You Can’t Have Healthy People On a Sick Planet

About a year ago, I was declared cancer-free after four months of chemotherapy at Providence St. John's Health Center in Santa Monica, Calif. I had been diagnosed with low-grade B cell non-Hodgkin Lymphoma. This was not my first encounter with cancer. I’d had breast cancer a number of years prior, which was treated with radiation and then a full mastectomy. I realize I’m lucky. I had caring, attentive doctors and nurses who saved my life. I also realize how much progress has been made in cancer research and I am deeply grateful.

Yet despite that, cancer has become epidemic. Approximately 40% of people in the U.S. will develop cancer and over 1.96 million new cases were expected to be diagnosed in 2023, according to the National Cancer Institute.

I’m a cancer survivor but also a climate activist and I’m very aware of the connection between the environment and health—especially cancer. The same fossil fuels that are driving the climate crisis are driving this health crisis. The Environmental Protection Agency keeps finding cancer-causing chemicals derived from fossil fuels—such as dioxins, benzene, and naphthalene—in the air, in our water, our food, our furniture, our clothing, the utensils we cook with…. They are also in our bodies. These poisons are even found in the umbilical cords of newborn children.

A Harvard Center for Public Health study found fossil fuel-related air pollution caused over 8 million deaths globally in 2018—that’s more in one year than died from COVID-19 in three years. It’s a crisis. Oil, gas, and coal are making the planet sick and making people and other animals sick.

Health care institutions have been heroic when it comes to curing people. But it’s time now for them to move upstream and help prevent the harm in the first place. After all, that’s the doctor’s creed: first do no harm.

So why, according to the environmental organization Stand.earth, have the four big healthcare pension funds in the U.S.—the Mayo Clinic, Kaiser Permanente, HCA Healthcare and Ascension Health—invested more than $4.5 billion dollars in fossil fuel companies?

Our health care system is responsible for almost 9% of the country’s greenhouse gas emissions because of the system’s reliance on fossil fuels to run its facilities and equipment, the petrochemical plastics used to make its devices, the anesthetic gases they use in the operating room, and the food and drugs it purchases.

Gary Cohen, co-founder of Health Care Without Harm, made me hopeful when he told me that the health care community—led usually by its nurses—has made big changes before. When they learned that medical waste incinerators were a leading contributor of cancer-causing dioxin emissions in the U.S., thousands of incinerators were closed and hospitals learned how to reduce their waste, reuse and recycle what they could, and use safer waste-treatment technologies to dispose of potentially toxic materials. When studies began to show that broken mercury thermometers were contributing to dangerous mercury levels in water and fish, the health sector phased out mercury thermometers and found safer alternatives, not only in our country but all around the world.

Health Care Without Harm has pushed hospitals and health care centers to commit to plans to achieve net zero emissions in the near future, and thousands more around the world are on the same path. More than 75 governments have committed to design low-carbon and climate-resilient health systems, including the U.S.

The health care community and hospitals in particular should lead the rest of society in addressing this intersectional health and climate crises, which the World Health Organization calls “one of the greatest health threats for humanity.”

There are some big steps that need to be taken. Hospitals need to embrace ensuring a healthy environment with the same heroism they embrace curing cancer. They can start to run hospitals on renewable energy and to buy supplies (including food) from local sources to reduce carbon from transportation emissions. That would also help communities by supporting local sustainable development. They can also reduce single-use plastics, eliminate polluting anesthetic gasses, electrify their vehicle fleets, move to more telemedicine, and waste less drugs and other supplies. Health care is 17% of the entire U.S. economy—think of the impact if the sector fully committed to these renovations.

Climate-smart health care is preventative medicine on a grand scale. Think about it: We can’t have healthy people on a sick planet. Thank you, health care institutions for helping me heal. And join me, health care institutions, in helping the planet heal.

Parts of this piece are adapted from remarks Fonda delivered at a City of Hope event in 2023.