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9 Ways AHPs Can Contribute to Environmental and Social Sustainability

The health sector, whose mandate is to prevent and cure disease, makes a significant contribution to the global climate crisis. If the global health sector were a country, it would be the fifth-largest greenhouse gas emitter on the planet.

Health systems generate significant environmental impacts both at the up and downstream. These range from service delivery to the natural resources and products health systems procure and consume, to the waste they generate. This, in turn, contributes to climate change, chemical contamination, resource depletion, biodiversity loss, air and water pollution.

So as health professionals, given we contribute to the problem we should also be part of the solution.


So, what is environmental and social sustainability?

Environmental sustainability is defined as the responsibility to conserve natural resources and protect global ecosystems to support health and wellbeing, now and into the future. Whereas social sustainability is defined as systems, structures and relationships that actively support the capacity of current and future generations to create healthy and liveable communities.

Environmental and social sustainability in health is important because:

  • It supports that tackling of upstream determinants of health,
  • It benefits consumers, health service providers and the health workforce,
  • It decreases environmental risks; and
  • It helps reduce costs and increase the resilience of health systems.

Therefore, health systems and health professionals can contribute to improving, maintaining, and restoring health, while reducing the negative impacts on the environment to benefit health and well-being of the current and future generations.


As allied health professionals, how can we contribute to sustainability?

The first step is to create awareness. There are two perspectives that have been identified in relation to creating awareness for environmental sustainability and behavioural change. The first perspective is that changes in behaviour are brought about by increasing public knowledge through raising awareness regarding an issue and by fostering an appropriate attitude. Whereas the second perspective focuses on individuals who systematically review their choices and then act in their own economic self-interest without the need to have enough knowledge and awareness in the first place.

The World Health Organisation (WHO) developed a strategic document that identifies avenues for action on environmental sustainability specifically in health systems. There are nine avenues that are the focus of this strategy:

  • Adopting: Adopting a national environmental sustainability policy for health systems
  • Minimising: Minimising and adequately managing waste and hazardous chemicals
  • Promoting: Promoting an efficient management of resources and sustainable procurement
  • Reducing: Reducing health systems’ emissions of greenhouse gases and air pollution
  • Prioritising: Prioritising disease prevention, health promotion and public health services
  • Engaging: Engaging the allied health workforce as an agent of sustainability
  • Increasing: Increasing community resilience and promoting local assets
  • Creating: Creating incentives for change
  • Promoting: Promoting innovative models of care.


1.     Adopt an environmental sustainability policy

Does your allied health practice or organisation have a sustainability policy?

It is a written statement which outlines the aims and principles in relation to managing the environmental effects and commitments of the business operations.

The policy should include:

  • The business mission and information about its operations.
  • A commitment to continually improve your environmental performance.
  • A commitment to effectively manage your significant environmental impacts.
  • The expectations that your business has in relation to external parties such as suppliers and contractors.
  • Recognition that you will comply with relevant environmental legislation as a minimum level of performance.
  • Education and training of employees in environmental issues and the environmental effects of their activities.
  • Monitoring progress and reviewing environmental performance against targets and objectives on a regular basis (usually annually or in the first six months initially).
  • A commitment to communicate your business’ environmental aims and objectives to all staff, as well as to customers, investors, and other external stakeholders.

The National Health Service England has developed some excellent resources, including a range of practical case studies, to help health professionals and organisations increase their environmental sustainability and governance.  Columbia University Global Consortium on Climate and Health Education provides a range of resources and training for health professionals and organisations, including workshops for people working in the community and rehabilitation sectors.

A recent scoping review that explored the environmental sustainability in occupational therapy  highlights the discipline specific issues facing different allied health groups, but also the paucity of  environmental sustainability literature that is specific to the allied health professions.  


2.     Minimise and manage waste in your practice

While not specific to allied health, health and medical waste is a significant pollutant and contributor to greenhouse emissions. Maria Koijk created an a powerful art installation of the waste created during her treatment for breast cancer (see above).

Prevent production:
  • Audit waste and reduce consumption of high-volume items within your practice.
  • Ask suppliers to reduce packaging.
  • Use procedure kits or sterilisable products to avoid individually wrapped items.
  • Choose suppliers that minimise packaging and have sustainability policies.
  • Reuse and maintain equipment – develop processes that keep track of when equipment needs to be serviced.
  • Separate high-value recyclables – are there products that can be more appropriately recycled.
  • Investigate recycling options through your local council – what options are available and match these options to your polices and practice processes.
  • Use recycling companies that work with manufactures to provide recycling solutions for general waste – seek out innovative approaches.
  • Commit to strict separation of other wastes – encourage and reward staff for good environment practice.


3.     Promote efficient management of your resources and sustainable procurement in your practice

Reducing water usage in health care facilities contributes to conservation of local water sources and to health systems resilience, especially in water-stressed regions, and is possible through various interventions (for example, installation of water-saving armatures and devices).

Three main principles can help guide action related to the use of energy within health systems: 1) reducing unnecessary usage, 2) increasing energy efficiency, and 3) understanding where energy supply resilience can be improved.

Environmental sustainability considerations can be incorporated during the design, construction and/or rehabilitation of buildings housing health care facilities. In the design phase, harmful pollution and carbon emissions from the extraction of raw materials can be minimised. Improving elements of building planning and design such as site location, artificial lighting, natural ventilation, and open and green spaces can also minimise environmental impacts, improve patient experience (for example, thermal comfort) and increase resilience to the projected impacts of climate change. Throughout the lifetime of a building, efficiency measures can include improved insulation, the use of natural ventilation, energy-efficient lighting or the installation of combined heat and power systems. In the rehabilitation of buildings, eliminating harmful substances is an important factor.

Influencing suppliers to factor environmental impacts into their manufacturing process is a powerful level for change. This can be achieved by:

  • Reducing demand by looking for opportunities to buy and use less, constantly questioning whether procured products are necessary, supporting interventions that reduce demand for products or use them more efficiently, and ensuring that procured products are not wasted.
  • Increasing efficiency by buying products, equipment or services that consume less and have a lower environmental impact during their in-use life and at disposal.
  • Assessing the environmental impact of products and services used or delivered by the health system and, where appropriate, substituting or innovating with alternative products, materials or approaches that have less impact on the environment and are more sustainable.


4.     Contribute to reducing emissions of greenhouse gases and air pollution

Examples of how we can achieve this include:

  • Help commuters reduce emissions – Encourage use of mass transit, establish vanpool/carpool programs to make employee commuting more efficient; consider telecommuting for employees. Provide lockers, showers, bike parking for employees who bike or walk to work.
  • When selecting office space, choose space that is close to public transport.
  • Reduce your office’s energy use by switching to energy efficient light bulbs (CFLs, LED bulbs), adjust thermostats to save energy when appropriate (up a few degrees in the summer, down a few degrees in the winter), and upgrade major equipment to the most energy-efficient model. Maintain and clean your heating and air conditioning system to ensure it is operating at peak efficiency. Optimize the building envelope with better insulation and energy-efficient windows.
  • Install On-Site Renewable Energy Capability—Facilities can install (or encourage their office building to install) solar panels to generate a portion of facility’s energy, and/or solar hot-water heating system.
  • Reduce Standby Energy Use—Plug computers and other electronic equipment into power strips and turn off when not in use.
  • Purchase Green Power—Use power generated from renewable sources like wind, solar
  • Purchase Energy-Efficient Products—Buy Energy Star or Federal Energy Management Program-designated products.
  • Request an energy audit for your office—Your utility provider may be able to perform an energy audit to help you set your energy efficiency goals.


5.     Have a strong focus on health prevention in your practice

We are an ageing population with increasing comorbidities. Chronic disease is and will continue to be a significant burden on individuals, the community, as well as the health care system. There is a strong link between environmental factors leading to poor health outcomes as well as reduced health and wellbeing contributing to environmental risks, which in turn will lead to greater healthcare usage and more impact on the environment.Consider:

  • Do you incorporate proactive behavioural change approaches in the management of your clients?
  • Do you regularly have a health promotion lens that incorporates the benefits and intersect between good health and environmental sustainability to assist with social sustainability?


6.     Engage the health workforce as an agent of sustainability 

Health care leaders have a tremendous opportunity to champion the sustainability movement and make a lasting positive impact on the industry and on the long-term health of their patients, their communities, and the world.

Another important role for health care leaders in promoting healthy populations is to educate the public about the impact of climate change on their health and the practices they can adopt to reduce their consumption of energy and natural resources.


7.     Increase community resilience and promote local assets

  • Consider promoting environmentally sustainable actions that increase health systems’ resilience to climate change, such as those fostering energy and water security.
  • Promote and enable the use of public transportation and non-motorized transportation (cycling and walking) for patients, visitors, and staff.
  • Consider using local green spaces for health promotion activities.
  • Get to know what services are available in your area that assist people to keep active and promote these in your practice.
  • Incorporate local assets that support people keeping active as part of your management plans.
  • Get involved in community activities where you have opportunities to support healthy and active lifestyles.


8.     Create incentives for change

Ask your suppliers about their environment policies and approaches to sustainability. Have you considered:

  • Superannuation / pension funds – who are they investing in, natural resources versus renewables
  • Your finance providers
  • Your energy providers
  • Your medical suppliers
  • Your telecommunications providers
  • Your insurance providers.

If everyone made decisions to engage with companies that had a greater commitment to environmental and social sustainability, it would drive meaningful change, as this is a market share lever for companies.


9.     Promote innovative models of care

Besides the significant potential for benefitting patients, practitioners and health systems at large, innovative models of care have great potential to deliver benefits in terms of environmental sustainability. Conversely, interventions towards greater environmental sustainability may help strengthen the overall sustainability of innovative models of care; this becomes clear as more and better estimates of the potential health and environmental benefits of innovative models of care become available.

Actively engaging in improving coordination between primary, secondary, and tertiary levels of care ensures that patients receive timely access to healthcare before their condition deteriorates, (likely resulting in greater usage of health care resources).

Other initiatives include engaging in the use of innovative technologies, including telemedicine and e-health, as well as keeping up to date with evidenced based approaches and clinical guidelines to inform effective and sustainable practice to minimise healthcare resources. Additionally, reviewing standard operating procedures to ensure they reflect environmental sustainability approaches can all be of benefit.



The Ripple EffecctIt’s not about doing everything all at once, but rather understanding that simple and small changes we do regularly can influence long-term change and really make a big difference.

If we all as collective commit to a few changes, this has the power to create a significant ripple effect that will ultimately contribute to changing the current trajectory into a world where our global goals on sustainability have been achieved.

If you have an example of how your organisation is engaging proactively with environmental sustainability and climate change involving allied health, please comment below or add to our forum discussion. For regular updates on allied health issues, subscribe to Allied Health Insights by following the link below.



Health care climate footprint report. Health Care Without Harm.

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Van Achterberg, T., Huisman-de Waal, G. G., Ketelaar, N. A., Oostendorp, R. A., Jacobs, J. E., & Wollersheim, H. C. (2011). How to promote healthy behaviours in patients? An overview of evidence for behaviour change techniques. Health promotion international26(2), 148-162.

Weisz U, Haas W, Pelikan JM, Schmied H (2011). Sustainable hospitals: a socio-ecological approach. GAIA – Ecological Perspectives for Science and Society. 20(3):191–198. ( hospitals_gaia_2011_3_weisz.pdf, accessed 22 May 2017)

West, E., Woolridge, A., & Ibarrola, P. (2020). How to manage healthcare waste and reduce its environmental impact. In Practice42(5), 303-308.

World Health Organisation (2017). Environmentally sustainable health systems: a strategic document. WHO Regional Office for Europe.