Essential hospitals can lead a holistic approach to climate and health

Health care systems are on the front lines of the climate crisis – anchoring disaster response while combating growing health impacts from heat waves, wildfires and other weather-related hazards. Most affected are America’s essential hospitals, which provide care for the nation’s most climate-sensitive patients.

Within this challenge lies an opportunity. Given their stature in the most affected communities, essential hospitals can lead a holistic approach to climate and health. But in a time of strained resources and incredible demand, most do not have the ability to do so. With more federal funding, essential hospitals can improve health, equity, and climate resilience in the most vulnerable communities.

The need for resilience is clear: climate change is affecting human and planetary health and the window of opportunity to secure a livable future is fast closing.

Extreme heat, the deadliest climate effect, exacerbates chronic conditions such as heart disease, respiratory illness and diabetes. Rising temperatures trigger other insidious effects on human health and well-being, including food-, water- and vector-borne disease as well as mental health effects and more.

The health burdens of climate change are not borne equally. While all Americans are at risk, low-income communities and communities of color are particularly vulnerable. Worse, climate impacts are layered on top of existing inequalities. Low-income communities and communities of color already endure higher disease burdens and lower life expectancies than more affluent and white populations. In fact, climate change is a risk multiplier for factors that contribute to disease and increase inequality.

These challenges are felt most acutely by America’s essential hospitals, which provide care to patients regardless of their uninsured status or ability to pay. Essential hospitals provide a disproportionate share of the nation’s uncompensated care and typically operate with little or no profit margin. Patients who rely on essential hospitals are often economically disadvantaged, members of historically underrepresented racial and ethnic groups, often with complex clinical needs – all factors that make them more vulnerable to the health impacts of climate change. put at risk.

Essential hospitals – and the health sector in general – have enormous power to effect change. Representing nearly 20 percent of US GDP, the health sector can leverage its purchasing power to drive the transition to a clean energy and low-carbon supply chain. And essential hospitals serve as important anchor institutions in the most affected communities, where they can address factors that increase vulnerability.

The health sector also plays a role in actually causing climate change. Despite its medical mission and commitment to “do no harm”, the health care industry is one of the most carbon-intensive service sectors in the industrialized world, producing up to 4.6 percent of all greenhouse gas emissions. The US health care system is responsible for nearly one-quarter of global sector emissions – a larger share than any other country. This large impact provides an important lever for change.

While the problems of climate change and inequality create a vicious cycle of harm, solving these problems can create a “virtuous circle” of mutually reinforcing benefits. For example, a reduction in emissions that also reduces air pollution can immediately reduce suffering from asthma and other respiratory diseases. And less air pollution means lower health care costs and less pressure on overburdened hospitals.

The potential benefits are staggering. In the United States, eliminating fossil fuel pollution could save 100,000 lives and $880 billion annually. Over the long term, air quality improvements alone could substantially offset or even exceed the costs of climate change mitigation.

With the aims and means to address climate change and inequality, health systems are taking action. For example, the Washington state-based Providence Hospital System is reducing waste, switching to renewable energy, purchasing local and sustainable foods and phasing out climate-altering anesthetic agents. Providence has cut emissions at its hospitals by nearly 12 percent and 26 of its facilities operate entirely on renewable energy.

and the Impact Purchasing Commitment, created by the Healthcare Anchor Network in partnership with Practice GreenHealth and Health Care Without Harm, guides healthcare toward industries that reduce their carbon footprint, produce safer products and services and Increase economic opportunities for businesses. Color and women.

Despite resource constraints, members of America’s essential hospitals are also taking steps to reduce their energy use and lower emissions. For example, Atrium Health in North Carolina cut energy use by 20 percent three years in a row, winning the U.S. Environmental Protection Agency’s (EPA) “Energy Star Partner of the Year” award. The resulting cost savings enabled Atrium to donate $10 million to affordable housing in the communities it serves.

Importantly, Essential Hospitals is working to build environmental and social resilience in the communities they serve. For example, Boston Medical Center – one of the largest essential hospitals and Level 1 trauma centers in New England – worked with local stakeholders to identify the top challenges facing its patient population: housing instability and food insecurity. In response, Boston Medical Center has committed nearly $7 million since 2017 to support community projects on housing and nutritional health.

Despite these inspiring examples, relatively few much-needed hospitals have the capacity to mitigate and prepare for climate change.

That can change. Currently, there is unprecedented momentum at the intersection of climate, health and equality. In addition to issuing an executive order requiring federal agencies to decarbonize their facilities, the Biden administration created a new Office of Climate Change and Health Equity in the Department of Health and Human Services. This new office launched the Health Care Sector Climate Pledge, asking health care stakeholders to commit to halving their greenhouse gas emissions by 2030 and building more climate-resilient infrastructure. It’s a call to action that 102 of the nation’s largest health systems have already met.

President Biden also signed into law the Inflation Reduction Act, which would invest $369 billion to drive the development of clean energy and cut the nation’s carbon footprint. It will provide financial support to enable health systems to cut emissions, while helping overburdened communities reduce pollution and making zero-emission infrastructure more affordable.

Collectively, these initiatives create a unique opportunity for transformation in the health sector. To achieve the greatest impact, the federal government should prioritize investment in essential hospitals that serve communities on the frontlines of climate change and health inequities. With more resources, Needy Hospitals can engage communities to define and implement just, equitable solutions to the great climate and health challenges of our time.

Kalpana Ramaiah, DrPH, is Vice President of Innovation at Essential Hospitals of America and Director of the Essential Hospitals Institute.

Gary Cohen is President of Health Care Without Harm and Practice Greenhealth.

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