Leading by Example Health Care’s Role in Improving Health Through Climate Action

Leading by Example: Health Care’s Role in Improving Health Through Climate Action

Why It Matters

"It is not possible to meaningfully improve health and health care without also integrating climate action."


Health care leaders have increasingly come to recognize that we cannot continue to make inroads in improving patient safety, tackle health equity, reduce the cost of care, and strengthen population health without attending to the causes and effects of a changing climate.

Many communities are already confronted with the realities of climate change. Those who are the most affected are the most vulnerable. They tend to be people of color, people living below the poverty line, and people on the front lines of many other health care issues. It is not possible to meaningfully improve health and health care without also integrating climate action.

Threats to Patient Safety and Workforce Well-Being

Heat waves, hurricanes, droughts, and other environmental forces shaped by climate change affect human health and patient safety. If a hurricane hits a hospital, health care leaders and providers must ensure that patients continue receiving high quality care, while withstanding severe disruptions. Hospitals must contend with simultaneously managing care for patients in the hospital while meeting the emerging needs of a community shaken by the latest climate event.

The climate crisis also poses a serious threat to the health and well-being of health care professionals, who already face elevated levels of stress and burnout. Health care workers have reported experiencing climate anxiety and distress, as they witness and cope with the devastating effects of climate change on their patients and communities. Moreover, health care workers may be exposed to higher risks of physical and mental health problems, such as heat illnesses, respiratory illnesses, and infectious diseases, because of working in hazardous and changing environmental conditions. Health systems bear the critical responsibility of managing the risks that a changing climate poses to their workforce.

A Call to Action

The health care sector — which straddles both the causes and effects of the climate crisis — is uniquely positioned to lead climate action. According to a recent report by the World Health Organization, the health care sector accounts for about 4.4 percent of global greenhouse gas (GHG) emissions. As significant contributors to climate change, health systems must deliver care more sustainably and reduce GHG emissions stemming from care delivery. By leading the charge in decarbonization (reducing carbon dioxide emissions) and transitioning to more environmentally sustainable practices, health care organizations can also tackle longstanding priorities related to delivering value-based care, improving patient experience and care quality, and reducing costs.

Ambitious Yet Achievable: Halving Emissions by 2030

To respond to this urgent crisis, the Biden-Harris Administration has set clear goals for the country to cut GHG emissions in half by 2030 and achieve net zero emissions by 2050. The health care sector has a vital role to play in achieving these goals and protecting the health of current and future generations. Many health care organizations have already committed to reducing their carbon footprint and building more climate-resilient infrastructure, as part of the Health Care Sector Climate Pledge launched by the US Department of Health and Human Services.

However, health care organizations may face challenges in implementing effective and sustainable decarbonization strategies, such as lack of data, resources, guidance, and leadership support. To help overcome these barriers, the Agency for Healthcare Research and Quality (AHRQ) partnered with the Institute for Healthcare Improvement (IHI) to develop a primer that offers practical guidance on high-priority measures and actions for health care organizations to reduce their carbon footprint and mitigate climate change.

AHRQ’s Decarbonization Primer

Reducing Healthcare Carbon Emissions: A Primer on Measures and Actions for Healthcare Organizations to Mitigate Climate Change, developed in collaboration with a team of experts in health care sustainability, clinical practice, and health system leadership, serves as an action guide for health care organizations to begin reducing their GHG emissions in six domains:

  • Building energy
  • Transportation
  • Anesthetic gas
  • Pharmaceuticals and chemicals
  • Medical devices and supplies
  • Food

For each domain, experts advanced a prioritized set of measures that organizations can use to track their progress in reducing GHG emissions. The primer also outlines a list of proven and promising strategies to reduce GHG emissions in each domain, along with examples of best practices and case studies from health systems that have successfully implemented these strategies.

In the year since the release of the primer, the Joint Commission has developed a new Sustainable Healthcare Resource Center as part of its Sustainable Healthcare Certification program. Other related guides include the Georgetown Climate Center’s Decarbonizing Health Care: Clean Energy Policy Options and CASCADE’s Greenhouse Gas Emissions Estimation in Canadian Healthcare.

At the Forefront of Climate Action

Health care organizations have recognized they are uniquely positioned to lead impactful change. As anchors in their communities, hospitals and health systems can model sustainability best practices with rippling change across their supply chains, local economies, and surrounding neighborhoods.

Over the last year, IHI convened a Collaborative of fourteen health care organizations committed to testing strategies and measures to advance clinical decarbonization — specifically in the realm of anesthetic gases and medical products. Sixteen clinical decarbonization projects are underway, with more than half documenting reductions in carbon emitting activities. Participants are elevating sustainability imperatives alongside health system quality goals and using improvement methods to learn from small-scale tests of change before scaling to new sites. 

Health care providers bear witness to the mounting adverse health impacts of weather extremes and pollution concentrated among marginalized communities — underscoring the need for urgent and equitable emissions reductions that promote climate justice.

Hospitals face the moral imperative to spearhead a systemwide transition to environmentally sustainable care delivery. Climate champions can jumpstart health care’s critical move towards a decarbonized care system that protects both people and planet. The climate crisis demands nothing less.

Bhargavi Sampath, MPH, is an IHI Director.

Photo by kazuend | Unsplash

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