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Climate-Smart Healthcare
Ensuring healthcare is resilient to disasters and is delivered in a way that helps rather than harms the health of our communities.
Healthcare should not hurt the health of the communities we care for.
All people have a right to healthcare that is accessible, affordable, and delivered in a way that does not pollute their communities or destabilize our climate. To fully care for our communities, we must transform our healthcare sector to reduce pollution and promote resilience.
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A loss of nearly
0
disability-adjusted
life years.
of U.S. air and climate emissions are caused by healthcare.
Up to
%
0
Currently, hospital systems are responsible for 8-10% of U.S. air pollution and climate emissions, four times that of the aviation industry. In addition to causing climate change, powering our healthcare with fossil fuels makes our communities sick now. Burning fossil fuels for energy causes air pollution that is well known to cause many of the conditions that our health professionals and health systems work so hard to prevent and treat, including preterm births, stillbirths, delayed cognitive development in children, asthma, heart attacks, COPD, cancer, strokes, and dementia.
As of 2018, air pollution generated by U.S. healthcare resulted in the loss of nearly 400,000 disability-adjusted life years, a similar magnitude to the deaths resulting from preventable medical errors. This reality leaves us stuck in a non-ethical cycle, where the process of providing care to patients itself perpetuates more sickness. It’s estimated that the U.S. health sector's energy use adds $600 million in direct health costs and over $5 billion in indirect costs each year. Meanwhile, every dollar a U.S. hospital saves on energy is equivalent to generating roughly $20 in new revenues. That means health systems are wasting their own money while making patients sick and costing society a lot of money.
Climate-smart healthcare means transforming health system energy use and procurement to avoid pollution, ensuring our healthcare delivery is resilient and available in the face of extreme weather, and engaging with communities to help them make evidence-based decisions around energy and adaptation so they can protect themselves. The good news is that this can all be achieved while saving money, decreasing the cost of care, improving employee satisfaction and retention, and improving community relations, making our health systems true anchor institutions.
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Our Climate-Smart healthcare effort innovates within our hospitals, clinics, and healthcare systems.
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Beyond conventional pollutants, we must also decrease the direct greenhouse gases emitted in hospital operations.
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We can build better operations systems and supply chains that conserve water and reduce both waste and emissions.
Now that we have affordable, pollution-free alternatives, we in healthcare have an ethical responsibility to switch to them. That means electrifying all possible energy use so we don’t burn fossil fuels in our buildings and fleets, it means maximizing efficiency in our buildings and operations, it means sourcing our electricity from renewables, and pushing our utilities to make healthier sources of energy available to our facilities.
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Our Climate-Smart healthcare effort advances patient care and reduces pollution by encouraging renewables, electrifying fleets, stocking healthy foods, overhauling the supply chain and supply-use practices, training health professionals to become climate-smart champions in their own places of work, and helping health systems partner with their communities on questions of energy and adaptation. As health workers, we can propel our health systems to meet the moment.
In particular, shifting anesthetic gases that have equal quality, but are cheaper and cause much less warming. Innovation in our care delivery, such as switching from a central gas delivery system to portable gas, can also reduce emissions leakage. These changes can save money and, more importantly, make operating rooms safer for health workers and patients. Innovative alternatives for emissions intensive products can be found beyond the operating room in pharmaceutical alternatives for inhalers and other equipment.
We must also switch to more sustainable materials and re-evaluate medical protocols that create high amounts of waste. Since hospitals use approximately 7% of all water in commercial and institutional U.S. facilities and thousands of pounds of paper per day, there is much to be gained through conservation practices.
Many international health systems also provide practice models that minimize single-use plastics while producing better health outcomes and lower infection rates. The growth of single-use plastics, which are derived from fossil fuels, may account for almost half of oil demand growth by midcentury if left unchecked. The life cycle of plastic also has serious environmental justice implications. Their production in areas like Cancer Alley is responsible for widespread suffering, and microplastics, recycling, and disposal pose additional health and equity challenges. Because much of healthcare emissions occur outside the facility, this means analyzing and working to reduce scope three emissions.
Planning can make our clinics more resilient for when we need them most.
Climate-smart healthcare also means ensuring we are capable of providing reliable, resilient care during extreme weather. For example, that means making sure our facilities are safe from flooding and that they have adequate ventilation to protect against wildfire smoke. Microgrids and batteries can also provide important backup generation for health infrastructure during power outages. A resiliency mindset also requires us to re-examine planning protocols for critical medical supplies and infrastructure. The vulnerability of our current medical supply chains has been illustrated several times in recent years, such as when Hurricane Maria resulted in a shortage of IV bags and life-saving medications in the U.S. for months after a manufacturing plant was damaged.
Our health workforce is a cornerstone to health system resilience.
Our care teams and administrators need to be trained in-depth about which health impacts to expect from climate extremes and have concrete plans to help healthcare professionals manage overflow during disasters and provide comprehensive care for their most vulnerable patients. This planning necessitates integration across community services often sectored off from traditional healthcare services, such as cooling centers and mental health programs. Learning about the intersection of climate and health is a critical part of having a trained workforce that will have the agency and tools to provide care when our communities need it most. Employee orientation, grand rounds, and signage can also help staff reduce waste.
Beyond training and planning, healthcare workers are human beings and their mental and physical health is also impacted by climate change and extreme weather. Staff climate health issues or barriers to transport, such as a flooded roadway, can lead to staff shortages. Staff shortages, combined with increased emergency room visit demands during extreme weather, can result in stress and burnout for healthcare workers. Specialty service providers might also consider re-locating following consistent climate disruptions, worsening geographic disparities in healthcare access.
However, sustainability initiatives can help hospitals and clinics recruit and attract talent. Six of 10 clinicians surveyed said a prospective employer’s policies and actions on climate change would impact their decision to apply for a job.
A prepared clinic prepares their community.
Lastly, climate-smart healthcare means engaging with our patients and communities to help them make evidence-based decisions around emergency preparedness, adaptation, and energy, so they can protect themselves. This is not only the right thing to do, but helps manage demand for healthcare services so our emergency rooms do not get overwhelmed. Our communities also get much of their trusted health information when they go in for care, which means that our clinics need to be publicly engaged in conversations about climate change and its causes. Healthcare workers need to be supported in connecting with their communities as they bring evidence-based health recommendations to their patients and local decision-makers.
How to talk about it - Example ask for C-suite or department leadership
Healthcare leaders must ensure the care we provide is resilient to disasters and is delivered in a way that helps rather than harms the health of our communities. Climate-smart healthcare means transforming health system energy use and procurement to avoid pollution, ensuring our healthcare delivery is resilient and available in the face of extreme weather, and engaging with communities to help them make evidence-based decisions around energy and adaptation so they can protect themselves. The good news is that this can all be achieved while saving money, decreasing the cost of care, improving employee satisfaction and retention, and improving community relations, making our health systems true anchor institutions. I'd like to see our health system or department be part of this critical work. Could we find a time to talk more deeply about what the best options for us might be?
Want to take action about this issue?
For more tips on helping your health system pursue climate-smart healthcare, please take a look at our Climate-Smart Healthcare Toolkit.