Climate-Smart Health Care Is Good for Patients and the Planet

The Lancet, a leading medical journal, recently warned that climate change is the greatest threat to global public health, with a toll that could far exceed the COVID-19 pandemic. Without dramatic reductions in greenhouse gas emissions, we can expect a rising tide of illness and death from extreme weather, food shortages and infectious disease.

The U.S. health care sector is a major source of these problems, producing 8.5 percent of U.S. greenhouse gas emissions, contributing to the very diseases it’s trying to treat. If the global health sector were a country, it would be the fifth-largest emitter of greenhouse gases.

But now, with support from a new White House commitment, the sector can be part of the solution. At the 2021 Global Conference on Health and Climate Change in Glasgow on Nov. 6, Department of Health and Human Services Assistant Secretary Rachel Levine announced that the Biden administration is joining the COP26 Health Programme, which commits national governments to building low-carbon, climate-resilient health care systems. In doing so, the United States joins a growing list of countries — a group that represents one-third of all greenhouse gases emitted worldwide by the health care sector.

A new Office of Climate Change and Health Equity at HHS is charged with making good on this commitment. In addition to developing incentives, training and possibly regulations to support the sector’s decarbonization, the office will focus on communities that have been disproportionately impacted by climate hazards and address health disparities to enhance community health resilience.

This is good news on many fronts. Decarbonizing the health sector will immediately improve air quality and reduce suffering from asthma and other respiratory diseases. Air pollution from burning fossil fuels is among the leading causes of illness and premature death. A recent Harvard School of Public Health report found that 8 million people worldwide die prematurely each year as a result of fossil fuel pollution — more than AIDS, malaria and tuberculosis combined.

Reducing air pollution will also reduce health care costs and relieve pressure on overburdened systems. A sustainable health care sector will stimulate innovations in low-carbon technologies and alternatives to petro-plastics, while boosting demand for renewable energy, green buildings, reusable supplies and climate-smart food production.

A number of pioneering health care providers have already proven that the sector can dramatically reduce emissions while saving money. The 19 members of Health Care Without Harm’s U.S. Health Care Climate Council, representing more than 6,800 hospitals and health centers in 41 states, are leading the way.

Ascension, one of the leading nonprofit Catholic health systems in the United States, cut its energy use by 29 percent from 2008 to 2018, saving nearly $62 million and reducing 1.5 million tons of carbon dioxide emissions across 141 health care facilities.

Kaiser Permanente is installing 70 megawatts of solar energy, and purchases the output from 330 MW of offsite wind and solar projects in California. The health system also implemented the first hospital-based, solar-powered microgrid with battery storage.

By removing unnecessary products from the facility’s surgical kits, Providence St. Vincent Medical Center is saving an estimated $1.5 million in supply purchases and $270,000 on expired items annually.

Hospitals and health systems are also leveraging their purchasing power and community investment to build climate resilience. Seattle Children’s Hospital, recognized as a Tree Campus Healthcare facility in 2020, plants native conifer trees in under-resourced areas that lack tree canopy, reducing the deadly urban heat island effect. In low-income neighborhoods, temperatures are sometimes 10 degrees hotter than more affluent neighborhoods with more tree cover. Cleveland Clinic, as a founding member of the Cleveland Climate Action Fund, has invested in stormwater management, clean energy, local food production and active transportation.

The momentum for climate-resilient health care is not only in industrialized countries. USAID recently announced an initiative called Power Africa, which aims to solarize 20,000 health clinics across the continent. International funding agencies are realizing that a core component of universal health care access is reliable off-grid, clean energy to power facilities, refrigerators for vaccines and other essential medicines and autoclaves to responsibly manage medical waste.

With the Biden administration’s commitment and the leadership of some of the nation’s largest health systems, we have taken a giant step forward. Health care must continue to expand its healing mission to include communities and the planet, as well as demonstrate how a critical part of our global economy can embed health equity and sustainability into its mission — now and into our turbulent future.


Gary Cohen has been a pioneer in the environmental health movement for more than 35 years, and is co-founder of Health Care Without Harm, a nonprofit helping the health care sector to lead in environmental sustainability and support the health and climate resilience of the communities they serve.

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