The 'threat multiplier' healthcare leaders can't afford to ignore

From excessive waste to greenhouse gas emissions, healthcare organizations play a key role in contributing to climate change.

Research suggests the United States is the highest contributor to the global healthcare climate footprint. The healthcare industry accounts for 8.5 percent of all greenhouse gas emissions in the U.S.. Worldwide, the healthcare industry is responsible for 4.4 percent of net emissions, which is the equivalent of 514 coal-fired power plants, according to a 2019 report from Arup and Health Care Without Harm, a group dedicated to achieving more sustainable healthcare practices. 

The medical supply chain accounts for 71 percent of healthcare's carbon footprint. Excess waste is created from plastic gloves, surgical supplies, medicine containers and gowns, among other materials. If the American healthcare sector were its own country, it would be the 13th largest source of greenhouse gas emissions in the world, according to a column by Baltimore-based Johns Hopkins physicians.

A 2010 study estimated that each occupied U.S. hospital bed created 33.8 pounds of waste per day. Hospitals also dispose of 2 million pounds of supplies that have never been used, which costs them $15 million each year.

Other key contributors to healthcare's carbon footprint are emissions from facilities, which account for 17 percent of its footprint, and indirect emissions from electricity, heating and cooling, which account for 12 percent, according to the Arup and Health Care Without Harm report.

A study by the National Health Service in England found that 2 to 3 percent of its carbon footprint is created by inhaled anesthetic gases. The drugs are vented through hospital rooftops and can be destructive to the ozone layer. Despite the potential consequences of releasing the gases into the atmosphere, the U.S. has no regulations on how to dispose them. 

Climate change poses an urgent threat to health 

On top of the healthcare industry's own contribution to climate change, raising global temperatures will apply pressure to the industry in the future. Climate change creates a vicious circle in healthcare: Many researchers have proven that rising global temperatures creates a myriad of health issues among the general public, increasing the amount of care health systems will need to provide, which in turn increases health systems' environmental impact.

Every year, 13 million people lose their lives directly or indirectly due to environmental factors such as air pollution, extreme weather events, food insecurity and forced displacement. Climate change only stands to raise this figure. As climate change continues to bring severe weather conditions and loss of precious habitat environments, health outcomes will worsen. Hospitals and health systems are likely to see increases in the number of patients needing care for asthma and respiratory-related illnesses, vector-borne diseases such as lyme disease, heat-related issues and mental health problems. The World Health Organization estimates that due to climate change, the world can expect approximately 250,000 additional deaths a year from malnutrition, malaria, diarrhea and heat stress between 2030 and 2050. A recent report concluded that currently the costs of caring for the effects of climate and air pollution far exceed $800 billion each year.

Climate change has been described as a "threat multiplier," meaning it will augment existing challenges and disparities, especially among vulnerable populations including older people, low-income people, women and people of color. 

In September, over 230 medical journals called for urgent action to be taken against climate change, urging leaders to pledge to actively keep global temperature increases below 1.5 degrees Celsius. Over 450 healthcare organizations representing 45 million workers worldwide have signed an open letter to global leaders, calling for urgent action to combat climate change to protect people's health. 

Recognizing the healthcare industry's role in climate change and the urgent threat climate change poses to health outcomes, 50 countries — including the U.S. — pledged to create more climate-resilient health systems during the United Nations Climate Conference Nov. 9.   

Spotlight on CommonSpirit

Chicago-based CommonSpirit Health shared an industry-leading pledge at the climate conference to achieve net-zero greenhouse gas emissions by 2040. As an interim goal, the health system will focus on cutting emissions from operations in half by 2030.

Shelly Schlenker, CommonSpirit's executive vice president and chief advocacy officer who was at the conference in Glasgow, said the announcement is an extension of decadeslong work the 140-hospital system has been doing to address climate change and its effect on health outcomes. 

"CommonSprit understands there is an unbreakable bond between people and our planet," Ms. Schlenker told Becker's. "For us, at its core, climate change is a health equity issue that disproportionately impacts vulnerable and underserved populations."

As part of CommonSpirit's comprehensive climate action plan to reach zero emissions, the system will adopt new energy-efficient technologies and work with supply chain partners to help reduce their emissions, among other focuses.

At present, CommonSpirit is retrocommissioning its hospitals, which is a systematic process that entails assessing and improving an existing building's operations. Through low- or no-cost changes, Ms. Schlenker said CommonSpirit can reduce the amount of energy used across the organization by 5 to 8 percent. 

By upgrading from fluorescent lighting to LED technology at San Francisco-based Dignity Health's hospitals, CommonSpirit is saving 41,000 metric tons of carbon dioxide annually, which is the equivalent of the energy used by 7,500 homes per year. The upgrade is also saving the system $10 million in energy costs, according to Ms. Schlenker. 

The health system also relies on solar power in various markets across its footprints and will continue to expand on this work, Ms. Schlenker said. Through a solar power initiative called the Salt River Project, CommonSpirit is getting about 4.2 megawatts of energy from a solar farm in Arizona, which is equivalent to the electricity needed to power 1,600 homes per year or nearly a million gallons of gasoline consumed. The effort will remove about 8,000 metric tons of carbon dioxide from the air annually.

While the road to becoming a more climate-resilient health system is complex, Ms. Schlenker's advice to other leaders is simple: Acknowledge the industry's role in climate change and understand that climate is "integrated into all the work we do around caring for our communities and social determinants of health," she said. 

Once leaders have made a case for why their organization needs to change and achieved buy-in from leaders at all levels, they should develop a climate action plan that includes science-based targets and short-term actions to adopt, according to Ms. Schlenker. From there, leaders should also consider how other factors such as supply chain, business travel and employee commuting affect the environment. Health systems should also commit to publicly reporting on their progress with environmental efforts and focus on reducing energy before looking to offset it, she added.

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