Wearable healthcare electronics are rapidly emerging as a distinct electronics sector in the digital era^1-6, offering substantial economic opportunities and crucial medical benefits. However, their interactions with environmental and social systems remain poorly understood^7-9, leaving critical sustainability challenges unaddressed. Although current efforts have focused on material-level improvements, broader system-level dynamics remain unexplored. Here we present an integrated systems engineering framework based on de novo life-cycle inventories and diffusion-linked scaling to quantify global eco-footprint hotspots and identify effective mitigation strategies. Cradle-to-grave analysis of representative wearable healthcare electronics (glucose, cardiac and blood pressure monitors and diagnostic imagers) generates full-spectrum environmental impact metrics, identifying warming impacts of 1.1-6.1 kgCO₂-equivalent per device. The global device consumption is projected to increase 42-fold by 2050, approaching 2 billion units annually and generating 3.4 MtCO₂-equivalent emissions alongside ecotoxicity and e-waste issues. Contrary to the conventional sustainability emphasis on plastics, this work demonstrates that recyclable or biodegradable plastics offer only marginal benefits, whereas substituting critical-metal conductors and optimizing circuit architectures can significantly reduce impacts without compromising performance. This systems engineering-based life-cycle assessment framework holds promise for establishing ecologically responsible innovation in next-generation wearable electronics.

Competing interests: The authors declare no competing interests.