Twenty years ago, the health care industry produced more toxic dioxin emissions than any other business sector, because of medical waste incinerators. Then environmental health advocate Gary Cohen decided to try to clean things up. His efforts have now won him a 2015 MacArthur 'genius' fellowship.
Cohen is co-founder and president of Health Care Without Harm, a non-profit organization that works with the health care industry to change its practices so they are less damaging to the environment. His MacArthur grant reflects not only his past successes, but his vision of the health care industry’s role in the future.
Cohen believes the industry can and should lead the way toward better energy and environmental practices worldwide, improving both human welfare and helping to reverse the effects of climate change.
“If we’re ever going to turn around the epidemic of chronic disease in our society, we have to get the health care sector to stop contributing to it,” Cohen says. “We have to get the health care sector to show us the way out of this toxics problem, to show us the way out of our addiction to fossil fuels, to be the early adopters of renewable energy sources.”
Cohen has already shown that change is possible. In the mid-1990s, hospitals were the largest source of dioxin contamination in the US. Dioxin is linked to cancer, learning disabilities and problems with brain development.
“The idea that hospitals were poisoning people in service of healing them was crazy, and a clarion call to address that,” Cohen says. He responded with Health Care Without Harm and by advocating for better waste practices.
“We showed the hospitals that burning waste was incredibly inefficient, and it was creating this toxics problem that was ubiquitous around the world,” Cohen explains. “[We showed them] that they could use alternative technologies, reduce their waste, save money in the process, and it was going to be good for the environment and good for the health of their communities.”
Cohen's organization achieved tremendous results. In the US, the number of medical waste incinerators dropped from about 4500 to 70 in less than a decade.
At the time, hospitals were also a significant source of mercury contamination, due to all the broken mercury thermometers that were either dumped down the drain or burned in incinerators. The mercury was emitted into the atmosphere, which would then build up in the environment, in fish and then in humans when we ate the fish.
Health Care Without Harm started by convincing one hospital in Boston to eliminate its use of mercury thermometers. Then they convinced the other hospitals in Boston to follow suit and began to bring the idea to other cities across the US.
In the end 5,000 hospitals, 14 pharmacy chains and 28 European countries committed to go mercury free and by 2013 there was a global treaty phasing out all mercury measuring devices by the year 2020, Cohen says.
Now he and his organization are looking to the future. The health care sector, Cohen says, still has all the contradictions built into our modern economy, and that needs to change.
“They're a major user of energy, which is derived from fossil fuels that have all sorts of public health impacts and are contributing to climate change,” he explains. “They’re one of the largest users of toxic chemicals, which are contributing to cancer and learning disabilities and all sorts of other health issues. And they serve food that's been drenched with pesticides and meat that's been grown with the overuse of antibiotics.”
So Health Care Without Harm is working with hospitals to change their purchasing practices, pushing them to better support renewable energy and to buy products with green chemicals that don't contaminate their patients or poison their workers.
They are also working with hospitals to change how they buy food, so they can support sustainable farmers in the community that “create healing food environments in their facilities for their patients [and] their employees, who spend 12 hours a day there,” Cohen says.
“We’re trying to link the idea that food is medicine, and that health care, in its purchasing practices, can be involved in a much larger healing strategy,” he explains. “Not only healing individual patients, but healing communities they serve, and healing the planet. That's the new mission of health care in the 21st century.”
The world is already learning, Cohen says, that health is a major way we will all experience climate change — whether it’s increased asthma in inner cities, more illnesses related to heat stress, or an increase in infectious diseases like Dengue fever and malaria, which could be carried by mosquitoes to warming climates.
“Climate change is going to impact everyone's health around the planet,” Cohen maintains. “When we can get the health care industry to rebrand climate change as a public health emergency, people will respond.”
“If people think that climate change has to do [only] with melting ice caps and polar bears — something very far away — they’re not going to be motivated to act,” he says. “But if they understand that climate change impacts their health and the health of their children and their communities, they're motivated to act."