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Public voices reveal complexities in selling health and environment win-wins

The UK public broadly supports efforts to reduce the environmental impact of health care, but some fear that environmental arguments could be used to justify cost-cutting or service reductions, .

It means the popular policy framing of "co-benefits"—where environmental and health gains are achieved simultaneously—may be more complicated than policymakers assume.

Researchers from King's College London and the University of Oxford held 12 focus groups with 82 participants across the UK, exploring perceptions of health care's environmental harms and co-benefits strategies.

According to lead author Dr. Gabrielle Samuel, participants welcomed strategies that reduce waste, prevent illness, and promote holistic care, but expressed skepticism about government motives.

"Participants liked the idea of win-win solutions. But when they tried to apply the co-benefits concept to real-world health care scenarios, they encountered tensions, ambiguities, and mistrust," says Dr. Samuel, Lecturer in Environmental Justice and Health.

Examples of such co-benefits include reduced air pollution through active travel and efficient public transport, or improved public health from reduced meat consumption.

However, the researchers found that definitions of what constitutes a "benefit" varied widely depending on personal experiences, health needs, and expectations of care.

The study warns that without careful attention to public values and lived experiences, co-benefits strategies risk oversimplifying complex trade-offs.

"Co-benefits should be seen as a process, not a panacea," said Dr. Samuel. "Public engagement is essential to navigate the ethical and practical tensions involved."

She urged policymakers to involve patients and the public in shaping co-benefits policies to ensure transparency, trust, and relevance.

Published in Sociology of Health & Illness, the report recommends that future policies make explicit the assumptions behind co-benefits claims; involve diverse public voices in decision-making; and remain open to revising strategies in light of unintended consequences.

The findings come as the NHS continues to pursue its net zero targets, with environmental sustainability increasingly embedded in health care policy.

Health care contributes significantly to greenhouse gas emissions, with estimates ranging from 4-5% globally and in the UK.