Enhancing the Australian healthcare sector’s responsiveness to environmental sustainability issues: suggestions from Australian healthcare professionals
Jillian L. Dunphy
+ Author Affiliations
- Author Affiliations
School of Community Health, Charles Sturt University, PO Box 789, Albury, NSW 2640, Australia. Email: jidunphy@csu.edu.au
Australian Health Review 37(2) 158-165 https://doi.org/10.1071/AH11108
Submitted: 2 November 2011 Accepted: 21 August 2012 Published: 15 March 2013
Abstract
Objective. Identify strategies to implement change across the Australian healthcare sector to better support social and natural environments.
Methods. Qualitative analysis of semi-structured interviews with Australian healthcare professionals.
Results. Interviewees described multiple barriers to implementing change and numerous strategies to overcome these barriers. They argued that action must be taken at the individual and systemic levels to produce substantial and effective change. The strategies recommended fall into four main categories: altering workplace cultures and professional identities, community engagement, political activity, and change from within. The overarching goals of these strategies are to reduce negative impacts on the natural environment, and increase social equity within and across generations.
Conclusions. By implementing the strategies described, a more cohesive effort to address sustainability issues across the sector can be made. This may improve local and global health, within current and future generations.
What is known about the topic? Healthcare has a significant impact on the natural and social environments, which in turn have a significant impact upon health and healthcare.
What does this paper add? This paper describes strategies to alter healthcare to better support environmental sustainability.
What are the implications for practitioners? Collective implementation of the described strategies may allow a more cohesive and effective response across the Australian healthcare sector, to enhance local and global health for current and future generations.
Additional keywords: Environmental health, healthcare ethics, health education, holistic health, professional education, social justice.
References
[1] Siegrist J, Marmot M. Social inequalities in health: new evidence and policy implications. Norfolk: Oxford University Press; 2006.[2] McMichael AJ, Friel S, Nyong A, Corvalan C. Global environmental change and health: impacts, inequalities, and the health sector. BMJ 2008; 336 191–4.
| Global environmental change and health: impacts, inequalities, and the health sector.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c%2FmsFOhug%3D%3D&md5=139624523acd6b4b529c6d970f798e42CAS |
[3] Wright CY, Diab R. Air pollution and vulnerability: solving the puzzle of prioritization. J Environ Health 2011; 73 56–64.
| 1:CAS:528:DC%2BC3MXhs1aqsrg%3D&md5=c5c8246b0b0ceeef104c8116875883e8CAS |
[4] Sayre L, Rhazi N, Carpenter H, Hughes NL. Climate change and human health: the role of nurses in confronting the issue. Nurs Adm Q 2010; 34 334–42.
[5] Laustsen G. Environment, ecosystems, and ecological behavior: a dialogue toward developing nursing ecological theory. Adv Nusr Sci 2006; 29 43–54.
[6] Pencheon D, Rissel CE, Hadfield G, Madden DL. Health sector leadership in mitigating climate change: experience from the UK and NSW. N S W Public Health Bull 2010; 20 173–6.
| Health sector leadership in mitigating climate change: experience from the UK and NSW.Crossref | GoogleScholarGoogle Scholar |
[7] Podein RJ, Hernke MT. Integrating sustainability and healthcare. Prim Care 2010; 37 137–47.
| Integrating sustainability and healthcare.Crossref | GoogleScholarGoogle Scholar |
[8] Worrell R, Appleby MC. Stewardship of natural resources: definition, ethical and practical aspects. J Agric Environ Ethics 2000; 12 263–77.
| Stewardship of natural resources: definition, ethical and practical aspects.Crossref | GoogleScholarGoogle Scholar |
[9] Brown V, Ritchie J, Grootjans J, Rohan BG. Living; public health and the future of life on the planet. In: Brown V, Grootjans J, Ritchie J, Townsend M, Verrinder G, editors. Sustainability and health: supporting global ecological integrity in public health. Crows Nest: Allen & Unwin; 2005. pp. 11–6.
[10] Bramley G, Dempsey N, Power S, Brown C. What is ‘social sustainability’, and how do our existing urban forms perform in nurturing it? Planning Research Conference 2006, Bartlett School of Planning, University College London (UCL), London, 5–7 April 2006; Available at http://www.city-form.org/uk/pdfs/Pubs_Bramleyetal06.pdf [verified 26 October 2011]
[11] Sherren K. Core issues: reflections on sustainability in Australian university coursework programs. Int J Sustain High Educ 2006; 7 400–13.
| Core issues: reflections on sustainability in Australian university coursework programs.Crossref | GoogleScholarGoogle Scholar |
[12] Lawrence RS, Saundry PD. Climate change, health sciences, and education. Am J Prev Med 2008; 35 426–8.
| Climate change, health sciences, and education.Crossref | GoogleScholarGoogle Scholar |
[13] Solomon BD. Biofuels and sustainability. Ann N Y Acad Sci 2010; 1185 119–34.
| Biofuels and sustainability.Crossref | GoogleScholarGoogle Scholar |
[14] Gill M, Stott R. Health professionals must act to tackle climate change. Lancet 2009; 374 1953–4.
| Health professionals must act to tackle climate change.Crossref | GoogleScholarGoogle Scholar |
[15] Busck O. Employee participation in environmental work in companies. In: Kornov I, Lund H, Remmen A, editors. Tools for a sustainable development. Aalborg: Aalborg University; 2006. pp. 109–35.
[16] Trede F, Higgs J. Framing research questions and writing philosophically. In: Higgs J, Horsfall D, Grace S, editors. Writing qualitative research on practice. Rotterdam: Sense Publishers; 2009. pp. 13–25.
[17] Penrod J, Bray Preston D, Cain RE, Starks MT. A discussion of chain referral as a method of sampling hard-to-reach populations. J Transcult Nurs 2003; 14 100–7.
| A discussion of chain referral as a method of sampling hard-to-reach populations.Crossref | GoogleScholarGoogle Scholar |
[18] Neira M, Legros I, Ivanov D. Global environmental change: opportunities and challenges for occupational health. Ital J Occup Environ Hyg 2010; 1 76–7.
[19] Griffiths J. Environmental sustainability in the national health service in England. Public Health 2006; 120 609–12.
| Environmental sustainability in the national health service in England.Crossref | GoogleScholarGoogle Scholar |
[20] Griffiths J. Who cares? Environmental sustainability in the National Health Service. In: Lopez RA, editor. Progress in sustainable development research. New York: Nova Scotia Publishers; 2008. pp. 71–115.
[21] Government of South Australia. Better Choices Better Health; final report of the South Australian Generational Health Review. Summary; 2003. Available at http://www.sahealth.sa.gov.au/wps/wcm/connect/7656d300428de215b4b9b6e7eece1070/generationalhealthreviewsummary-ce-0304.pdf?MOD=AJPERES&CACHEID=7656d300428de215b4b9b6e7eece1070 [verified 23 July 2012]
[22] Australian Government Department of Health and Ageing. Towards a national primary health care strategy: a discussion paper from the Australian Government; 2008. Available at http://www.health.gov.au/internet/main/publishing.nsf/content/d66fee14f736a789ca2574e3001783c0/$file/discussionpaper.pdf [verified 23 July 2012]
[23] Blancett SS, Flarey DL. Reengineering nursing and health care: the handbook for organizational transformation. Gaithersburg: Aspen Publishers; 1995.
[24] Masterman-Smith H. Worker citizens and the environment. In: Aslin H, Lockie S, editors. Engaged environmental citizenship. CDU/ANU Press: Canberra; in press.
[25] Hudson K. Close the door on crisis management. Nurs Manage 2010; 41 51–3.
| Close the door on crisis management.Crossref | GoogleScholarGoogle Scholar |
[26] Govindarajulu N, Daily BF. Motivating employees for environmental improvement. Ind Manage Data Syst 2004; 104 364–72.
| Motivating employees for environmental improvement.Crossref | GoogleScholarGoogle Scholar |
[27] Wise M, Nutbeam D. Enabling health systems transformation: what progress has been made in re-orientating health services? Promot Educ 2007; S2 23–7.
[28] Baum F. The new public health. 3rd ed. Melbourne: Oxford University Press; 2008.
[29] Germov J. Imagining health problems as social issues. In: Germov J, editor. Second opinion: an introduction to health sociology. 4th ed. Melbourne: Oxford University Press; 2009. pp. 3–24.
[30] Annadale E. The political economy of health and healthcare. In: Earle S, Letherby G, editors. The sociology of healthcare: a reader for health professions. Houndsmill, Basingstoke: Palgrave Macmillan; 2008. pp. 3–12.
[31] Beck U. Risk society. London: Sage; 1992.
[32] Moynihan R, Smith R. Too much medicine? Almost certainly. BMJ 2002; 324 859–60.
| Too much medicine? Almost certainly.Crossref | GoogleScholarGoogle Scholar |
[33] Navarro V. Medicine under capitalism. New York: Prodist; 1976.
[34] Quinlivan B. Health is wealth. Business Review Weekly, 23 May–19 June 2002; pp. 46–8.
[35] Waitzkin H. The second sickness: contradictions of capitalist health care. 2nd ed. Lanham, Maryland: Rowman and Littlefield; 2000.
[36] Collyer F, White K. Corporate control of healthcare in Australia (No. 42 Discussion Paper). Canberra: Australia Institute; 2001. Available at http://www.tai.org.au/documents/dp_fulltext/DP42.pdf [verified 26 October 2011].
[37] Sword W. A socio-ecological approach to understanding barriers to prenatal care for women of low income. J Adv Nurs 1999; 29 1170–7.
| A socio-ecological approach to understanding barriers to prenatal care for women of low income.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M3lsFyhtw%3D%3D&md5=d7fe39839cad3be1f163fbcfd8d5f65fCAS |
[38] Wade DT. Education and debate: do biomedical models of illness make for good healthcare systems? BMJ 2004; 329 1398–401.
| Education and debate: do biomedical models of illness make for good healthcare systems?Crossref | GoogleScholarGoogle Scholar |
[39] McLaren L, Hawe P. Continuing professional education: ecological perspectives in health research. J Epidemiol Community Health 2005; 59 6–14.
| Continuing professional education: ecological perspectives in health research.Crossref | GoogleScholarGoogle Scholar |
[40] Van Leeuwen JA, Waltner-Toews D, Abernathy T, Smit B. Evolving models of human health toward an ecosystem context. Ecosyst Health 1999; 5 204–19.
| Evolving models of human health toward an ecosystem context.Crossref | GoogleScholarGoogle Scholar |
[41] Howard J, Rapport D. Ecosystem health in professional education: the path ahead. EcoHealth 2004; 1 S3–7.
| Ecosystem health in professional education: the path ahead.Crossref | GoogleScholarGoogle Scholar |
[42] Stineman MG, Streim JE. The biopsycho-ecological paradigm: a foundational theory for medicine. PM R 2010; 2 1035–45.
| The biopsycho-ecological paradigm: a foundational theory for medicine.Crossref | GoogleScholarGoogle Scholar |
[43] Moynihan R. Too much medicine? The business of health – and its risks for you. Sydney: ABC Books; 1998.
