Welcome to the 'Green Corner' of the Counties Manukau Health Library.


Resources to support and promote:

- 'green' hospitals and environmental sustainability in the health sector

- awareness of environmental impacts on health and wellbeing


*If you are accessing the library resources off site, when prompted for a user name and password to access any of our online resources, please enter your staff employee number and first name.  New staff members can request a temporary password from the library if your employee number is not being recognised.

Health Professionals working in the Counties Manukau region are also able to register for online access to a selection of databases and resources and are invited to register using the online form and send to library@middlemore.co.nz with the words 'elibrary registration' in the subject line.  Your access includes the Proquest Database, Journal and eBook Collections, Nursing Reference Centre Plus, and Clinicalkey.  ClinicalKey includes access to 600 journals, 1,500 ebooks and an excellent point of care tool: First Consult.



Proquest Public Health Database

The Public Health Database is the ideal starting point for public health information for researchers and professionals. It delivers core public health literature from thousands of publications, much of it in full text.

Latest articles on "green hospitals' and environmental sustainability in healthcare


see also:

Perspective: Climate Change — A Health Emergency



Two physicians from PSR’s Greater Boston chapter have just published a must-read article in the prestigious New England Journal of Medicine:  “Climate Change – A Health Emergency.” It is a strong and cogent statement of the challenge the world faces from climate change and the responsibility of physicians (and, by extension, other health  professionals) to respond.



Addressing the carbon footprint of healthcare organisations.

The December issue of Public Health Research and Practice focused entirely on climate change and health. The issue has a number of excellent articles on various aspects of climate and health, however, our favourite article discusses eight ways that healthcare organisations can address their carbon footprint. This article is a great guide if you're feeling unsure of how to start addressing climate change in your workplace.



Selected Reports and Documents

COP26 Health Programme: Overview of Initiatives and Commitments on Climate Change and Health

Health has been chosen as a COP26 science priority area. The COP26 Health Programme has been established to bring stronger health focus and ambition to COP26. The key health priorities for COP26 include:

  1. Building climate resilient health systems;
  2. Developing low carbon sustainable health systems;
  3. Adaptation Research for Health;
  4. The inclusion of health priorities in Nationally Determined Contributions,
  5. Raising the voice of health professionals as advocates for stronger ambition on climate change

Call for emergency action to limit global temperature increases, restore biodiversity, and protect health (2021)
Wealthy nations must do much more, much faster.

Posters presented at the 2021 Sustainable Healthcare and Climate Health Aotearoa conference. (2021)

Biophilic design in healthcare and rehabilitation 
Collaborative research on climate change health impacts as a mitigation tool 
Developing an Australian Glossary on Health and Climate Change  
Empowering the New Zealand frontline 
Reducing desflurane usage at the Sunshine Coast University Hospital 
Room Service, Mercy Hospital’s journey to introduce a sustainable, waste reducing model of food service for in-patients 
Towards environmentally sustainable healthcare: a new frontier for dietitians 
Unnecessary Vitamin D testing: an opportunity to reduce the carbon footprint of healthcare 
Weather and work-related fatal injury: what is the link?

Transforming the health system for sustainability: environmental leadership through a value-based health care strategy (2021)

This policy issues brief released by the Australian Healthcare and Hospitals Association’s Deeble Institute this week examines the sustainability of the Australian health system, particularly in response to climate change. The authors argue that transforming the health system for sustainability requires consideration of the systemic and complex nature of climate change as a determinant of health, for today’s and future generations. This will require attention to both patient level processes and different framework requirements at each level of the health system

Real, Urgent & Now: Communicating the Health Impacts of Climate Change (2021)

This document is designed to support you to:

Speak with confidence about climate change and its health impacts with patients/clients, colleagues and communities guiding and supporting behavioural change that promotes positive health outcomes and a safe climate;
Join a growing cohort of health professionals who recognise their unique authority and responsibility to talk to the public, media, and decision-makers about the health impacts of climate change and the health benefits of climate action;
Take a leadership role in encouraging health services, clinics, hospitals, offices, and other health care facilities to be as environmentally sustainable as possible;
Promote actions that reduce greenhouse gas emissions and offer health co-benefits. For example: walking, riding or using public transport instead of driving cars; shifting to a healthier, plant-based diet; or switching to renewable energy;
Reduce your personal carbon footprint;
Advocate for action on climate change within personal and professional circles, and your community

Global Road Map for Healthcare Decarbonisation: A navigational tool for achieving zero emissions with climate resilience and health equity (2021)

The Road Map, developed by Health Care Without Harm in collaboration with Arup, sets out actions the health sector can take to align itself with the ambition of the Paris Agreement while simultaneously achieving global health goals. 

 Along with outlining why the health sector must decarbonise, the Road Map:

  • Sets out possible healthcare emissions trajectories up to 2050
  • Identifies three decarbonisation pathways the health sector needs to navigate to reduce emissions
  • Highlights 7 high impact action areas for the health sector to take
  • Outlines high level recommendations for driving change

The 2020 report of the Lancet Countdown on health and climate change: responding to converging crises (December, 2020)

Recycling and Environmental Sustainability in the New Zealand Healthcare Setting: A Practice-led Case Study Research-Project [thesis] (2020)
This thesis presents my experience of establishing and leading a recycling and environmental sustainability research project in the New Zealand (NZ) healthcare setting. It is presented as a practice-led case study undertaken to change practice primarily targeting the NZ healthcare sector. It incorporates both quantitative and qualitative data. As such it represents the first of its kind in NZ to explore the impact of a recycling and environmental sustainability programme in the healthcare setting.

Sustainable Health Equity: Achieving a Net-Zero UK  (2020)
The UCL Institute of Health Equity (IHE) was commissioned by the UK Committee on Climate Change (CCC) to develop recommendations that could both improve the nation’s health, reduce health inequalities and achieve Net-Zero carbon emissions by 2050. Professor Sir Michael Marmot was asked by the CCC to chair an independent UK Health Expert Advisory Group in January 2020 to advise on the potential health impacts of the government’s carbon reduction targets. Those targets have informed next month’s sixth carbon budget, which will present options for achieving Net-Zero emissions.  The Advisory Group highlight how the direct and indirect impacts of climate change will likely widen existing health inequalities in the UK. The Group warns if health equity isn’t considered when developing policies to reduce greenhouse gas emissions, there is a risk that their benefits to health, such as cleaner air, healthier average diets and lower home energy bills, will be unequally distributed.  

WHO Guidance for Climate Resilient and Environmentally Sustainable Health Care Facilities (2020)
The aim of this guidance is to enhance the capacity of health care facilities to protect and improve the health of their target communities in an unstable and changing climate; and to empower health care facilities to be environmentally sustainable, by optimizing the use of resources and minimizing the release of waste into the environment. Climate resilient and environmentally sustainable health care facilities contribute to high quality of care and accessibility of services, and by helping reduce facility costs also ensure better affordability. They are, therefore, an important component of universal health coverage (UHC).

The Environmental Sustainability Audit Tool
ANZCA recognises that the healthcare sector is highly interconnected with activities that emit pollution to air, water, and soils, resulting in a significant ecological footprint and contribution to anthropogenic climate change. We have established an Environment Sustainability Working Group to promote sustainability and ensure ANZCA stays committed to minimising the health impact of climate change.

The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate
Climate change underpins all the social and environmental determinants of health but also has positive implications. The Lancet Countdown: Tracking Progress on Health and Climate Change is an international, multi-disciplinary research collaboration between academic institutions following on from the 2015 Lancet Commission on Health and Climate Change, which emphasised that the response to climate change could be “the greatest global health opportunity of the 21st century

 The New Zealand Medical Association declaration that climate change is a serious and leading threat to health and health equity, both in New Zealand and worldwide (2019)
“Recognisable health threats from climate change include the direct impacts such as illness and deaths from high temperatures and other extreme weather events, biologically - mediated events that includes the changing patterns of infectious disease and socially-mediated impacts with loss of livelihood, forced migration, economic vulnerability and increased risks of conflict,” says Dr Kate Baddock, Chair of NZMA.


Health care's climate footprint: how the healthsector contributes to the global climate crisis and opportunities for action (2019)
According to this report, if the global health care sector were a country it would be the fifth-largest greenhouse gas emitter on the planet. The report finds that health care’s footprint is equivalent to 4.4 per cent of global net emissions and that fossil fuel combustion makes up well over half of health care’s global climate footprint. The report makes the case for a transformation of the health care sector that aligns it with the Paris Agreement goal of limiting climate change to 1.5 degrees Celsius.

Sustainability and the health sector. Ministry of Health (2019)
This publication aims to support and encourage the health sector to take an active role in incorporating sustainability practices and reducing carbon emissions.  It highlights the wide-ranging benefits of sustainability and provides ideas of how health facilities in New Zealand can reduce their environmental footprints and contribute to the transition to a sustainable, low-emissions world. It also acknowledges that a multi-agency approach is required to effect change, and signals that the Ministry of Health intends to continue to work with District Health Boards and other agencies to create a knowledge base of evidence and expertise to facilitate sustainable thinking throughout the health sector.

Plastics in the envionment2019: Te Ao Hurihuri - The Changing world. NZ Royal Society (2019)
Evidence summary on plastics in the environment. There is growing concern about the use of plastics and their effects on the environment and human health. This document sets out how plastics are made, used and disposed of. It also covers how plastics enter the environment and the risks plastics pose to wildlife and humans

Environment Aotearoa 2019 (2019)
Environment Aotearoa 2019 provides an overview of the state of our environment. Using five broad themes the report presents nine priority environmental issues.

Climate Change Toolkit for Health Professionals (2019)

This toolkit consists of eight modules which have been prepared as stand-alone documents that can be read by themselves, but they have also been prepared to complement one another. It has been designed as a tool for health professionals and students in the health care and public health sectors who want to engage more directly on the issue of climate change as educators with their patients, peers and communities, and/or as advocates for the policies, programs and practices needed to mitigate climate change and/or prepare for climate change in their workplaces and communities.

'Climate change and health: do people understand the link: a qualitative research study' . State of Victoria. (2019) 
A summary of the findings of qualitative research conducted by Sustainability Victoria about public awareness of the links between health and climate change.

Auckland Council Research and Evaluation Unit (RIMU) and Chief Sustainability Office. Climate Change Risk Assessment (CCRA) series (2019)

The eight reports in the CCRA consider various components of key risks – that is, hazard, exposure, and vulnerability – across sectors and systems of interest: people (heat vulnerability, climate change and air quality), society (social vulnerability and flooding), and natural environment (terrestrial and marine ecosystems), as well sea level rise at regional and local scales. A summary report has also been produced.

Workshop Report. Sustainable and healthy food in healthcare (2018)

A workshop to discuss opportunities and experiences in delivery sustainable and healthy food options in healthcare facilities.

COP24 Special report: Health & Climate Change (2018) 

The report provides information on the connection between climate change and health, ways in which the health community are implementing the Paris agreement, and recommendations for policy makers for maximising the health benefits of tackling climate change.

Lancet Commission Report 'The Global Syndemic of Obesity, Undernutrition, and Climate Change' (2019)

Commission following on from two Lancet Series on obesity looks at obesity in a much wider context of common underlying societal and political drivers for malnutrition in all its forms­ and climate change. The Commission urges a radical rethink of business models, food systems, civil society involvement, and national and international governance to address The Global Syndemic of Obesity, Undernutrition, and Climate Change.

Lancet Countdown on Health and Climate Change (2018)

The Lancet Countdown's 2018 report tracks 41 indicators across five key domains in health and climate change, continuously strengthening its methods, data and analysis. It arrives at three key conclusions:

  • IMPACT: Present day changes in heat waves labour capacity, vector-borne disease, and food security provide early warning of compounded and overwhelming impacts expected if temperature continues to rise.

  • DELAY: A lack of progress in reducing emissions and building adaptive capacity threatens both human lives and the viability of the national health systems they depend on, with the potential to disrupt core public health infrastructure and overwhelm health services.

  • OPPORTUNITY: Despite these delays, trends in a number of sectors see the beginning of a low-carbon transition, and it is clear that the nature and scale of the response to climate change will be the determining factor in shaping the health of nations for centuries to come.


The 1.5 Health Report | ClimateTracker (2018)

The 1.5 Health Report provides a summary of all the implications of global warming on human health and lives, as described in the IPCC Special Report on 1.5°. 


Climate Change and Environmental Health | ESR (New Zealand, 2017)

The effects of climate change will be wide ranging and are expected to have some environmental health effects, i.e. aspects of human health influenced by physical, chemical, biological, social and psychosocial factors in our environment. To help in anticipating future environmental health risks in New Zealand over the next 50 – 100 years so that plans can be put in place for mitigating or adapting to these effects, an understanding of what these effects are, where they might be most felt and who will be most vulnerable to them is needed.

The Ministry of Health commissioned ESR to undertake a review of the scientific literature relating to climate change and environmental health, to summarise the national and international understanding of these likely effects and to identify gaps in this understanding. The work provides information that can act as a basis for deciding on the next steps needed for putting mitigation and adaptation strategies in place.


Climate-smart healthcare: low carbon and resilience strategies for the health sector | The World Bank (2017)

Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases.


Health Care & Climate Change – An Opportunity for Transformative Leadership | Health Care Without Harm (2014)

The report provides detailed guidelines and case studies to help hospital leaders and facilities’ staff develop comprehensive strategies to reduce their reliance on fossil fuels through the use of “clean technology.”

Carbon footprinting in health systems: one small step towards planetary health | Lancet Planetary Health (2017)

Studies have shown the potential for triple bottom line solutions in health-care settings: with carbon mitigation options being able to offer improved economic performance in terms of efficiency gains; social gains through improved patient choice; and environmental dividends in terms of reduced carbon emissions. As an added benefit, climate change mitigation can also lead to improved health through improved air quality.

There exists a need for a better understanding of climate change and mitigation in the health sector. Carbon footprinting studies are just a first step. Options need to be evaluated in terms of their cost-effectiveness and many could be win–win in terms of energy savings.


Green hospitals, green healthcare | International Journal of Energy Production and Management (2017)

In order to achieve a green healthcare system, a deep knowledge of its strengths and weaknesses is needed, as well as of the internal dynamics. According to this target, our research focuses on the identification of opportunities for improving the existing health facilities according to the new concepts related to green hospitals. We deal with the study of various aspects as the site and its environment, better access, efficient management of resources (particularly water and energy), waste reduction, use of renewable and low emission materials, as well as all factors in design that can improve the users’ wellness.

Cutting emissions in healthcare | Counties Manukau Health (2018)

by Dr David Galler .  [ This is the story of a long term project at Counties Manukau Health ]

"In late November 2017 a small group of people at Middlemore Hospital celebrated a remarkable achievement – a reduction in the Carbon footprint of the Counties Manukau DHB by 21.2% in just 5 years.

That work which began in 2011 was fuelled by the good will of a small group of ordinary people: doctors, nurses and others who took it upon themselves to take action on Climate Change by doing the same simple things at work that so many were already doing at home; conversations about small stuff in the main, recycling and reducing waste, then a growing desire to learn more about our own Carbon footprint and the relationship between Climate Change and healthcare more generally... "



World Health Organisation publications on the environmental and social determinants of health (various)


Selected Articles

Climate change mitigation policies and co-impacts on indigenous health: a scoping review (2020)

A radical revision of the public health response to environmental crisis in a warming world: contributions of Indigenous knowledges and Indigenous feminist perspectives (2020)

Healthy and Climate-Friendly Eating Patterns in the New Zealand Context (2020)

'Can Medical Care Exist Without Plastic?' - "Hospitals are filled with sterile single-use plastic. Environmental advocates are looking for less wasteful ways to keep healthcare hygienic" (2019)

Pro-equity climate change and environmental sustainability action by district health boards in Aotearoa/New Zealand (2018)

Linking disaster risk reduction, climate change, and the sustainable development goals (2017)





Networks and Resource Centres


OraTaiao: The New Zealand Climate and Health Council

Comprises health professionals in Aotearoa/New Zealand concerned with:

  • The negative impacts of climate change on health.
  • The health gains that are possible through strong, health-centred climate action.
  • Highlighting the impacts of climate change on those who already experience disadvantage or ill-health (equity impacts).
  • Reducing the health sector's contribution to climate change. 

see  Publications 


Global Green and Healthy Hospitals

GGHH is an international network of hospitals, health care facilities, health systems, and health organizations dedicated to reducing their
environmental footprint and promoting public and environmental health. 

see Case Studies from GGHH members


Climate and Health Alliance

The Climate and Health Alliance is a coalition of health care stakeholders who work together to see the threat to human health from climate change and ecological degradation addressed through prompt policy action.

see Resources :

Newsletters - News, campaigns, latest research and events from Climate and Health Alliance headquarters.

Briefing Papers - Briefing papers provide an overview of the Alliance's stance on current events and topics

External Reports - Latest reports from Australia and around the world on climate and health research

Research - View international and national research on climate change and the associated health impacts.


Centre for Sustainable Health Care 

CSH provides a wide range of materials to support health professionals to develop sustainable approaches to designing, managing and delivering healthcare.  All the resources are freely available and have been developed by CSH or in partnership with us. 

If you're looking for peer-reviewed literature you'll find a list of academic articles in Publications and also in the CSH Resource Library, which is hosted on the CSH Networks site.  The Resource Library also has a wealth of toolkits, case studies and documents shared by members of the CSH online networks.  As well as browsing, you'll be able to filter by subject area (or network) or use the search engine to find specific resources.

see Resources