And with everything that goes with that, they have negative environmental impacts."
They are very much part of urban environments. "They own lots of capital and infrastructure. "The health-care sector is buying an enormous quantity of products," Miller says. It includes individuals driving to see a doctor for an in-person physical that may not be medically necessary-and the use of certain kinds of inhalers and anesthetic gases that are not environmentally-friendly. That includes massive hospitals that require heating and cooling-and may be generating power from coal-to the overuse of single-use medical items such as hypodermic needles and syringes, as well as the packaging that becomes garbage. When she speaks of health care and its impact on environmental degradation, Miller is referring to everything involved in caring for the health of society. Miller is director of IHPME's Centre for Sustainable Health Systems and chair in Health Management Strategies. "Globally, if health care were a nation, it would be the fifth largest emitter."
"In Canada and in most other countries, the health-care sector accounts for about five percent of greenhouse gas emissions," says Miller, professor of health policy at the Institute of Health Policy, Management and Evaluation (IHPME) in the Dalla Lana School of Public Health at the University of Toronto.
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