HomeHealthHealth CareEssential hospitals can lead a holistic approach to climate and health

Essential hospitals can lead a holistic approach to climate and health

Healthcare systems are on the front lines of the climate crisis, embedding disaster relief as they deal with the increasing health impacts of heatwaves, wildfires and other weather-related threats. Hardest hit are America’s essential hospitals, which care for the country’s most climate-sensitive patients.

Within this challenge lies an opportunity. Given their status in the most affected communities, essential hospitals could lead a holistic approach to climate and health. But in a time of tight resources and relentless demand, most lack the capacity to do so. With more federal funding, essential hospitals could improve health, equity and climate resilience in the most vulnerable communities.

The need for resilience is clear: climate change impacts human and planet health and the opportunity to secure a livable future is close quickly.

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

The health burdens of climate change are not shared equally. While all Americans are at risk, low-income and communities of color are particularly vulnerable. Even worse, the climate impacts come on top of existing inequalities. Al low-income communities and communities of color carry a higher burden of disease and a lower life expectancy than more affluent and white populations. In fact, climate change is a threat multiplier for factors contributing to disease and rising inequality.

These challenges are most acutely felt by America’s essential hospitals, who care for patients regardless of their insured status or means. Essential hospitals provide a disproportionate share of the country’s uncompensated care and typically operate on little or no profit margin. The patients dependent on essential hospitals are often economically disadvantaged, members of historically underrepresented racial and ethnic groups, often with complex clinical needs – all factors that put them at increased risk of the health impacts of climate change.

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

The health sector also plays a role in this cause climate change. Despite its healing mission and commitment to “do no harm,” healthcare is one of the most carbon-intensive service sectors in the industrialized world. to 4.6 percent of all greenhouse gas emissions. The US healthcare system is responsible for approx a quarter of the global sector’s emissions — a larger share than any other country. This excessive impact is an important lever for change.

While the problems of climate change and inequality create a vicious circle of harm, the solutions to these problems can create a virtuous circle of mutually reinforcing benefits. Emission reductions that also reduce air pollution, for example, can immediately reduce suffering from asthma and other respiratory diseases. And less air pollution means lower healthcare costs and less pressure on overburdened hospitals.

The potential benefits are amazing. In the United States, eliminating fossil fuel pollution can save money 100,000 lives and $880 billion a year. In the long term, only air quality improvement could significantly offset or even exceed the costs of climate change mitigation.

With the motive and resources to tackle climate change and inequality, health systems are taking action. For example, Washington State’s Providence Hospital System is reducing waste, switching to renewable energy, sourcing local and sustainable food, and eliminating climate-changing anesthetics. Providence has reduced the emissions of its hospitals with nearly 12 percent and 26 of the facilities run entirely on renewable energy.

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And the Impact purchasing obligationcreated by the Healthcare Anchor Network in partnership with Practice Greenhealth and Health Care Without Harm, healthcare procurement targets industries that reduce their environmental footprint, produce safer products and services, and increase economic opportunity for businesses owned by people of color and women.

Despite limited resources, members of America’s essential hospitals are also taking steps to reduce their energy consumption and emissions. For example, Atrium Health in North Carolina reduce energy consumption by 20 percent, which has won the U.S. Environmental Protection Agency (EPA) “Energy Star Partner of the Year” award for three consecutive years. The resulting cost savings enabled Atrium to donate $10 million toward affordable housing in the communities it serves.

Importantly, essential hospitals work to build environmental and social resilience in the communities they serve. For example, Boston Medical Center, one of New England’s largest essential hospitals and level 1 trauma centers, worked with local stakeholders to identify the biggest challenges facing its patient population: housing instability and food insecurity. In response, Boston Medical Center nearly invested $7 million since 2017 to support community housing and healthy food projects.

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

That could change. There is currently unprecedented momentum at the intersection of climate, health and justice. In addition to issuing a executive order By requiring federal agencies to decarbonise their facilities, the Biden administration created a new one Office of Climate Change and Health Equity at the Department of Health and Human Services. This new office launched the Health Care Sector Climate Pledge, asking healthcare stakeholders to halve their greenhouse gas emissions by 2030 and build more climate-resilient infrastructure. It is a call to action that has already been fulfilled by 102 of the largest health systems in the country.

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President Biden also signed into law Inflation Reduction Act, which will invest $369 billion to boost clean energy growth and reduce the country’s environmental footprint. It will provide financial support to enable health systems to reduce emissions while helping overburdened communities reduce pollution and make 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 must prioritize investment in essential hospitals that serve communities on the front lines of climate change and health inequality. With more resources, essential hospitals can engage communities in defining and implementing just, equitable solutions to the major climate and health challenges of our time.

Kalpana Ramiah, DrPH, is vice president of innovations and director of Essential Hospitals Institute at America’s Essential Hospitals.

Gary Cohen does president of Health Care Without Harm and Practice Greenhealth.



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