US health care rises to meet the climate crisis, bringing opportunity for transformation

Americans are seeing and feeling the impacts of the climate crisis in their daily lives. In the last two years, there have been 42 extreme weather events collectively costing $245 billion and taking the lives of over 1,000 people. Wildfires, hurricanes, tornadoes, flooding and extreme heat are blanketing much of the country.

Here and beyond our borders, the climate crisis has become a health crisis. The World Health Organization estimates nine out of 10 people on Earth are breathing air that is not healthy, and much of it the result of burning fossil fuels. UNICEF reports approximately 1 billion children — nearly half of the world’s children — live in countries that are at “extremely high risk” from the impacts of climate change.

In the United States, despite the mounting damage from our nation’s continuing dependence on fossil fuels, the industry maintains a stranglehold on our democracy, slowing the pace of change needed to drive our economy toward a renewable energy future. The good news is that progress on climate is not completely reliant on elected officials who may be influenced by the fossil fuel industry. Instead, leadership is coming from an unlikely source — the health care sector.

Health care sits at the epicenter of our collective climate trauma. Its facilities take care of people who are injured in extreme weather events, people who are suffering from respiratory disease and asthma from pollution, as well as children and elderly adults whose bodies can’t handle temperatures over 100 degrees.

Health care also occupies a unique position in the American economy. It’s the largest share, compromising nearly 20 percent of the U.S. GDP. We spend $18 trillion each year on health care. It is also the only part of the economy that is underpinned by an ethical framework to “do no harm.” 

So, what does it mean to do no harm in a world where our continued reliance on fossil fuels is killing us and threatening the planet’s ability to sustain us?

For the health care sector, it means kicking its addiction to fossil fuels to operate its buildings, provide medical equipment, prescribe pharmaceuticals, feed its employees and patients, transport people, as well as deliver care. It means understanding that the same health inequities that plague our communities are exacerbated by climate-related conditions, so addressing racial and health injustices also means addressing climate injustices. It means that if we can harness the enormous power and influence of the health care sector for climate solutions, we can move the largest share of the economy toward greater health and equity.

At the White House on June 30, 61 of the largest U.S. hospital and health sector companies representing over 650 hospitals and thousands of other providers across the country, announced their collective commitment to reduce their greenhouse gas emissions by 50 percent by 2030 and to reach net-zero no later than 2050. This group includes members of the U.S. Health Care Climate Council, a leadership body of health systems committed to protecting their patients, employees and communities from the health impacts of climate change.

This expression of commitment aligns the health care sector with the Biden administration’s climate goals, as well as with the UN’s global Health Programme launched at the last climate summit in Glasgow. It also aligns the private health care sector with the federal one, since President Biden signed an executive order in December committing all the Veterans Administration, military hospitals and Indian Health Service facilities to these same climate goals.

Importantly, the commitment opens the door to extraordinary transformation of the largest part of America’s economy. In order to meet these ambitious climate action goals, health care will need to deal with its enormous supply chain, which accounts for over 80 percent of its total climate footprint. The health systems that signed the Department of Health and Human Services’ (HHS) Health Care Sector Pledge, along with the Veterans Administration and military hospitals that are mandated by the administration’s executive order, have a combined purchasing power estimated at nearly $100 billion.

This economic influence, if aggregated through collective standards and sustainable criteria, can mean a massive acceleration in the purchase of electric vehicles, renewable energy, energy-efficient medical equipment, local and sustainable food, as well as smarter drug prescribing practices, greater use of telemedicine, fewer unnecessary clinical tests and improved pathways of care that better align with the health of the planet.

The commitment also creates an opportunity for the sector to realign its priorities to support community health, community wealth and climate resilience. If hospitals exercise their role as “anchor institutions,” rooted in and accountable to the communities they serve, they can use their purchasing power to invest in local, racially diverse businesses and use their investments to support healthy housing and food systems. Hospitals can also use their workforce development to provide jobs to local residents and leverage their political clout for policies that drive their cities and states toward a renewable energy path that will clean up the air, lower disease and reduce health care costs.

Americans can all agree that they want health care that doesn’t cause harm. We want a health care system that is responsive to the challenges we collectively face. We want health care that focuses more on prevention in addition to treating people once they are sick — taking care of everyone who needs help. The movement of the sector to assume leadership for addressing its own climate footprint and to leverage its economic and social influence to bring change beyond the sector is a powerful step in the right direction.

Gary Cohen is president and co-founder of Health Care Without Harm and Practice Greenhealth, and he has worked to further the environmental health movement for more than 35 years. His achievements include The MacArthur Foundation’s Fellows Award in 2015 and the White House’s Champion of Change Award for Public Health and Climate Change in 2013.