Rethinking Hospital Sustainability: Circular Economy and Health Literacy; Comment on “A Review of the Applicability of Current Green Practices in Healthcare Facilities”

Document Type : Commentary

Authors

Department of Health Sciences, University of Florence, Florence, Italy

Abstract

Climate change poses critical dangers to both environmental and human health, highlighting the need for sustainable healthcare strategies. In their recent paper, Soares et al explore how circular economy principles can be implemented in hospital settings in order to reduce environmental impact. This commentary expands on their work by highlighting a complementary but underexplored dimension: organizational health literacy (OHL). OHL emphasizes patient education and engagement, recognizing that informed and empowered patients are key to more efficient healthcare use. By enhancing patients’ understanding of their health conditions and care options, OHL helps prevent unnecessary procedures, tests, and hospital visits, thereby indirectly reducing resource consumption and supporting sustainable practices such as minimizing waste, conserving energy, and promoting telemedicine. In this way, OHL directly supports the operationalization of circular economy interventions described by Soares et al, ensuring their effectiveness and long-term sustainability. Merging OHL with circular economy practices represents a holistic pathway towards sustainable, equitable, and resilient healthcare delivery.

Keywords


  1. World Health Organization (WHO). One health. WHO; 2017. https://www.who.int/news-room/questions-and-answers/item/one-health. Accessed June 12, 2025.
  2. World Health Organization (WHO). Climate Change and Health. WHO; 2021. https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health. Accessed June 12, 2025.
  3. Lenzen M, Malik A, Li M, et al. The environmental footprint of health care: a global assessment. Lancet Planet Health. 2020;4(7):e271-e279. doi:1016/s2542-5196(20)30121-2
  4. Soares AL, Buttigieg SC, Bak B, et al. A Review of the Applicability of Current Green Practices in Healthcare Facilities. Int J Health Policy Manag. 2023;12:6947. doi:34172/ijhpm.2023.6947
  5. Baccolini V, Rosso A, Di Paolo C, et al. What is the prevalence of low health literacy in European Union member states? a systematic review and meta-analysis. J Gen Intern Med. 2021;36(3):753-761. doi:1007/s11606-020-06407-8
  6. World Health Organization (WHO). Health Promotion Glossary of Terms 2021. WHO; 2021. https://iris.who.int/bitstream/handle/10665/350161/9789240038349-eng.pdf. Accessed June 12, 2025.
  7. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(2):97-107. doi:7326/0003-4819-155-2-201107190-00005
  8. Herndon JB, Chaney M, Carden D. Health literacy and emergency department outcomes: a systematic review. Ann Emerg Med. 2011;57(4):334-345. doi:1016/j.annemergmed.2010.08.035
  9. Derakhshan Z, Larijani B, Shamsi-Gooshki E, Salari P. Presenting a comprehensive definition of unnecessary healthcare services and their drivers: a systematic review and meta-synthesis. Med J Islam Repub Iran. 2023;37:106. doi:47176/mjiri.37.106
  10. Brach C, Keller D, Hernandez LM, et al. Ten Attributes of Health Literate Health Care Organizations (Discussion Paper). National Academy of Medicine; 2012. doi:31478/201206a
  11. Andrieu B, Marrauld L, Vidal O, Egnell M, Boyer L, Fond G. Health-care systems' resource footprints and their access and quality in 49 regions between 1995 and 2015: an input-output analysis. Lancet Planet Health. 2023;7(9):e747-e758. doi:1016/s2542-5196(23)00169-9
  12. Zanobini P, Del Riccio M, Lorini C, Bonaccorsi G. Empowering sustainable healthcare: the role of health literacy. Sustainability. 2024;16(10):3964. doi:3390/su16103964
  13. Saini V, Garcia-Armesto S, Klemperer D, et al. Drivers of poor medical care. Lancet. 2017;390:178-190. doi:1016/s0140-6736(16)30947-3
  14. van Bree EM, Snijder LE, Ossebaard HC, Brakema EA. Environmental impact of physical visits and telemedicine in nursing care at home: comparative life cycle assessment. J Med Internet Res. 2025;27:e67538. doi:2196/67538
  15. Patel KB, Gonzalez BD, Turner K, et al. Estimated carbon emissions savings with shifts from in-person visits to telemedicine for patients with cancer. JAMA Netw Open. 2023;6(1):e2253788. doi:1001/jamanetworkopen.2022.53788
  16. Lindsey M, Chen SR, Ben R, Manoogian M, Spradlin J. Defining environmental health literacy. Int J Environ Res Public Health. 2021;18(21):11626. doi:3390/ijerph182111626

Articles in Press, Corrected Proof
Available Online from 11 October 2025
  • Received Date: 01 July 2025
  • Revised Date: 21 September 2025
  • Accepted Date: 30 September 2025
  • First Published Date: 11 October 2025
  • Published Date: 11 October 2025