On Climate Change, Hospitals Move Past Awareness to Action | Deloitte US has been saved
By Elizabeth Baca, M.D., M.P.A., specialist leader, Deloitte Consulting, LLP
I live in Sacramento, California where I am seeing, feeling, and breathing the effects of climate change every day. The month of June ended with seven consecutive days at or above 100-degrees. That is the third-longest stretch of triple-digit temps ever recorded here.1 During my afternoon workout in the pool (other activities are not really possible with this heat), I caught the unmistakable smell of wildfires burning in the distance. Extreme drought conditions in the region have led swaths of private forestlands to be closed due to increased risk of fire. Farms are being impacted and local water restrictions are in effect.
Climate change is having a profound impact on the planet—and on the health of its inhabitants. Many health care stakeholders are trying to adapt to this changing environment while developing strategies to improve sustainability and reduce their carbon footprints. Hospitals and health systems are major contributors to greenhouse gas emissions; changing that situation has become a priority for many organizations. However, the need to reduce carbon emissions is often competing with other priorities. Many hospitals and health systems, for example, are still recovering from a severe drop in patient volume caused by the COVID-19 pandemic. They might also be feeling the effects of inflation, high fuel prices, supply chain challenges, and staffing shortages as patient volume rebounds. But this sector is accustomed to responding to multiple issues simultaneously.
How are health systems improving sustainability, reducing emissions?
Last month, I moderated a virtual panel that explored the role hospitals and health systems can play in addressing climate change and in building a more resilient Future of Health.TM The goal of the program, which was hosted by Reuters and sponsored by Deloitte, was to raise awareness and explain the clear connections between climate change and health. (Watch the recording of the session.) The leaders who sat on my virtual panel offered key insights from their perspective. My home in California offered a compelling backdrop for this discussion.
Seema Wadhwa, executive director of environmental stewardship at Kaiser Permanente, told attendees that her organization, in 2020, became the first US health system to achieve carbon-neutral status.2 Reaching that milestone required many investments that have proven to be cost-neutral or have created positive returns, she said. For example, more than 100 Kaiser Permanente sites are now equipped with solar panels, and early investments in large-scale renewable energy have offered a hedge to volatility in the energy market. Immediate and aggressive actions are crucial for addressing and limiting health impacts related to climate change, she said. Seema reports up to the Chief Health Officer within Kaiser’s Community Health division. She explained the position was designed to help the organization view climate change through a health lens. “Climate change is both a health issue and a health equity issue, which is the core of why we're here,” she said.
Noah Dunlap, vice president of insights, innovation and Project Management Office at Advantus Health Partners (Bon Secours Mercy Health’s supply chain subsidiary), said environmental sustainability is a focus at BSMH. “As health care providers, we have the opportunity and the responsibility to assess our environmental footprint and make changes that will contribute to a more resilient health care system for those we serve,” he said.
Here are a few strategies my panelists suggested hospital and health system leaders should consider as they look to become more environmentally conscious:
- View climate change as a public health crisis: Climate change is a public health crisis that could result in an increase in emergency room visits for heatstroke, asthma, and various vector-borne diseases. But if climate change isn’t viewed as a true public health crisis, efforts to address it are unlikely to go far enough, explained Zoë Beck, director of sustainability at Tennessee-based HCA HealthCare, which operates 182 hospitals and 2,300+ sites of care in 20 states and the United Kingdom. The core mission of any health organization is to address or improve health issues that affect the communities they serve, she said.
- Consider the long-term impact on health: Hospitals and health systems care for members of the community from the cradle to the grave. Communities that have a high percentage of minority populations tend to be disproportionately impacted by air pollution, dirty water, and other environmental factors. This leads to increased risk of asthma, diarrhea, stillbirth, and maternal mortality. Ignoring the long-term impact that the environment has on health could have a profound impact on the bottom line, said David Callaway, M.D., a practicing emergency medicine physician at Atrium Health, a health system based in Charlotte, North Carolina. He said his organization has made significant investments in addressing the drivers of health (also known as social determinants) as a form of preventive care. Initiatives are aimed at improving housing options, providing education and job training, and improving access to healthy food.
- Highlight climate and sustainability efforts to help recruit and retain: Dr. Callaway said he recently spent the night working in a packed emergency department. While patient volume has nearly returned to pre-COVID levels, his health system—like most—faces a highly competitive labor market for nurses and other health care professionals, he said. Many millennials and Gen-Z professionals care about the environment and often seek out purpose-driven employers. Communicating the organization’s goals and progress toward sustainability and climate should be incorporated into recruitment and retention strategies, he added. Noah agreed and said employees often want to be a part of a movement and want to know how they can pitch in to help.
- Scrutinize every part of the supply chain: Every link of the supply chain should be scrutinized to see if more sustainable practices can be implemented. Dr. Callaway estimated that 38% of his organization’s carbon footprint is tied to the supply chain. He added that hospitals and health systems often have enough size and leverage to negotiate environmentally conscious contracts. “It’s important to coordinate all the disparate stakeholders to make sure sustainability is always on the table,” he said. Zoë agreed and noted that some vendors might already be reducing their carbon footprint and either don’t know that their efforts are reducing their footprint, or don’t know how to communicate that to their customers.
- Increase use of alternative care models: Dr. Callaway said his health system is working to increase access to care by embracing environmentally conscious models of care such as hospital-at-home and virtual care. Increased use of these models could reduce carbon emissions and help make the organization more resilient and better prepared for extreme weather events, supply chain disruptions, or health emergencies. “Building a resilient health system will help to ensure our financial strength.”
White House says hospitals pledge to cut emissions
Late last month, the White House announced that many of the nation’s largest hospital and health-sector companies—representing more than 650 hospitals and thousands of other providers—had committed to cut greenhouse gas emissions by 50% by 2030.3 On May 31, the US Department of Health and Human Services (HHS) announced the Office of Environmental Justice, which will sit within the Office of Climate Change and Health Equity.4 The goal of the new office will be to “protect the health of disadvantaged communities and vulnerable populations on the frontlines of pollution, and other environmental hazards that affect health.”
After achieving carbon-neutral status, Seema said joining HHS’s call to action was a natural step for her organization. Getting there required a strong focus on renewable energy, such as wind and solar. Solar panels have been installed at more than 100 sites. “I am excited that for the first time there is an office of climate change and a pledge to bring others to the table,” she said. Dr. Callaway noted that a $12 million investment in energy-efficiency upgrades in 2012 decreased energy consumption by more than 30% and offset about $30 million in operational expenses over eight years. “That’s a $30 million return on a $12 million investment.”
The reality of climate change can be daunting, but the health care leaders who are working to address it give me hope for the future. As I've noted in the past, if the US health care system were a separate country, it would be among the top 10 largest producers of carbon dioxide. But if hospitals and health systems are unified, they can lead efforts to reduce greenhouse gas emissions substantially and improve sustainability. Over the past several years, a handful of health care organizations have made climate change a priority, and many more have joined the fight. We appear to be reaching a tipping point in terms of action. For health care stakeholders, it is time to move beyond awareness to action.
Endnotes:
1 June heat wave continues on with 7th consecutive 100-degree day in Sacramento, KCRA-TV, June 27, 2022
2 Kaiser Permanente’s health system reaches carbon-neutral status, Fierce Healthcare, September 15, 2020
3 Pledge to reduce greenhouse gas emissions 50% by 2030, White House press release, June 30, 2022
4 Biden-Harris administration establishes HHS Office of Environmental Justice, HHS press release, May 31, 2022
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