Q&A: Health care is the lynchpin to tackling our multiple global crises

The health sector sits at the epicenter of addressing the collective trauma of racial injustice, climate change, and COVID-19. That is according to Gary Cohen, president and founder of Health Care Without Harm, an organization working to help the health sector address its carbon footprint and become advocates for environmental health and justice.

“Where do people go when they contract COVID? Where do people go when it's 120 degrees or when there’s a hurricane that impacts their health? They go to the clinic or hospital in their community. It's the anchor for trauma and response, but also for recovery,” Cohen said, explaining that all three issues are intertwined.

While global emissions have dropped as a result of COVID-19, this is likely to be short term. Fossil fuels are the root cause of both the climate crisis as well as outdoor air pollution, which kills over 4 million people every year. Furthermore, people living in high pollution communities are likely to be more vulnerable to COVID-19’s respiratory impacts, while structural and racial inequalities have exacerbated this pandemic at every turn. These crises are all intertwined, but the health sector can simultaneously address them if it “expands its healing mission,” Cohen said.

“Health care can't just be about treating sick people, but about creating the conditions for health for everyone on the planet,” he said, adding that the health sector also needs to heal itself since it represents all the contradictions of our global economy built on fossil fuels and toxic chemicals.

“[The health sector] is now recognizing that the conditions that are making people sick in the first place have to do with poor housing, food insecurity, pollution, racism, and violence in their communities. [Health care providers] need to see themselves as being in service of addressing those wounds and being partners in a much more systemic healing,” Cohen said.

Speaking to Devex, Cohen dug into how climate change, COVID-19, and racial injustice intersect and what steps it can take to create a health sector that can help heal these global crises.

This conversation has been edited for length and clarity.

How are climate change and the current pandemic intertwined?

Both are fundamentally about public health. They each show us that we’re truly connected to everyone else on the planet. The COVID pandemic has shown us that the health of someone across the street or across the country or across the world is linked to my health. It’s exactly the kind of collective trauma that climate change represents. The acceleration of the climate crisis will affect everyone on the planet.

The other [issue] is that COVID and the climate crisis don’t affect everyone equally. More people of color are getting sick and dying in the United States than white people due to COVID, as are people who already suffer economic and health disparities and more likely to live in communities with polluted air.

How are these issues of racial injustice, climate change, and health equity changing the global health landscape?

We need to provide health care to everyone on the planet. It's a fundamental human right. If we don't provide basic health care for people, then we're basically saying they're expendable and that our addiction to fossil fuels trumps the rights of all children to breathe clean air and grow up in healthy and stable environments.

There are three levels in which health care needs to operate: the individual, the community, and the planetary level.

What challenges do you think the health care systems had that led to this moment of concurrent health, ecological, social, political, and economic crises?

A lot of health systems don't have the capacity to address so much disruption, damage, and suffering. In many cases, health care institutions are not resilient in the face of climate threats. They’re not designed to be the last buildings standing in a hurricane or flood. Their supply chains are global and can be easily disrupted, as we have tragically witnessed through the pandemic.

Hospitals and clinics need to be redesigned so that they can actually be that anchor and safe harbor for their communities when disaster strikes. A core part of that resilience is operating their facilities on renewable energy, rather than fossil fuels.

When we consider a COVID-19 vaccine, we need to guarantee cold storage so everybody in the world has access to it. Is that cold storage capacity going to be run on fossil fuels? Which are driving this climate crisis. Or can we have it run on renewable energy?

We also need to rethink our political role in society. We need to become advocates and truth-tellers. Politicians in far too many places are abusing this crisis by downplaying its severity and how it’s spread. People trust health professionals to tell them the truth about what's really happening. We need a whole army of health professionals around the world telling the truth about how profound the climate crisis is and how we need to kick our addiction to fossil fuels and toxic chemicals in order to survive the next century.

We need integrated solutions: universal access to health care, climate-smart investments in renewable energy, and low-carbon and toxic-free solutions that build a more equitable society.

Let's leverage the economic clout of health care — which is 10% globally — to embed health, equity, and climate resilience as core values of a new business ethic for the 21st century.

Do you think this moment of crisis is enough to trigger the change that's needed?

It has to because we’ll see, over the next decade, an acceleration of the climate crisis. The fundamental struggle that we face is this: whose rights will prevail on the planet? If it's the rights of the fossil fuel industry, which continues to destroy the planet, our health, and pollute our democracy, then we are going to have a public health and ecological disaster of Biblical dimensions.

The entire business model of the fossil fuel industry requires it to externalize harm. That's why there is no price on carbon. All the damage is externalized onto society. We can’t allow their license to pollute to prevail over the rights of our children to grow up toxic-free, to have clean air to breathe, to have enough food to eat, to live in healthy neighborhoods, to have the ability to thrive wherever they live. The key question is this: Who owns the future?

What steps would you say health systems need to take to ensure they foster health, equity, sustainability, and social justice?

Health leaders need to make a commitment around a few key ideas. One is that they heal themselves. That means detoxifying their energy and supply-chain and using their purchasing clout to lead us toward an equitable economy built on renewable energy, green chemistry, and sustainable agriculture.

Second, they need to create health in the community ... as opposed to waiting for people to show up at the doorstep of their hospitals and clinics. They need to move upstream and partner with other sectors to address the pollution, racism, unemployment, hunger, violence, and toxic stress that is contributing to the epidemic of diseases in our societies.

Third, health leaders need to leverage their trusted role in society and become messengers and advocates for climate solutions that also encompass health and equity. We need health care professionals to become planetary healers. Our future on Earth depends on it.

For more information on how to create more equitable and resilient societies that provide dignified work for all, universal health care, and a healthy climate, join the Skoll Foundation and Health Care Without Harm for a virtual event on Sept. 16.