Posted: 05 Nov. 2020 10 min. read

Can health care and life sciences organizations build a more sustainable and equitable future of health?

By Sarah Thomas, managing director, Deloitte Center for Health Solutions, Deloitte Services LP

The pandemic has underscored the importance of our relationships with people and with our environment. For me, being able to get outside and exercise, watch the leaves change, and safely socialize with friends has kept my spirits up. My children are grown, but I’m happy when I see neighborhood kids taking a break from screens to make sidewalk art with colored chalk, ride their bikes, or walk along the sidewalk with their parents and dogs. Staying connected to the world outside of our computers has been critical to staying well.

But the world outside is being altered, which could have a negative impact on our health. Climate change continues to contribute to droughts, wildfires, and hurricanes, making it impossible for many people to shelter at home from the pandemic. In addition, fires send particulates into the air, exacerbating symptoms for people who suffer from respiratory problems, including those who have, or have had, COVID-19. And people who live in areas that have high levels of pollution, particularly low-income populations, tend to be less healthy than other populations. This can place them at higher risk for complications, and even death, from COVID-19.1 In addition, infection-control efforts have increased plastic and other waste, leading to mountains of personal protective equipment (PPE) in landfills and floating debris and microplastics in our oceans…and in the fish we eat.2 If we burn this trash in incinerators, it could pollute our air with toxic gasses and particulates.

Public health, equity, and health care organizations

As my colleague Elizabeth Baca noted in her recent blog, up to 80% of health outcomes are affected by social, economic, and environmental factors. These drivers of health (also known as social determinants of health) include the physical environment, food, infrastructure, economy, wealth, employment, education, social connections, and safety. Black and Hispanic people more likely to be exposed to pollution, which attributes to negative health outcomes.3

Many health care and life sciences organizations are making commitments to include “impact on equity” in their missions to improve the health of their patients and customers. A focus on climate and the environment can be a part of that strategy. Addressing climate change and improving the environment also can improve other drivers of health that contribute to inequity like access to healthy food. At the same time, working to slow climate change could help make the health system itself more resilient by making it less vulnerable to supply chain disruption due to floods and fires, for example.

Hospitals are a major source of greenhouse gas and waste. The combined health sectors of Australia, Canada, England, and the US emit 748 million metric tons of carbon dioxide equivalents annually. If the health sectors of these countries were an independent nation, they would rank seventh in the world for greenhouse gas emissions.4 Some drug and device manufacturers also contribute to the degradation of the environment—through manufacturing and distribution processes, packaging waste, and pollution of water with pharmaceutical residues.5 Even stakeholders that are not disproportionate contributors to the problem (e.g., health plans) could commit their influence, resources, and expertise to help solve this societal problem.

In a recent report on post-COVID-19 resiliency, Deloitte’s global CEO, Punit Renjen, stated, “Whereas philanthropic and social causes often seek time and resources from organizations, one of the most impactful and lasting contributions is influence. Where there is racial or economic injustice, it is often ossified systems and entrenched institutions that perpetuate the unfair status quo. Given each of our organizations’ vast web of relationships—with customers, vendors, ecosystem partners, governments, communities—how do we connect and leverage the full potential of these networks to reform social systems and structures? Climate change is one area where coordinated action can make a difference.”

How might the future of health improve sustainability?

Over the next 20 years, we expect the health care ecosystem will undergo important and transformational changes that could support a strategy to address climate and the environment. One major trend could be a migration of care away from traditional inpatient and outpatient settings to people's own homes. As we’ve learned from COVID-19, one of the best ways to manage infection is to avoid coming into contact with sick people. Many health systems have developed protocols and tools to help patients manage and monitor their conditions at home. A side benefit is less need for PPE.

At the heart of Deloitte’s vision for the future of health is an expectation that fewer people will get sick—the result of healthy behaviors, medical breakthroughs, continuous monitoring, and the ability to detect and treat disease in the earliest stages. Today’s emerging cell and gene therapies are the beginning of what could be a profound change to the way disease is treated. Fewer people might need long-term therapeutic treatment, further reducing the need for drugs, devices, and care.

Immediate opportunities to make a business case

Addressing climate change and working to improve the environment and other drivers of health can have a positive impact on health outcomes, equity, and resilience. It also can confer more tactical benefits. Some of these include: 

  • Cost savings: Reductions in waste and energy use can help reduce health care spending. The future of work—increased virtual work in particular—translates to fewer commuters and less need for redundant building space. Fewer people working in offices could help reduce rent costs and shrink the carbon footprint at the same time.
  • Compliance with new regulations: A growing number of cities and states are driving efforts to reduce carbon emissions. Stakeholders that develop a strategy now will likely be positioned to comply with new rules.
  • Improved reputation: A focus on the environment, sustainability, and equity could attract consumers who care about those issues. It could also engender trust in the organization’s brand. Consider how many hotels have increased their focus on sustainability.
  • Ability to attract and retain talent: Climate change is a social issue of intense passion for many people, particularly younger generations. Our Global 2020 survey of Millennials and Generation Z found that, despite the challenges of COVID-19, these generations are focused on larger societal issues. The pandemic appears to have reinforced their desire to help drive positive change in their communities and around the world.

What to do next

We suggest a three-part approach to developing a strategy to address sustainability and climate change, equity, and improved public health.

First, identify how your organization can act. Identify areas where emissions and waste can be reduced without requiring additional investment. Second, develop a shared vision aligned with your organization’s broader mission and strategy and develop a common understanding of the problem, solutions, and opportunities. Third, build a long-term roadmap for transformational change. Figure out how your organization can demonstrate leadership and where you can join forces with other stakeholders for maximum impact.

Staying connected to the world outside is essential to maintaining our health and well-being…and our sanity. There were some weeks last summer when we couldn’t safely go outside because of poor air quality, excessive heat, or impending storms, and we all suffered. Organizations—including health care and life sciences organizations—that work with other stakeholders to address climate change, equity, and sustainability could help build a resilient recovery for our economy, people, and planet.

Endnotes

1. Boiling point: These maps show how air pollution and COVID-19 can be a deadly mix, Los Angeles Times, October 8, 2020

2. Increased plastic pollution due to COVID-19 pandemic, Elsevier Public Health Emergency Collection, August 17, 2020

3. Inequity in consumption of goods and services adds to racial–ethnic disparities in air pollution exposure, National Academy of Sciences, March 26, 2019

4. Reducing pollution from the health care industry, American Medical Association, August 2, 2020

5. Drugs in the water, Harvard Health Publishing, June 2011

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Sarah Thomas

Sarah Thomas

Managing Director | Center for Health Solutions

Sarah is the managing director of the Center for Health Solutions, part of Deloitte LLP’s Life Sciences & Health Care practice. As the leader of the Center, she drives the research agenda to inform stakeholders across the health care landscape about key trends and issues facing the industry. Sarah has more than 13 years of government experience and has deep experience in public policy, with a focus on Medicare payment policy.