Climate change and climate-induced crises are having a profound impact on health — worsening chronic diseases and mental health conditions, for example — and disproportionately affecting groups already at risk, including people of color, people with low incomes, those with preexisting health conditions, older adults, and children. Climate change also interferes with the health system’s ability read more to deliver safe, effective care because of hospital closures and disruptions across the supply chain. Finally, the costs of caring for the victims of climate change and repairing health facilities following climate events are high, with health systems bearing much of the burden.
The health system itself plays a significant role in the ongoing climate crisis, contributing at least 8.5 percent of the total U.S.-based greenhouse gases (GHGs) that are responsible for climate change. Because these emissions ultimately cause harm to patients, the health care workforce, and society, decarbonization is a critical component of care quality improvement. From regulators, to employees, to communities, pressure is mounting for health care leaders to implement decarbonization strategies that limit the effects of climate change.
What Can Health Systems Do to Reduce Greenhouse Gas Emissions?
Understand the emissions footprint. It is important to aggregate data to understand the current and projected emissions footprint. Understanding the total amount of GHGs emitted from both direct (e.g., health care facility operations) and indirect (e.g., emissions from purchased items, such as electricity, food, and medical products) emissions will allow facilities to understand where they are, measure progress over time, and identify “hot spots” — problematic areas where special attention is needed. It is important to focus on supply chain emissions, which make up the majority of health systems’ emissions. These are generated by the production and transportation of goods and services, including pharmaceuticals and other medical products and devices, as well as by the transport and processing of waste.
Define emissions targets. Short- and long-term emissions targets should reflect organizational priorities and evolving stakeholder expectations. Many organizations have aligned their targets with international and White House and Department of Health and Human Services pledges that seek to reduce emissions by half by 2030 and reach net-zero emissions by 2050. Organizational goals also may include adopting standards like the Science Based Targets initiative that aligns decarbonization with the latest climate science.
Establish governance mechanisms. Board directors and executives can play a key role in advancing decarbonization as an organizational priority. They should make sure that climate resilience — that is, the ability to prepare, respond, and recover from climate events — and decarbonization are thoroughly integrated into the strategic planning process. Boards can establish accountability and tie executive compensation to achieving decarbonization and other sustainability goals. They also can ensure that health systems appoint a chief sustainability officer and team that have the necessary support from leadership to create and implement a decarbonization action plan.
Identify, prioritize, and activate decarbonization strategies. Prioritize decarbonization strategies based on clear criteria, such as the potential effect on equity, alignment with community stakeholder goals, impact on “hot spots,” and other benefits, such as increased resiliency or operational cost-savings. Decarbonization strategies can include switching to renewable energy sources, using energy-efficient construction, ensuring transportation efficiency, reducing food waste, eliminating leakage of anesthetic gases, and prioritizing reusable supplies. Clinical changes will likely be necessary, such as switching to low-carbon inhalers, emphasizing prevention and wellness, reducing unnecessary or low-value care, and enabling virtual and digital care delivery, as appropriate. By accessing existing resources already developed for hospitals and following the example of leading health systems in the United States and abroad, health systems can make sure they are adopting tested and successful strategies.
Measure and report progress. Over time, measure the impact of decarbonization strategies and progress toward meeting emissions targets. Currently, health systems’ reporting of GHG emissions is voluntary and variable. That said, several health care organizations have taken steps to increase reporting and disclosure. The benefits of increased transparency include improved brand reputation, increased employee retention, and reduced exposure to risk.
Achieving net-zero emissions is not an easy or short-term task, but health systems can use these steps to combat the climate crisis, improving health and health equity in the process.
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