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Greening up: Environmental sustainability in general practice

Climate change and health

The World Health Organisation (WHO) predicts 250,000 additional deaths globally from climate‑sensitive diseases (such as heat stress, malnutrition, vector‑borne diseases and injury) from 2030 onward. (5) Australia is particularly vulnerable to the impacts of climate change, including species loss, floods, heatwaves, drought, storms, bushfires and risk of zoonoses. Climate change threatens the foundations of good health: clean air, safe drinking water, nutritious food supply and safe shelter. (5) It also undermines many of the social determinants of health, such as livelihoods, equality, mental health, and access to healthcare and social support structures. (6) These impacts are direct, indirect or social in nature.

An example of direct climate-change impact is the increase in morbidity and mortality resulting from higher temperatures and heatwaves, particularly among groups such as older adults and those with pre‑existing cardiovascular and respiratory diseases. (1) The indirect impacts of climate change result from interactions of climate with other systems; for example, declining agricultural yields and quality caused by drought, resulting in poorer nutrition despite higher caloric intake, and changes in the distribution of vectors that spread infectious disease, caused by flooding and habitat loss. (1) Social impacts of climate change include conflict, forced migration and damage to livelihood. (1)

Critically, these climate‑sensitive health risks are disproportionately felt by vulnerable populations, including Aboriginal and Torres Strait Islander peoples, low socioeconomic communities, migrants, older adults, and those with underlying health conditions. You can read more on the WHO website.

Climate action can have huge health benefits. The Lancet has stated that the response to climate change is ‘the greatest global health opportunity of the 21st century’.(9)

  1. Parise I. A brief review of global climate change and the public health consequences. Aust J Gen Pract 2018,47(7):451–56.
  2. AdaptNSW. Causes of climate change. Sydney South, NSW: New South Wales Government [date unknown] [Accessed 17 May 2022].
  3. Climate Council. Agriculture’s contribution to Australia’s greenhouse gas emissions. Sydney, NSW: Climate Council, 2021 australia‑agriculture‑climate‑change‑emissions‑methane [Accessed 17 May 2022].
  4. Intergovernmental Panel on Climate Change. Climate change 2021: The physical science basis – Summary for policymakers. Geneva: IPCC, 2021 downloads/report/IPCC_AR6_WGI_SPM_final.pdf [Accessed 17 May 2022].
  5. World Health Organization. Climate change overview. Geneva: WHO [date unknown] climate‑change#tab=tab_1 [Accessed 17 May 2022].
  6. World Health Organization. Climate change and health. Geneva: WHO, 2021 fact‑sheets/detail/climate‑change‑and‑health [Accessed 17 May 2022].
  7. The Royal Australian College of General Practitioners. Climate change and human health: Position statement. Melbourne, Vic: RACGP, 2019 media/documents/RACGP/Position%20statements/Climatechange‑and‑human‑health.pdf [Accessed 17 May 2022].
  8. National Health Service. Delivering a ‘net zero’ National Health Service. London: NHS, 2020. Available at www.england. delivering‑a‑net‑zero‑national‑health‑service.pdf [Accessed 17 May 2022].
  9. McAlister S, McGain F, Peterson M, et al. The carbon footprint of hospital diagnostic imaging in Australia. Lancet, 2022.24:100459.
  10. British Medical Association. Sustainable and environmentally friendly general practice: GPC England policy document. London: BMA, 2020 media/2570/bma‑sustainable‑and‑environmentally‑friendlygeneral‑practice‑report‑june‑2020.pdf [Accessed 17 May 2022].
  11. Pernigotti D, Stonham C, Panigone S, et al. Reducing carbon footprint of inhalers: Analysis of climate and clinical implications of different scenarios in five European countries. BMJ, 2021,8:e001071. doi:10.1136/ bmjresp‑2021‑00107. [Accessed 17 May 2022].
  12. Woodcock, A, et al. Effects of switching from a metered dose inhaler to a dry powder inhaler on climate emissions and asthma control: Post‑ hoc analysis. Thorax BMJ, 2022. doi:10.1136/ thoraxjnl‑2021‑218088. [Accessed 17 May 2022].
  13. New South Wales EPA. The waste hierarchy. Sydney, NSW: NSW EPA 2021 [Accessed 17 May 2022].
  14. E bi K, Tong S. Preventing and mitigating health risks of climate change. Environ. Res., 2019;174:9–13. doi:10.1016/j. envres.2019.04.012. [Accessed 17 May 2022].
  15. Royal College of General Practitioners. Sustainable development, climate change and green issues. London: RACGP, 2022 [Accessed 17 May 2022].
  16. Xie E, de Barros EF, Abelsohn A, et al. Challenges and opportunities in planetary health for primary care providers. Lancet Planet. Health, 2018;2(5):e185–e187. doi:10.1016/S25425196(18)30055‑X. [Accessed 17 May 2022].
  17. B ansal A, Blashki G. Six steps to both greener and better primary care. London: The BMJ Opinion, 2020 [Accessed 17 May 2022].
  18. Office of Environment and Heritage. I am your optimisation guide: Heating, ventilation and air conditioning systems. Sydney, NSW: New South Wales Government, 2015 business/150317HVACGuide.pdf [Accessed 17 May 2022].
  19. Sustainability Victoria. Reduce heating, ventilation and air conditioning (HVAC) costs in your business. Melbourne, Vic: Victorian Government, 2021. Available at www.sustainability. [Accessed 17 May 2022].
  20. The Royal New Zealand College of General Practitioners. Greening general practice: A toolkit for sustainable practice. Auckland: RNZCGP, 2016 [Accessed 17 May 2022].
  21. Sustainability Victoria. Avoid food waste at home. Melbourne, Vic: Victorian Government, 2022 avoid‑waste/food‑waste [Accessed 17 May 2022].
  22. Downes J, Borg K, Florin F. A type of ‘biodegradable’ plastic will soon be phased out in Australia – That’s a big win for the environment. Melbourne, Vic: The Conversation, 2021 [Accessed 17 May 2022].
  23. Greener Practice. Why Environmentally Sustainable Practice? UK: Greener Practice, [date unknown] [Accessed 17 May 2022].
  24. SEE Sustainability. Helping you get your practice to netzero. UK: SEE Sustainability, 2022. Available at https:// [Accessed 17 May 2022].
  25. Myhre G, Shindell D, Bréon FM, et al. Anthropogenic and natural radiative forcing. In: Stocker TF, et al, editors. Climate Change 2013: The Physical Science Basis. Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge: Cambridge University Press; 2013. [Accessed 17 May 2022].
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