COVID-19 has disrupted our health systems in extraordinary ways. From setting up surge capacity plans to rapidly developing treatment protocols, those who work in our hospitals have fought this disease head-on, despite all the uncertainties. Just as health workers and administrators have worked tirelessly to adapt their hospitals to the pandemic, they must also lead the charge against another crisis: climate change.
Climate change has become a public health emergency. It worsens chronic diseases like asthma and increases the frequency of infectious diseases like COVID-19. According to the World Health Organization, climate change will cause a 250,000 deaths per year between 2030 and 2050 without significant reduction in greenhouse gas emissions.
In many ways, our health systems are on the front lines of the climate crisis. They provide medical care to a growing number of patients whose illnesses are exacerbated by climate change. However, these efforts can be interrupted when these systems are structurally and financially affected by more frequent extreme weather events. One example is the impact of Hurricane Maria. Due to severe damage to Puerto Rico and intravenous bag factories, doctors and nurses across the country have been unable to administer IV fluids and drugs.
While providing medical care to patients suffering from conditions made worse by the climate crisis, healthcare systems are also inadvertently contributing to the problem. Currently, the American health care system represents a quarter of all greenhouse gas emissions in the healthcare world – more than the health care system of any other nation.
Fortunately, health systems are beginning to recognize their role in addressing climate change and its impact on the health of communities. Energy efficiency, transport and food sustainability are all potential areas of intervention.
Hospitals can reduce their energy use through changes large and small. The Cleveland Clinic is a prime example of how these types of changes can be incorporated into health systems. The organization has undergone a major renovation of luminaires from fluorescent lamps to LEDs, and in the process saved 28 million kilowatt hours and over $ 2 million per year. Recognizing that their computers were another large amount of power consumption, they invested in software that put 40,000 non-critical computers and monitors into sleep mode when not in use, saving the system. $ 400,000 per year.
In addition to these minor changes, the Cleveland Clinic has also tackled the biggest energy consumer in its hospitals: the heating, ventilation and air conditioning (HVAC) system. By adjusting the air changes per hour to meet guidelines rather than exceeding them, the organization saved $ 250,000 per year. The organization has also started back of operating room (OR)or reducing the number of air exchanges when operating theaters were not in use, resulting in savings of $ 2 million per year. These adjustments had no impact on patient care. Like Cleveland Clinic, Kaiser Permanente has also sought to achieve carbon neutrality by establishing long-term power purchase agreements in wind and solar. The deals would provide clean energy to 27 of the 39 hospitals, build large-scale wind and solar farms, and establish a large battery storage system.
Transportation is another major source of emissions for hospitals, as 60% of transport emissions in the United States come from 76% of workers who drive alone or who drive light vehicles. A number of health systems are attempting to meet this challenge by promoting alternative means of transport and establishing partnerships with their cities and local organizations. At Seattle Children’s Hospital, staff members can enjoy his bicycle center on site, which offers free maintenance and discounted cycling equipment. This effort allows the hospital to achieve its goal of reducing the percentage of staff driving alone to 30% by 2030 while promoting the physical well-being of employees. It also helps solve the significant traffic congestion problem in Seattle and allows for greater patient capacity.
Like Seattle Children’s Hospital, the University of California, San Francisco (UCSF) has sought to reduce its carbon footprint through its multi-pronged transportation initiative. The system has reduced its percentage of single occupancy vehicles at 25% by encouraging vans and carpools, by offering pre-tax benefits for commuters reduce the cost of public transport and install bicycle racks with shower stations on all hospital campuses. Currently, 23% of the staff drive hybrid or electric vehicles with a final target of 50% by 2025. UCSF also operates 15 electric buses and installed several charging stations for electric vehicles in its car parks.
Food consumption and waste have also become essential elements of sustainable development efforts in all industries. By substituting 50% plant-based foods for animal products, we could avoid 1.6 billion tonnes greenhouse gas emissions by 2030. While agriculture contributes to 24% of greenhouse gas pollution worldwide, regenerative agriculture could reduce carbon dioxide by 23.2 gigatons and generate $ 1.2 trillion by 2050. Fortunately, some hospitals have recognized the importance of food not only for the health of our bodies, but also for the health of our planet. At Boston Medical Center, the 2000 square foot rooftop farm provides fresh produce to patients and the local community while reducing the hospital’s carbon footprint. This is because carbon-breathing factories help reduce building heating and cooling costs and shift the transport of food to internal production. Rooftop farm water usage is controlled by a smart phone app, which shuts off the water based on the weather forecast, and it also resolves combined sewer overflows by slowing the flow of water from the rooftop. rain in sewage.
Right now, climate change demands our action from the individual to the organizational level. Without serious efforts to engage in sustainable interventions, the carbon footprint of health systems will continue to increase and increase the burden of disease. Fortunately, healthcare organizations across our country have shown that they are willing to take the necessary action to reverse climate change. By investing in our planet, health systems also invest in our collective health and our future.
Christine James, MD, is an allergist-immunologist and a member of Climate Health Now, a California-based organization of health professionals that recognizes climate change as a public health emergency, and of the Public Health Advisory Committee of Climate Action Campaign.
Sweta Chakraborty, PhD, is a behavioral scholar, author and regular TV news commentator. She is the US representative for We Don’t Have Time and is also a member of the EcoHealth Alliance Board of Directors.