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Climate change and other environmental challenges (biodiversity loss, pollution, soil depletion, etc.) are critical threats to health. Climate change alone has been identified as “the biggest global health threat of the 21st century.” 


According to the Intergovernmental Panel on Climate Change (IPCC), the world has little more than 10 years – until 2030 – to make major modifications in how we live, work and play if we are to avoid the kind of catastrophic changes that will make the maintenance of complex human societies impossible.

The health system has a large role to play in this undertaking, because despite its mission to support health, its practices are actually part of the problem. With large physical facilities that operate 24-7, care arrangements that foster substantial travel by patients, caregivers and providers, and a profound reliance on carbon-intensive and polluting technologies and other products (drugs, devices, disposables, etc), health systems are significant contributors to greenhouse gas emissions and broader environmental impacts, including through air pollution.

Read our snapshot on this topic here

Take a look at our new video on this Flagship Project:



We are in a cross provincial collaboration with the Centre for Sustainable Health Systems in Ontario and an international collaboration with the Centre for Sustainable Healthcare in the UK.

Creating Sustainable Health Systems in a Climate Crisis


HPI's Sustainable Health System's Flagship Project Team is proud to announce CASCADES (Creating a Sustainable Canadian Health System in a Climate Crisis) - a national project aiming to reduce greenhouse gas emissions linked to health care and create a low-carbon ‘green’ health system. To visit the CASCADES Canada website, click here.

Flagship Project Co-Leads


Dr. Daniel Rainham

Faculty of Health

Peter Tyedmers
Faculty of Science

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Dr. Sean Christie, M.D.

Faculty of Medicine

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Community Lead:
Nathan Ayer

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Nathan Ayer is a Senior Sustainability Advisor with EarthShift Global based in Halifax, NS where he provides consulting services and training in life cycle assessment (LCA) and sustainability assessment for a wide range of clients, including Fortune 500 companies, government, and academia. He has worked and studied in the field of environmental management for over 15 years, including roles in government, private industry, and as an academic researcher and instructor. He is an LCA Certified Practitioner (LCACP) under the American Centre for Life Cycle Assessment (ACLCA) and in 2020 completed an Interdisciplinary PhD at Dalhousie University focusing on the assessment of wood biomass energy systems and green technology development.

Translating Knowledge Into Action

Research project aims to improve environmental performance of health care systems
July 6, 2023

Dalhousie's Faculty of Health released a new article on HPI's Sustainable Health Systems Flagship Project and an exciting new research opportunity. The Flagship team was successful in obtaining just over $500,000 in research support from the Department of Surgery and NSERC’s Alliance Missions grants competition. Read more here. 

CASCADES releases new greenhouse gas emission in healthcare playbook
April 7, 2023

Led by CASCADES Regional Director for Atlantic Canada Jessica Nowlan, Greenhouse Gas Emissions Estimation in Canadian Healthcare provides an overview of how greenhouse gas (GHG) emissions are measured in healthcare and information on the current state of GHG emissions estimation in healthcare organizations across Canada. It also provides guidance and resources to support health systems and care organizations with key considerations for starting, continuing, or expanding GHG emissions estimation in their organizations.


CASCADES releases new playbook looking to embed environmental sustainability into healthcare quality 
March 31, 2023

Led by HPI Managing Director Gillian Ritcey,
Training for better health outcomes: Integrating sustainability into healthcare quality improvement education provides ideas, examples and resources for facilitators, education leads, instructional designers and quality leads of healthcare-based quality improvement (QI) programs to identify opportunities to incorporate principles of sustainability into new or existing QI courses, resources and plans. 

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In January 2023, HPI teamed up with Dalhousie's
Global Health Office and CASCADES  to offer the second IPE Mini-Course on Sustainable Health Systems. The course was oversubscribed with 40 trainees from across faculties at Dalhousie.  The goal of the course is to use the lens of the climate crisis in healthcare as an anchor to consider the need for interprofessional collaboration and action to tackle this issue.

HealthcareLCA Launch: The new home of environmental healthcare impact assessments
December 2022


To support the global transition towards sustainable health systems, researchers at Dalhousie University's Healthy Populations Institute and Brighton and Sussex Medical School (BSMS) have launched a new open-access, interactive database of healthcare’s environmental impacts.

The new HealthcareLCA database serves as an up-to-date evidence repository, bringing together new and existing assessments into one publicly accessible location. The platform allows users to sort, search and filter data according to their individual needs and interests.

Learn more about HealthcareLCA here.

Read the accompanying Lancet Planetary Health Article here.

Watch the launch webinar here. 

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Dalhousie’s Healthy Populations Institute and Global Health Office hosted an in-person hub for Atlantic Canada during the Summer Institute on Sustainable Health Systems
June 2022

The inaugural summer institute held online and in-person at various host institutions across the country in late June, was designed to generate increased awareness about this impact and emphasize the need to move toward more sustainable health systems.
Read the final summary report here
Read the Dal news story here


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Blog Post: Effective and Equitable Planetary Health Praxis is Decolonial, Observations from a Black Femme
April 1, 2022

HPI practicum student Yolanda Watungwa reflects on her experience with the Sustainable Health Systems Flagship Project. Read her full blog here.


HPI's Sustainable Health Systems Team publishes groundbreaking review
July 12, 2021

Environmental Health Perspective released Operating in a Climate Crisis: A State-of-the-Science Review of Life Cycle Assessment within Surgical and Anesthetic Care.

Results found that anesthetic gases; single-use equipment; and heating, ventilation, and air conditioning system operation were the main emissions hot spots identified among operating room- and procedure-specific analyses. Single-use equipment used in surgical settings was generally more harmful than equivalent reusable items across a range of environmental parameters. Despite the recent proliferation of surgical and anesthesiology-related LCAs, extant studies address a miniscule fraction of the numerous services, procedures, and products available today.  Read the full article here.



Greening Nova Scotia's healthcare system in a Covid-19 world. 
The Coast released a lengthy article on HPI's Sustainable Health System's Flagship Project, highlighting neurologist and co-lead Dr. Sean Christie. 
Read the full article here.
December 3, 2020

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In October 2020 , HPI teamed up with the Centre for Sustainable Health Systems at the University of Toronto and co-facilitated the first cross-provincial online Masterclass in Sustainable Health Systems. 20 health professionals attended to gain knowledge, develop skills and forge collaborations that will help them advocate for and participate in a shift to high quality, low carbon care. In April 2021, the second Masterclass hosted 25 new health professionals from across the country. 


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In September 2020, HPI led an Interprofessional Education Mini-Course at Dalhousie titled Healthcare in a Changing Climate: The Need for Sustainable Health Systems and Planetary Health. 23 medicine, health and dentistry trainees attended the course to learn how to incorporate sustainability into their future health professions. Part of the course included a Greening Healthcare Case Competition in collaboration with Pulse.  

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