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Hartman  M, Martin  A, McDonnell  P, Catlin  A, National Health Expenditure Accounts Team.  National health spending in 2007: slower drug spending contributes to lowest rate of overall growth since 1998.  Health Aff (Millwood). 2009;28(1):246-261. PubMedGoogle ScholarCrossref
 Economic Input-Output Life Cycle Assessment (EIO-LCA), US 1997 industry benchmark model. Carnegie Mellon University Green Design Institute. Accessed March 17, 2009
Ramaswamy  V, Boucher  O, Haigh  J,  et al.  Radiative forcing of climate change.  In: Houghton  JT, Ding  Y, Griggs  DJ, Noguer  M, van der Linden  PJ, Dai  X, Maskell  K, Johnson  CA, eds.  Climate Change 2001: The Scientific Basis: Contribution of Working Group I to the Third Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge, UK: Cambridge University Press; 2001;351-416.Google Scholar
 Inventory of US greenhouse gas emissions and sinks: 1990-2007 [April 2009, EPA 430-R-09-004]. US Environmental Protection Agency. Accessed May 18, 2009
 NHS England carbon emissions carbon footprinting report [May 2008]. National Health Service. Accessed March 25, 2009
Hendrickson  CT, Lave  LB, Matthews  HS.  Environmental Life Cycle Assessment of Goods and Services: An Input-Output Approach. Washington, DC: Resources for the Future; 2006.
Research Letter
November 11, 2009

Estimate of the Carbon Footprint of the US Health Care Sector

Author Affiliations
  • 2Section of Hospital Medicine, Department of Medicine, University of Chicago, Chicago, Illinois
JAMA. 2009;302(18):1970-1972. doi:10.1001/jama.2009.1610

To the Editor: Despite heightened worldwide interest in sustainable health care, the carbon footprint of the US health care sector has not yet been estimated. Quantifying the environmental impact of health care is important to determine the potential value of mitigation efforts and to reduce harm associated with health care delivery. We estimated the carbon footprint of the US health care sector, defined as total greenhouse gas (GHG) emissions attributable to the production of health care goods and services.

Health care GHG emissions were estimated using 2007 data on health expenditures published by the National Health Accounts Team1 and the Environmental Input-Output Life-Cycle Assessment (EIOLCA) model developed by the Carnegie Mellon University Green Design Institute.2 The EIOLCA is based on the 1997 Industry Benchmark Producer Price input-output table from the US Bureau of Economic Analysis and is a matrix showing the dollar amounts of commodities that industries purchase from each other to produce their own commodities. EIOLCA augments input-output tables with data on pollutants and emissions released as by-products of each commodity. Category-specific GHG/dollar coefficients that express the amount of carbon dioxide (measured in metric tons) embodied in each dollar of health care produced were obtained from the EIOLCA. Category-specific health spending was multiplied by its corresponding coefficient to obtain GHG totals and then summed across categories to estimate the health care sector carbon footprint.