Greening Healthcare Spaces: The Carbon Cost of Tree Loss in Public Healthcare Facilities

Abstract

Sustainable landscape design integration with green infrastructure in healthcare institutions is progressively recognised for its potential to improve patient well-being, environmental performance, and energy efficiency. In many parts of the world, including developed nations, healthcare landscapes are guided by detailed policies that promote the preservation of green assets and encourage design strategies that align with environmental targets. In contrast, Malaysia still lacks specific, enforceable landscape
planning and maintenance guidelines within healthcare institutions. This absence of standardised frameworks has resulted in inconsistent landscape management practices and limited stakeholder awareness regarding landscaping decisions and their ecological and energy-related impacts. This study aims to evaluate the environmental consequences of landscape design decisions in Malaysian healthcare facilities, focusing on carbon sequestration loss resulting from the removal of mature trees and replacing less effective green infrastructure elements. Concentrating on selected public hospitals in Perak, this research adopts a quantitative approach involving detailed tree inventories, carbon sequestration estimations, and photographic site observations to assess the impact of landscape modification. The findings reveal inconsistent practices being implemented, such as a tendency to prioritise short-term aesthetic or functional improvements, which can lead to the removal or neglect of mature trees without adequate recognition of their ecological benefits. In addition, safety issues related to fragile mature trees and physical and visual barriers are among the leading causes of removal or inefficient maintenance. Ad hoc planting of young trees to replace mature trees makes this a less wise move in achieving optimal energy efficiency, as young trees can only absorb a limited carbon storage capacity. This study highlights the need for outcomes in outlining landscape guidelines in healthcare institutions that incorporate sustainable landscape planning, mature tree preservation, and carbon accounting in hospital development and maintenance. Overall, the framework and findings from this research are vital for aligning Malaysia’s healthcare infrastructure with broader environmental and energy conservation goals in the face of current global threats that significantly impact the green environment, energy environment and healthcare environment.