Patients ‘generally open’ to considering the environmental impacts of treatments

Key takeaways:

• Patients were open to discussing links between the environment and health, especially if it was their own health.
• There is a need to better educate physicians on climate health, a researcher said.

Both physicians and patients showed openness to considering environmental factors when discussing treatment options, a qualitative study published in Nature Climate Change showed.

“Studies have shown that the U.S. health care industry is responsible for 8.5% of national greenhouse gases emissions and about 25% of health care emissions worldwide,” Andrew Hantel, MD, a faculty member in the Divisions of Leukemia and Population Sciences at Dana-Farber Cancer Institute, said in a press release. “The downstream health consequences of these emissions are responsible for the same level of loss of life as pancreatic cancer or colon cancer every year.”

Because of the impact that health care can have on the environment, “we wanted to assess if and how physicians view their responsibility to address this issue, ” he added. “We also asked patients how willing they would be to make changes in their care that might reduce emissions and limit harm to others.”

In the study, the researchers conducted several focus groups — three of which comprised patients and four of which comprised physicians — and discussed topics like professional duties to the environment, navigation of personal and climate health interests and climate and health inequities.

Overall, the study included 46 participants, most of whom came from diverse groups.

Most physicians assumed that patients had a lack of interest in the environmental impacts related to their health conditions and expressed that medical school had not prepared them to address ethical issues related to health and the environment.

Hantel and colleagues found that patients instead appeared “generally open” to the idea of discussing connections between the environment and health, particularly discussions related to their own or their community’s health.

Patients also emphasized the importance of understanding climate health for both themselves and their physicians. They felt that physicians lacked education on the environment’s impact on health and that paternalism could impede climate-informed health discussions.

“They also encouraged physician responsibility through advocacy and action to reduce health care delivery waste,” the researchers wrote.

Both patients and physicians felt that the patient’s needs should be prioritized over environmental concerns but were open to alternative options that helped the environment in cobeneficial situations.

Hantel gave an example of one way a treatment option could be both effective for health and the environment.

"Asthma or chronic obstructive pulmonary disease, for example, can be managed in part using powdered or aerosolized inhalers," he explained. "For many patients they're equally effective medications, but powdered inhalers have significant environmental benefits."

Physicians and patients all expressed limited knowledge on climate change and health and strategies that promoted sustainability but “advocated for improving physicians’ understanding of climate-related health to promote informed health counselling,” Hantel and colleagues wrote.

“Our findings point to the need to better educate physicians and health professionals about changes they can make, as well as those they can advocate for within their institutions, which benefit patients but also are less toxic to the environment,” Hantel said in the release. “The goal isn't to shift the burden of climate-informed health care decisions onto patients, but to engage with them on these issues and make sure they're a normal part of conversations with their doctors.”

References:

• Hantel A, et al. Nat Clim Chang. 2024;doi:10.1038/s41558-024-02121-z.
• Study finds doctors and patients interested in environmental impact of health care decisions. Available at: https://www.dana-farber.org/newsroom/news-releases/2024/study-finds-doctors-and-patients-interested-in-environmental-impact-of-health-care-decisions. Published Sept. 12, 2024. Accessed Sept. 11, 2024.