Louise Zacest: 30 October 2022

In April this year, Deloitte Insights published a compelling article about the link between climate change and human health. The lives we enjoy today and our ongoing health and wellbeing are so closely connected to the health and wellbeing of our planet. And we all need to think about how our businesses and industries have a part to play.

The Deloitte article resonated for me in identifying that medical providers including health insurers have a responsibility to operate in a more sustainable way to help mitigate the impacts of climate change, while also keeping communities resilient and well during times of extreme environmental events such sea level rise, extreme heat or drought.

The theme of sustainability was echoed at the International Federation of Health Plans (IFHP) biennial conference held in Vancouver earlier this month, which I attended. IFHP is the leading executive network within the global health insurance industry, and the biennial conference is one of many events designed to bring industry professionals together to examine the current opportunities and challenges for our sector.

Since the conference, I’ve been reflecting on what sustainability means for the health sector a little closer to home. With adverse climate events on the rise in Aotearoa, the devastating flooding events in Nelson in August this year come to mind, there is no doubt that people’s physical health and mental wellbeing are being impacted.

So, I considered the question, how can New Zealand’s health insurance sector develop sustainable business initiatives that help build our climate resilience while also supporting the health and wellbeing of our Members?

While as an industry our direct carbon footprint is relatively small, collectively we fund more than $1.3 billion of health services each year, with a significant portion of that funding being directed into hospital procedures. While it’s not well known, healthcare is one of the biggest contributors to greenhouse gas emissions worldwide, arising predominately from energy usage, waste and the use of anaesthetic gases. According to The World Health Organisation (WHO), health services consume considerable energy resources, and generate large amounts of air pollution, which also leaves a carbon footprint, both in terms of long-lived CO2 as well as short-lived climate pollutants such as methane, nitrous oxides and black carbon. Other health-harmful airborne emissions from health care facilities typically include anaesthetic gases that are released during certain medical procedures. For example, exposure to gases such as nitrous oxide (N20), can have impacts on health-workers’ reproductive and respiratory health.

As large consumers of energy and water, health care activities have a significant climate impact. In developed countries, including New Zealand, health facilities have been estimated to contribute between 3-8% of national greenhouse gas emissions. Hospitals are also among the most energy-intensive commercial and institutional buildings. They consume significant amounts of energy for processes such as: heating, cooling, lighting and ventilation; appliances and medical equipment use; cooking, laundry, refrigeration and other appliance use; and supply procurement and transport. Sewage and solid waste disposal also require energy combustion and may be an air pollution source, for example, when waste is burned.

In developing countries, where access to energy may be very restricted, the use of inefficient coal, diesel and kerosene energy production also generate high concentrations of health damaging fine particulates which increase risks of cardiovascular disease and strokes, as well as respiratory diseases and some cancers.

In New Zealand, according to the New Zealand Energy Efficiency and Conservation Authority (EECA), the health sector is the largest emitter in the public sector, excluding emissions from transport . Without prompt and direct nation-wide action to reduce greenhouse gas emissions, the health sector will face increasing pressure from the burden of climate change related illnesses. Reducing greenhouse gas emissions is also an opportunity to improve the health, wellbeing and resilience of our communities.

For these reasons it is critical that the New Zealand health sector steps up to mitigate and adapt to the effects of climate change.

Speaking with international colleagues in Vancouver, there are clear opportunities for private health insurers to take the lead, particularly at a time when many public systems are facing pressures due to the lingering impacts of COVID-19 on access to services.

Specific opportunities include working with private hospitals to encourage sustainable practices and helping our customers understand and offset the climate impact of health services they consume. In addition, as organisations with large balance sheets, there is opportunity to look at social investment and support start-up initiatives with a focus on addressing climate change. For example, Iñaki Ereño, CEO of UK-based Bupa, has driven an international effort within Bupa to identify initiatives and partner with 500 organisations focussed on positively contributing to the health of our planet.

New Zealanders are known for our ‘number 8 wire’ approach to innovation, and if we collaborate at an industry level, I’m sure we could drive creative and sustainable solutions.

The issue of keeping communities resilient and well during times of environmental change is also one we need to tackle collectively. We have already seen how COVID-19 lockdowns affected people’s wellbeing. Imagine how future years of continual ‘freak weather events’ could potentially impact our communities.

As a member-based organisation, we are a community. We also work with employers and their communities of staff and their families. Let’s think about how we can work together to support wellbeing today and in the future.

As always, I’m interested to hear your thoughts on how we can mitigate climate change, ensure healthcare sustainability and build our health and wellbeing resilience. Please feel free to email me at ceo@unimed.co.nz.

Louise Zacest
Chief Executive Officer