The environmental footprint of health care: a global assessment

Lancet Planet Health. 2020 Jul;4(7):e271-e279. doi: 10.1016/S2542-5196(20)30121-2.


Background: Health-care services are necessary for sustaining and improving human wellbeing, yet they have an environmental footprint that contributes to environment-related threats to human health. Previous studies have quantified the carbon emissions resulting from health care at a global level. We aimed to provide a global assessment of the wide-ranging environmental impacts of this sector.

Methods: In this multiregional input-output analysis, we evaluated the contribution of health-care sectors in driving environmental damage that in turn puts human health at risk. Using a global supply-chain database containing detailed information on health-care sectors, we quantified the direct and indirect supply-chain environmental damage driven by the demand for health care. We focused on seven environmental stressors with known adverse feedback cycles: greenhouse gas emissions, particulate matter, air pollutants (nitrogen oxides and sulphur dioxide), malaria risk, reactive nitrogen in water, and scarce water use.

Findings: Health care causes global environmental impacts that, depending on which indicator is considered, range between 1% and 5% of total global impacts, and are more than 5% for some national impacts.

Interpretation: Enhancing health-care expenditure to mitigate negative health effects of environmental damage is often promoted by health-care practitioners. However, global supply chains that feed into the enhanced activity of health-care sectors in turn initiate adverse feedback cycles by increasing the environmental impact of health care, thus counteracting the mission of health care.

Funding: Australian Research Council, National eResearch Collaboration Tools and Resources project.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Environmental Exposure / adverse effects
  • Environmental Pollutants / adverse effects*
  • Environmental Pollution / adverse effects*
  • Global Health*
  • Health Care Sector*
  • Humans
  • Malaria / epidemiology*
  • Risk
  • Water Supply / statistics & numerical data*


  • Environmental Pollutants