Participants liked the idea of win-win solutions. But when they tried to apply the co-benefits concept to real-world healthcare scenarios, they encountered tensions, ambiguities, and mistrust.
Dr Gabrielle Samuel, Lecturer in Environmental Justice and Health
23 June 2025
Public Voices Reveal Complexities in Selling Health and Environment Win-Wins
Study questions simplicity of policymakers’ ‘co-benefits’ approach
The UK public broadly supports efforts to reduce the environmental impact of healthcare, but some fear that environmental arguments could be used to justify cost-cutting or service reductions, shows a new study.
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 healthcare’s environmental harms and co-benefits strategies.
According to lead author Dr Garbielle Samuel, participants welcomed strategies that reduce waste, prevent illness, and promote holistic care, but expressed scepticism about government motives.
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 and 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 healthcare policy.
Healthcare contributes significantly to greenhouse gas emissions, with estimates ranging from 4-5% globally and in the UK.
Read the full paper
In this story
Lecturer in Environmental Justice and Health