Protecting our patients' future through perioperative sustainability: Action and advocacy for the pediatric surgeon

Climate change is a significant threat to human health and health equity. Marginalized populations, including children, are most impacted by our rapidly changing environment. Both the prevalence of pediatric surgical disease, as well as the ability to deliver surgical care, are affected by climate change. Ironically, healthcare systems have a significant, deleterious effect on the planet. However, there are many proven mitigation strategies to reduce the injurious climate impact of the delivery of surgical services, augment equity, and improve health. We describe five domains through which pediatric surgical care providers can act to generate more sustainable healthcare systems: reduce, repurpose, reuse, refuse, and recycle. We highlight successful examples instituted through various healthcare organizations and provide recommendations that pediatric surgical care providers can use to support the health of our planet through their daily work. These actions can increase sustainability, reduce cost, and promote equity for our patients and future generations.