range work settings and has already attracted the interest of some organizations in the health sector.

Beyond greening its own operations, the health sector also has an important role to play in raising public awareness of the connections between health and the environment, and advocating broader action to address these links. For example, the Registered Nurses Association of Ontario and the Ontario College of Family Physicians were instrumental in the successful campaign to ban the cosmetic use of pesticides in Ontario. These organizations mobilized their own expertise and memberships. They also helped to inform and motivate broader public support for the ban on the basis of a preventative approach to the health risks associated with pesticides.

The recognition that human health depends on a healthy environment is the third and, in fact, most fundamental reason for environmental leadership from the health sector. Environmental risk factors play a role in more than 80 percent of the diseases reported to the World Health Organization and the WHO considers that a full quarter of the global disease burden can be attributed to preventable environmental health hazards.⁹ In Canada, Boyd and Genuis estimate that adverse environmental exposures are associated with up to 25,000 deaths, 194,000 hospitalizations, 1.8 million restricted activity days for asthma sufferers, and 24,000 new cases of cancer each year, costing the economy as much as $9.1 billion.¹⁰

Traditional “environmental issues” with consequences for human health extend from air and water quality, to toxic chemicals in consumer products and pesticides, to climate change and biodiversity. What we do to nature we do to ourselves because, quite simply, humans are not separate from nature. This is the basis for the David Suzuki Foundation’s interest in environmental health issues. We engage with policy-makers, organizations, communities, and individuals to promote a healthy environment for Canadians.

Highlights of the Foundation’s work to date in this area include our recommendation for a national environmental health strategy, contained in the report Prescription for a Healthy Canada; analysis and advocacy related to specific environmental health policies; and practical solutions for healthy, green living from Suzuki’s Queen of Green.

In Prescription for a Healthy Canada (David Boyd, 2007), we examined the key environmental health issues in Canada, including indoor and outdoor air pollution, water pollution, industrial chemicals, heavy metals, pesticides, toxic substances in consumer products, climate change, ozone depletion, and declining biodiversity. The study assessed shortcomings in Canadian environmental policy in these areas and considered leading environmental policies adopted by other jurisdictions. This analysis led to the recommendation for a national environmental health strategy with five priority areas for action: improving research and monitoring; strengthening laws, regulations, and policies; building professional capacity and raising public awareness; confronting the unjust distribution of environmental harms and protecting vulnerable populations; and prioritizing environmental health on the international stage.

Much of the David Suzuki Foundation’s ongoing policy work on environmental health issues connects to specific recommendations in Prescription for a Healthy Canada. For example, over the past two years, our campaign on the cosmetic use of pesticides focused on the development of Ontario’s new province-wide ban on lawn and garden pesticides. Complementing policy work in this area, the popular David Suzuki Digs My Garden contest promoted and showcased pesticide-free lawns and gardens in communities across the country.

The growing number of provincial and municipal prohibitions on lawn and garden pesticides illustrates the good news about environmental threats to health: the majority of adverse exposures can be prevented. Health professionals and health organizations have been at the forefront of various initiatives to promote healthy environments. Given the urgency of many environmental problems today, leadership from the health sector is welcome and needed.

Healthy people need a healthy planet. The David Suzuki Foundation looks forward to collaborating with health professionals, building on the joint position statement towards an environmentally responsible Canadian health sector and responding to its call for action.

Call to Action from the Joint Position Statement Towards an Environmentally Responsible Canadian Health Sector

references

1. Organisation for Economic Co-operation and Development. OECD.StatExtracts. (2007 statistics)
   
2. Statistics Canada. 2006 Census. The Daily. Mar 4, 2008.
   
3. Jeanette W. Chung; David O. Meltzer. “Estimate of the Carbon Footprint of the US Health Care Sector.” The Journal of the American Medical Association, 2009; 302 (18): 1970 DOI: 10.1001/jama.2009.1610
   
4. Pew Centre on Global Climate Change. Inside Global Warming Basics. Figure 4B. GHG Emissions by Sector.
   
5. Doctors, pharmacists top list of professionals Canadians trust most. Financial Post. Sep 23, 2009.
   
6. Other Facts About Canada’s Most Trusted. Reader’s Digest.ca. Adapted from Reader’s Digest Canada, June 2009.
   
7. Sanmartin et al. “Comparing Health and Health Care Use in Canada and the United States.” Health Affairs, 200-6; 24(4): 1133-42 DOI: 10.1377/hlthaff.25.4.1133
   
8. Clark W and Schellenberg G. “Who’s Religious?” Canadian Social Trends, Summer 2006. Statistics Canada – Catalogue No. 11-008.
   
9. Prüss-Üstün A and Corvalán. Preventing Disease Through Healthy Environments. World Health Organization. 2006.
   
10. Boyd DR, Genuis SJ. “The Environmental Burden of Disease in Canada: Respiratory Disease, Cardiovascular Disease, Cancer, and Congenital Affliction.” Environ Res. 2008 Feb;106(2):240-9. Epub 2007 Sep 29.

What are the barriers to greening the health sector and how can the David Suzuki at Work program support health professionals to be environmental leaders? - Lisa Gue