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Abstract

Climate change is a threat multiplier, exacerbating underlying vulnerabilities, worsening human health, and disrupting health systems’ abilities to deliver high-quality continuous care. This review synthesizes the evidence of what the health care sector can do to adapt to a changing climate while reducing its own climate impact, identifies barriers to change, and makes recommendations to achieve sustainable, resilient health care systems.

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2023-04-03
2024-10-12
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Literature Cited

  1. 1.
    AEP 2018. 2018 Public-Private Analytic Exchange Program (AEP) underway. ASIS Blog Feb. 28. https://www.asisonline.org/publications--resources/news/blog/2018-public-private-analytic-exchange-program/
    [Google Scholar]
  2. 2.
    Armour S, Burton TM. 2018. Hospitals wrestle with shortage of IV bags, linked to hurricane. Wall Street Journal Jan. 7. https://www.wsj.com/articles/hospitals-wrestle-with-shortage-of-iv-bags-linked-to-hurricane-1515349271
    [Google Scholar]
  3. 3.
    Astron Health Care 2022. Hospital design: an opportunity to make your patients feel better. Astron Blog Jan. 4. https://www.astronhealthcare.com/blog/hospital-design-an-opportunity-to-make-your-patients-feel-better/
    [Google Scholar]
  4. 4.
    Baker N, Bromley-Dulfano R, Chan J, Gupta A, Herman L et al. 2020. COVID-19 solutions are climate solutions: lessons from reusable gowns. Front. Public Health 8:590275
    [Google Scholar]
  5. 5.
    Baugh J, Kemen K, Messervy J, Biddinger P. 2021. Beyond the hazard vulnerability analysis: preparing health systems for climate change. R. I. Med. J. 104:55–59
    [Google Scholar]
  6. 6.
    Bawaneh K, Nezami FG, Rasheduzzaman M, Deken B 2019. Energy consumption analysis and characterization of healthcare facilities in the United States. Energies 12:3775
    [Google Scholar]
  7. 7.
    Bell SA, Klasa K, Iwashyna TJ, Norton EC, Davis MA 2020. Long-term healthcare provider availability following large-scale hurricanes: a difference-in-differences study. PLOS ONE 15:e0242823
    [Google Scholar]
  8. 8.
    Brook RD, Rajagopalan S, Pope CA 3rd, Brook JR, Bhatnagar A et al. 2010. Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation 121:2331–78
    [Google Scholar]
  9. 9.
    Brown C, Peterson E, Lubik A. 2022. Climate change and health vulnerability and capacity assessment Summ. Rep., Vanc. Coast. Health Fraser Health Vancouver, BC: http://www.vch.ca/Documents/HealthADAPT-Vulnerability-Capacity-Summary.pdf
    [Google Scholar]
  10. 10.
    Bryan AF, Levine DM, Tsai TC 2021. Home hospital for surgery. JAMA Surg 156:679–80
    [Google Scholar]
  11. 11.
    Cavallo A, Cavallo E, Rigobon R. 2014. Prices and supply disruptions during natural disasters. Rev. Income Wealth 60:S449–71
    [Google Scholar]
  12. 12.
    CBS News 2018. Protective masks fly off store shelves in wildfire-ravaged California. CBS News Nov. 19. https://www.cbsnews.com/news/fires-in-california-protective-masks-high-demand-camp-fire-bay-area/
    [Google Scholar]
  13. 13.
    Chung JW, Meltzer DO. 2009. Estimate of the carbon footprint of the US health care sector. JAMA 302:1970–72
    [Google Scholar]
  14. 14.
    Citizens for Tax Justice 2016. Puerto Rico and Section 936: a taxing lesson from history. Tax Justice Blog Aug. 9. https://ctj.org/puerto-rico-and-section-936-a-taxing-lesson-from-history/
    [Google Scholar]
  15. 15.
    Clarke DV, Newsam J, Olson DP, Adams D, Wolfe AJ et al. 2021. Acute hospital care at home: the CMS waiver experience. NEJM Catalyst https://catalyst.nejm.org/doi/full/10.1056/CAT.21.0338
    [Google Scholar]
  16. 16.
    Colbert CY, French JC, Brateanu A, Pacheco SE, Khatri SB et al. 2022. An examination of the intersection of climate change, the physician specialty workforce, and graduate medical education in the U.S. Teach. Learn Med 34:329–40
    [Google Scholar]
  17. 17.
    Constible J. 2020. Preparing U.S. hospitals for COVID-19 and the climate crisis. NRDC Expert Blog April 24. https://www.nrdc.org/experts/juanita-constible/preparing-us-hospitals-covid-19-and-climate-crisis
    [Google Scholar]
  18. 18.
    Desai SP, Gordon J, Harris CA 2019. The economic impact of hurricane evacuations on a coastal Georgia hospital: a case study. Front. Public Health 7:149
    [Google Scholar]
  19. 19.
    Dosa DM, Skarha J, Peterson LJ, Jester DJ, Sakib N et al. 2020. Association between exposure to Hurricane Irma and mortality and hospitalization in Florida nursing home residents. JAMA Netw. Open 3:e2019460
    [Google Scholar]
  20. 20.
    Drug Shortages Task Force, FDA (US Food Drug Adm.) 2020. Drug shortages: root causes and potential solutions Rep., US FDA Silver Spring, MD: https://www.fda.gov/media/131130/download
    [Google Scholar]
  21. 21.
    Eckelman M, Mosher M, Gonzalez A, Sherman J. 2012. Comparative life cycle assessment of disposable and reusable laryngeal mask airways. Anesth. Analg. 114:1067–72
    [Google Scholar]
  22. 22.
    Eckelman MJ, Huang K, Lagasse R, Senay E, Dubrow R, Sherman JD. 2020. Health care pollution and public health damage in the United States: an update. Health Aff 39:2071–79
    [Google Scholar]
  23. 23.
    Eckelman MJ, Sherman J. 2016. Environmental impacts of the US health care system and effects on public health. PLOS ONE 11:e0157014
    [Google Scholar]
  24. 24.
    Eckelman MJ, Sherman JD. 2018. Estimated global disease burden from US health care sector greenhouse gas emissions. Am. J. Public Health 108:S120–22
    [Google Scholar]
  25. 25.
    Eckelman MJ, Sherman JD, MacNeill AJ. 2018. Life cycle environmental emissions and health damages from the Canadian health care system: an economic-environmental-epidemiological analysis. PLOS Med 15:e1002623
    [Google Scholar]
  26. 26.
    Edney A. 2020. Saline shortage feared with hurricane season threatening production. Bloomberg July 16. https://www.bloomberg.com/news/articles/2020-07-16/hurricane-season-could-threaten-saline-solution-production
    [Google Scholar]
  27. 27.
    Esmaeili A, McGuire C, Overcash M, Ali K, Soltani S, Twomey J. 2018. Environmental impact reduction as a new dimension for quality measurement of healthcare services: the case of magnetic resonance imaging. Int. J. Health Care Qual. Assur. 31:910–22
    [Google Scholar]
  28. 28.
    Feinmann J. 2021. How covid-19 revealed the scandal of medical oxygen supplies worldwide. BMJ 373:n1166
    [Google Scholar]
  29. 29.
    First Street Found 2021. The 3rd national risk assessment: infrastructure on the brink First Street Found. New York: https://assets.firststreet.org/uploads/2021/09/The-3rd-National-Risk-Assessment-Infrastructure-on-the-Brink.pdf
    [Google Scholar]
  30. 30.
    Gatenby PAC. 2011. Modelling the carbon footprint of reflux control. Int. J. Surg. 9:72–74
    [Google Scholar]
  31. 31.
    Gilchrist A. 2015. Volatile generic drug prices continue to skyrocket. Pharmacy Times Sept. 2. https://www.pharmacytimes.com/view/volatile-generic-drug-prices-continue-to-skyrocket
    [Google Scholar]
  32. 32.
    Golan MS, Jernegan LH, Linkov I. 2020. Trends and applications of resilience analytics in supply chain modeling: systematic literature review in the context of the COVID-19 pandemic. Environ. Syst. Decis. 40:222–43
    [Google Scholar]
  33. 33.
    Guenther R, Blabus J. 2015. Primary protection: enhancing health care resilience for a changing climate Rep., US Dep. Health Hum. Serv. Washington, DC: https://toolkit.climate.gov/sites/default/files/SCRHCFI%20Best%20Practices%20Report%20final2%202014%20Web.pdf
    [Google Scholar]
  34. 34.
    Haines A, Ebi K. 2019. The imperative for climate action to protect health. N. Engl. J. Med. 380:263–73
    [Google Scholar]
  35. 35.
    Health Hum. Serv 2021. 2021 climate action plan Rep., Dep. Health Hum. Serv., Washington, DC https://www.hhs.gov/sites/default/files/hhs-climate-action-plan-9-28-2021.pdf
    [Google Scholar]
  36. 36.
    Hua CL, Thomas KS, Peterson LJ, Hyer K, Dosa DM. 2021. Emergency department use among assisted living residents after Hurricane Irma. J. Am. Med. Dir. Assoc. 22:918–22.e1
    [Google Scholar]
  37. 37.
    Iakovou EW, Chelsea CC III 2020. How to build more secure, resilient, next-gen U.S. supply chains. TechStream Dec. 3. https://www.brookings.edu/techstream/how-to-build-more-secure-resilient-next-gen-u-s-supply-chains/
    [Google Scholar]
  38. 38.
    Inst. Med 2009. Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report BM Altevogt, C Stroud, SL Hanson, D Hangling, LO Gostin Washington, DC: Natl. Acad. Press
    [Google Scholar]
  39. 39.
    IPCC (Intergov. Panel Clim. Change) 2018. Special report: global warming of 1.5°C Rep., IPCC New York: https://www.ipcc.ch/sr15/
    [Google Scholar]
  40. 40.
    Jeswani HK, Azapagic A. 2020. Environmental impacts of healthcare and pharmaceutical products: influence of product design and consumer behaviour. J. Cleaner Prod. 253:119860
    [Google Scholar]
  41. 41.
    Kishore N, Marqués D, Mahmud A, Kiang MV, Rodriguez I et al. 2018. Mortality in Puerto Rico after Hurricane Maria. N. Engl. J. Med. 379:162–70
    [Google Scholar]
  42. 42.
    Kløverpris NH 2018. Establishing LCA in the healthcare sector. Designing Sustainable Technologies, Products and Policies: From Science and Innovation EG Benetto, K Gericke, M Guiton 89–94. Cham, Switz: Springer
    [Google Scholar]
  43. 43.
    Ko J, Schlaerth H, Bruce A, Sanders K, Ban-Weiss G. 2022. Measuring the impacts of a real-world neighborhood-scale cool pavement deployment on albedo and temperatures in Los Angeles. Environ. Res. Lett. 17:044027
    [Google Scholar]
  44. 44.
    Kumar J, Tardif-Douglin M, Powell T, Kennedy J 2022. The potential of the home hospital model to transform acute care delivery. Health Aff. Forefront Jan. 25. https://www.healthaffairs.org/do/10.1377/forefront.20220124.298372/
    [Google Scholar]
  45. 45.
    Landrigan PJ, Fuller R, Acosta NJR, Adeyi O, Arnold R et al. 2017. The Lancet Commission on pollution and health. Lancet 391:462–512
    [Google Scholar]
  46. 46.
    Langreth R, Koons C. 2017. U.S. hospitals face a shortage of this most basic necessity. Bloomberg Nov. 14. https://www.bloomberg.com/news/articles/2017-11-14/this-simple-lifesaving-liquid-is-suddenly-in-short-supply
    [Google Scholar]
  47. 47.
    Leblanc MR, Lalonde J, Lalonde DH 2007. A detailed cost and efficiency analysis of performing carpal tunnel surgery in the main operating room versus the ambulatory setting in Canada. Hand 2:173–78
    [Google Scholar]
  48. 48.
    Lenzen M, Malik A, Li M, Fry J, Weisz H et al. 2020. The environmental footprint of health care: a global assessment. Lancet Planet. Health 4:e271–79
    [Google Scholar]
  49. 49.
    Lin A, Ma F, Rees M. 2016. Life cycle of an adhesive bandage. Design Life-Cycle http://www.designlife-cycle.com/adhesive-bandage
    [Google Scholar]
  50. 50.
    Lin S, Zhang W, Sheridan S, Mongillo M, DiRienzo S et al. 2021. The immediate effects of winter storms and power outages on multiple health outcomes and the time windows of vulnerability. Environ. Res. 196:110924
    [Google Scholar]
  51. 51.
    Lown Inst 2017. Right Care Series in the Lancet. Lown Institute https://lowninstitute.org/projects/right-care-series-in-the-lancet/
    [Google Scholar]
  52. 52.
    MacNeill AJ, Hopf H, Khanuja A, Alizamir S, Bilec M et al. 2020. Transforming the medical device industry: road map to a circular economy. Health Aff 39:2088–97
    [Google Scholar]
  53. 53.
    MacNeill AJ, Lillywhite R, Brown CJ. 2017. The impact of surgery on global climate: a carbon footprinting study of operating theatres in three health systems. Lancet Planetary Health 1:e381–88
    [Google Scholar]
  54. 54.
    MacNeill AJ, McGain F, Sherman JD. 2021. Planetary health care: a framework for sustainable health systems. Lancet Planet. Health 5:e66–68
    [Google Scholar]
  55. 55.
    Malik A, Lenzen M, McAlister S, McGain F. 2018. The carbon footprint of Australian health care. Lancet Planet. Health 2:e27–35
    [Google Scholar]
  56. 56.
    Manatakis DK, Georgopoulos N. 2014. Reducing the cost of laparoscopy: reusable versus disposable laparoscopic instruments. Minim. Invasive Surg 2014.408171
    [Google Scholar]
  57. 57.
    Mazer-Amirshahi M, Fox ER. 2018. Saline shortages—many causes, no simple solution. N. Engl. J. Med. 378:1472–74
    [Google Scholar]
  58. 58.
    McAlister S, Ou Y, Neff E, Hapgood K, Story D et al. 2016. The environmental footprint of morphine: a life cycle assessment from opium poppy farming to the packaged drug. BMJ Open 6:e13302
    [Google Scholar]
  59. 59.
    McGain F, McAlister S, McGavin A, Story D. 2010. The financial and environmental costs of reusable and single-use plastic anaesthetic drug trays. Anaesthesia Intensive Care 38:538–44
    [Google Scholar]
  60. 60.
    McGain F, McAlister S, McGavin A, Story D. 2012. A life cycle assessment of reusable and single-use central venous catheter insertion kits. Anesth. Analg. 114:1073–80
    [Google Scholar]
  61. 61.
    McGain F, Moore G, Black J 2016. Hospital steam sterilizer usage: Could we switch off to save electricity and water?. J. Health Serv. Res. Policy 21:166–71
    [Google Scholar]
  62. 62.
    McGain F, Muret J, Lawson C, Sherman JD 2020. Environmental sustainability in anaesthesia and critical care. Br. J. Anaesth. 125:680–92
    [Google Scholar]
  63. 63.
    McGain F, Sheridan N, Wickramarachchi K, Yates S, Chan B, McAlister S 2021. Carbon footprint of general, regional, and combined anesthesia for total knee replacements. Anesthesiology 135:976–91
    [Google Scholar]
  64. 64.
    McGain F, Story D, Lim T, McAlister S. 2017. Financial and environmental costs of reusable and single-use anaesthetic equipment. Br. J. Anaesth. 118:862–69
    [Google Scholar]
  65. 65.
    Miller FA, Young SB, Dobrow M, Shojania KG. 2021. Vulnerability of the medical product supply chain: the wake-up call of COVID-19. BMJ Qual. Saf. 30:331–35
    [Google Scholar]
  66. 66.
    Miller RE, Blair PD. 2009. Input-Output Analysis: Foundations and Extensions Cambridge, UK/New York: Cambridge Univ. Press
    [Google Scholar]
  67. 67.
    Nansai K, Fry J, Malik A, Takayanagi W, Kondo N. 2020. Carbon footprint of Japanese health care services from 2011 to 2015. Resour. Conserv. Recy. 152:104525
    [Google Scholar]
  68. 68.
    Natl. Acad. Sci. Eng. Med 2020. Strengthening Post-Hurricane Supply Chain Resilience: Observations from Hurricanes Harvey, Irma, and Maria Washington, DC: Natl. Acad. Press
    [Google Scholar]
  69. 69.
    Natl. Acad. Sci. Eng. Med 2022. Building Resilience into the Nation's Medical Product Supply Chains Washington, DC: Natl. Acad. Press
    [Google Scholar]
  70. 70.
    NHS England, NHS Improv 2020. Delivering a ‘net zero’ National Health Service Rep., NHS Engl., NHS Improv London: https://www.england.nhs.uk/greenernhs/publication/delivering-a-net-zero-national-health-service/
    [Google Scholar]
  71. 71.
    NHS Sustain. Dev. Unit 2009. NHS England carbon emissions carbon footprinting report Rep., NHS Sustain. Dev. Unit London: https://www.sd-commission.org.uk/publications.php@id=816.html
    [Google Scholar]
  72. 72.
    Nogueira LM, Sahar L, Efstathiou JA, Jemal A, Yabroff KR. 2019. Association between declared hurricane disasters and survival of patients with lung cancer undergoing radiation treatment. JAMA 322:269–71
    [Google Scholar]
  73. 73.
    NYC Plan 2018. Resilient industry mitigation and preparedness in the city's industrial floodplain Rep., NYC Plan New York: https://www1.nyc.gov/assets/planning/download/pdf/plans-studies/resilient-industry/resilient-industry-full-report.pdf
    [Google Scholar]
  74. 74.
    Paavola A. 2017. 4 ways the FDA is addressing the saline bag shortage. Becker's Hospital Review Nov. 17. https://www.beckershospitalreview.com/supply-chain/4-ways-the-fda-is-addressing-the-saline-bag-shortage.html
    [Google Scholar]
  75. 75.
    Parks RM, Benavides J, Anderson GB, Nethery RC, Navas-Acien A et al. 2022. Association of tropical cyclones with county-level mortality in the US. JAMA 327:946–55
    [Google Scholar]
  76. 76.
    Parvatker AG, Tunceroglu H, Sherman JD, Coish P, Anastas P et al. 2019. Cradle-to-gate greenhouse gas emissions for twenty anesthetic active pharmaceutical ingredients based on process scale-up and process design calculations. ACS Sustain. Chem. Eng. 7:6580–91
    [Google Scholar]
  77. 77.
    Paterson J, Berry P, Ebi K, Varangu L. 2014. Health care facilities resilient to climate change impacts. Int. J. Environ. Res. Public Health 11:13097–116
    [Google Scholar]
  78. 78.
    Philipsborn RP, Sheffield P, White A, Osta A, Anderson MS, Bernstein A. 2021. Climate change and the practice of medicine: essentials for resident education. Acad. Med. 96:355–67
    [Google Scholar]
  79. 79.
    Pichler P-P, Jaccard IS, Weisz U, Weisz H. 2019. International comparison of health care carbon footprints. Environ. Res. Lett. 14:064004
    [Google Scholar]
  80. 80.
    Pollard AS, Paddle JJ, Taylor TJ, Tillyard A. 2014. The carbon footprint of acute care: How energy intensive is critical care?. Public Health 128:771–76
    [Google Scholar]
  81. 81.
    Romanello M, Di Napoli C, Drummond P, Green C, Kennard H et al. 2022. The 2022 report of the Lancet countdown on health and climate change: health at the mercy of fossil fuels. Lancet 400:1619–54
    [Google Scholar]
  82. 82.
    Romanello M, McGushin A, Di Napoli C, Drummond P, Hughes N et al. 2021. The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future. Lancet 398:1619–62
    [Google Scholar]
  83. 83.
    Roughneen S. 2017. Ireland has become a mecca for U.S. tech companies. Can Trump lure them home?. Los Angeles Times Feb. 10. https://www.latimes.com/world/europe/la-fg-ireland-economy-2017-story.html
    [Google Scholar]
  84. 84.
    Rubbio I, Bruccoleri M, Pietrois A, Rogonese B. 2020. Digital health technology enhances resilient behaviour: evidence from the ward. Int. J. Oper. Prod. Manag. 40:34–67
    [Google Scholar]
  85. 85.
    Salas RN. 2020. The climate crisis and clinical practice. N. Engl. J. Med. 382:589–91
    [Google Scholar]
  86. 86.
    Salas RN. 2022. The growing link between climate change and health. NEJM Catal3 https://doi.org/10.1056/CAT.22.0052
    [Google Scholar]
  87. 87.
    Salas RN, Friend TH, Bernstein A, Jha AK 2020. Adding a climate lens to health policy in the United States. Health Aff 39:2063–70
    [Google Scholar]
  88. 88.
    Salas RN, Jha AK. 2019. Climate change threatens the achievement of effective universal healthcare. BMJ 366:l5302
    [Google Scholar]
  89. 89.
    Salas RN, Knappenberger P, Hess J. 2019. Lancet countdown on health and climate change. Policy brief for the United States of America Brief, Lancet Countdown London: https://www.lancetcountdownus.org/wp-content/uploads/2020/11/LancetCountdownPolicyBrieffortheUS2019.pdf
    [Google Scholar]
  90. 90.
    Salas RN, Maibach E, Pencheon D, Watts N, Frumkin H. 2020. A pathway to net zero emissions for healthcare. BMJ 371:m3785
    [Google Scholar]
  91. 91.
    Salas RN, Solomon CG. 2019. The climate crisis—health and care delivery. N. Engl. J. Med. 381:e13
    [Google Scholar]
  92. 92.
    Sanchez SA, Eckelman MJ, Sherman JD. 2020. Environmental and economic comparison of reusable and disposable blood pressure cuffs in multiple clinical settings. Resour. Conserv. Recycl. 155:104643
    [Google Scholar]
  93. 93.
    Santos-Burgoa C, Sandberg J, Suárez E, Goldman-Hawes A, Zeger S et al. 2018. Differential and persistent risk of excess mortality from Hurricane Maria in Puerto Rico: a time-series analysis. Lancet Planet. Health 2:e478–88
    [Google Scholar]
  94. 94.
    Schär C, Fuhrer O, Arteaga A, Ban N, Charpilloz C et al. 2020. Kilometer-scale climate models: prospects and challenges. Bull. Am. Meteorol. Soc. 101:E567–87
    [Google Scholar]
  95. 95.
    Sherman J, Le C, Lamers V, Eckelman M. 2012. Life cycle greenhouse gas emissions of anesthetic drugs. Anesth. Analg. 114:1086–90
    [Google Scholar]
  96. 96.
    Sherman JD, McGain F, Lem M, Mortimer F, Jonas WB, MacNeill AJ 2021. Net zero healthcare: a call for clinician action. BMJ 374:n1323
    [Google Scholar]
  97. 97.
    Sherman JD, Raibley LA 4th, Eckelman MJ 2018. Life cycle assessment and costing methods for device procurement: comparing reusable and single-use disposable laryngoscopes. Anesth. Analg. 127:434–43
    [Google Scholar]
  98. 98.
    Sherman JD, Thiel C, MacNeill A, Eckelman MJ, Dubrow R et al. 2020. The green print: advancement of environmental sustainability in health care. Resour. Conserv. Recycl. 161:104882
    [Google Scholar]
  99. 99.
    Siegert M-W, Saling P, Mielke P, Czechmann C, Emara Y, Finkbeiner M. 2020. Cradle-to-grave life cycle assessment of an ibuprofen analgesic. Sustain. Chem. Pharm. 18:100329
    [Google Scholar]
  100. 100.
    Skarha JG, Gordon L, Sakib N, June J, Jester DJet al 2021. Association of power outage with mortality and hospitalizations among Florida nursing home residents after Hurricane Irma. JAMA Health Forum 2:e213900
    [Google Scholar]
  101. 101.
    Slingo J, Bates P, Bauer P, Belcher S, Palmer T et al. 2022. Ambitious partnership needed for reliable climate prediction. Nat. Clim. Change 12:499–503
    [Google Scholar]
  102. 102.
    Smith KR, Jerrett M, Anderson HR, Burnett RT, Stone V et al. 2009. Public health benefits of strategies to reduce greenhouse-gas emissions: health implications of short-lived greenhouse pollutants. Lancet 374:2091–103
    [Google Scholar]
  103. 103.
    Snoga JL, La-Viola BA, Sanchez CK. 2019. Containing generic-drug cost. US Pharm 44:32–35
    [Google Scholar]
  104. 104.
    Spencer BJ. 2005. International outsourcing and incomplete contracts. Can. J. Econ./Rev. Can. D'écon. 38:1107–35
    [Google Scholar]
  105. 105.
    Sullivan JK, Lowe KE, Gordon IO, Colbert CY, Salas RN et al. 2022. Climate change and medical education: an integrative model. Acad. Med. 97:188–92
    [Google Scholar]
  106. 106.
    Sur P. 2020. The coronavirus exposed the US’ reliance on India for generic drugs. But that supply chain is ultimately controlled by China. CNN May 16. https://www.cnn.com/2020/05/16/business-india/india-pharma-us-china-supply-china-intl-hnk/index.html
    [Google Scholar]
  107. 107.
    TCFD (Task Force Clim.-Related Financ. Discl.) 2020. Guidance on scenario analysis for non-financial companies Rep., TCFD New York: https://assets.bbhub.io/company/sites/60/2020/09/2020-TCFD_Guidance-Scenario-Analysis-Guidance.pdf
    [Google Scholar]
  108. 108.
    Tennison I, Roschnik S, Ashby B, Boyd R, Hamilton I et al. 2021. Health care's response to climate change: a carbon footprint assessment of the NHS in England. Lancet Planet. Health 5:e84–92
    [Google Scholar]
  109. 109.
    Thiel CL, Eckelman M, Guido R, Huddleston M, Landis AE et al. 2015. Environmental impacts of surgical procedures: life cycle assessment of hysterectomy in the United States. Environ. Sci. Technol. 49:1779–86
    [Google Scholar]
  110. 110.
    Thurston GD, Balmes JR, Garcia E, Gilliland FD, Rice MB et al. 2020. Outdoor air pollution and new-onset airway disease. An Official American Thoracic Society Workshop Report. Ann. Am. Thorac. Soc. 17:387–98
    [Google Scholar]
  111. 111.
    Univ. Iowa Flood Cent 2016. Iowa statewide floodplain mapping Resour., Iowa Flood Cent. Iowa City, IA: https://iowafloodcenter.org/projects/iowa-statewide-floodplain-mapping/
    [Google Scholar]
  112. 112.
    [Google Scholar]
  113. 113.
    US Dep. Commer 2011. Reliance on foreign sourcing in the healthcare and public health (HPH) sector: pharmaceuticals, medical devices, and surgical equipment Rep., US Dep. Commer. Washington, DC: https://www.bis.doc.gov/index.php/documents/other-areas/642-department-of-homeland-security-dhs-assessment-impact-of-foreign-sourcing-on-health-related-infra/file
    [Google Scholar]
  114. 114.
    US Food Drug Adm 2011. Pathway to global product safety and quality Rep., US Food Drug Adm. Silver Spring, MD: https://www.ipqpubs.com/wp-content/uploads/2011/09/FDA-Pathway-to-Global-Product-Safety-and-Quality.pdf
    [Google Scholar]
  115. 115.
    Verschuur J, Koks EE, Hall JW. 2020. Port disruptions due to natural disasters: insights into port and logistics resilience. Transp. Res. D Transp. Env. 85:102393
    [Google Scholar]
  116. 116.
    Vicedo-Cabrera AM, Scovronick N, Sera F, Royé D, Schneider R et al. 2021. The burden of heat-related mortality attributable to recent human-induced climate change. Nat. Clim. Chang. 11:492–500
    [Google Scholar]
  117. 117.
    Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Beagley J et al. 2021. The 2020 report of the Lancet Countdown on health and climate change: responding to converging crises. Lancet 397:129–70
    [Google Scholar]
  118. 118.
    Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova K et al. 2019. The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate. Lancet 394:1836–78
    [Google Scholar]
  119. 119.
    Weisz U, Pichler P-P, Jaccard IS, Haas W, Matej S et al. 2020. Carbon emission trends and sustainability options in Austrian health care. Resour. Conserv. Recycl. 160:104862
    [Google Scholar]
  120. 120.
    Wheat S, Lemery J, Limaye VS. 2022. We're awash in climate change data, but health damages remain undercounted. Health Affairs Forefront March 24. https://www.healthaffairs.org/do/10.1377/forefront.20220323.649504/
    [Google Scholar]
  121. 121.
    WHO (World Health Organ.) 2020. WHO guidance for climate resilient and environmentally sustainable health care facilities Rep., WHO Geneva: https://www.who.int/publications/i/item/9789240012226
    [Google Scholar]
  122. 122.
    World Weather Attrib 2021. Western North America extreme heat virtually impossible without human-caused climate change. World Weather Attribution July 7. https://www.worldweatherattribution.org/western-north-american-extreme-heat-virtually-impossible-without-human-caused-climate-change/
    [Google Scholar]
  123. 123.
    Wu R. 2019. The carbon footprint of the Chinese health-care system: an environmentally extended input-output and structural path analysis study. Lancet Planet. Health 3:e413–19
    [Google Scholar]
  124. 124.
    Young IR, Zieger S, Babanin AV. 2011. Global trends in wind speed and wave height. Science 332:451–55
    [Google Scholar]
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