Climate change is increasingly affecting the health and well-being of people across the United States, leading to worsening health outcomes that disproportionately impact marginalized communities. Hospitals and health systems are mandated to support the health and well-being of the communities they serve, and there is growing awareness throughout the health sector about the need to properly address environmental impact and reduce carbon emissions. Through facility operations, the industry’s supply chain of goods and services, and money, the healthcare sector produces 8.5% of US carbon emissions. Health care organizations are increasingly prioritizing sustainable projects that reduce this environmental impact and make it a more sustainable and sustainable part of health care, while also having significant health, social, and economic benefits.
The National Academy of Medicine spoke with hospital directors and hospitals, about the initiatives supporting the initiatives of their organizations and how others can act in the field, including concrete actions that are before and long-term benefit. In this conversation, Janice E. Nevin, President and CEO of ChristianCareBased in Wilmington, Delaware, she negotiates opportunities for health care organizations to support projects that engage caregivers and communities.
Why is decarbonizing the health sector an issue that is important to you and your organization?
Tea Lance Commission He characterized climate change as both “the greatest global health threat” and “the greatest global health opportunity” of the 21st century.
At ChristianaCare our core values are love and excellence. We go with love, and guided by love, we approach difficult problems and develop solutions.
Over the past few years, we have increasingly recognized the strong link between health and the environment, including long-term environmental problems such as air and water pollution, natural disasters such as floods and tsunamis, and man-made disasters.
We also recognize that health equity and environmental health are inextricably linked. Members of protected communities often live in areas where they are more likely to be exposed to natural disasters and pollution. In our home state of Wilmington, we have double-digit differences in life expectancy between people living just a few miles apart, and neighborhoods damaged by flooding in recent years have experienced real damage.
Hospitals account for more than a third of the health care industry’s greenhouse gas emissions. So we have both the responsibility and the opportunity to speak.
While we live our mission by reducing our own carbon footprint to have a positive health effect on the communities we serve, we often find that an environmentally sustainable solution is also the best solution from a purely business perspective. Last year we measured our Target 1 and Target 2 carbon emissions. We have already found that Target 2 emissions have been reduced by 80% by purchasing zero-emissions electricity. That change was a no-brainer before we fully understood the impact on our carbon footprint. The transition to zero-emissions electricity has saved us money—proof that calling for environmental justice has an economic benefit. If we can simultaneously improve health and wellness equity through the way we buy our products, reduce our waste and the energy we use in our buildings, why can’t we? For all is to be gained.
What obstacles did you face when you started your decarbonization journey? How did you win these?
Perhaps it wasn’t the perfect time to undertake such a substantial environmental, social and governance (ESG) initiative, but the middle of the pandemic was definitely a challenging time.
ChristianaCare, like all health systems across the country, has faced strong financial pressures. Recognizing the initial costs of ESG work will ultimately provide a long-term financial benefit to help us push through that challenge.
Another obstacle is that in a large organization, with almost 14,000 employees, there are many different opinions. Some people simply do not believe that climate change is a real threat. Others believe that it is true, but they do not believe that people did it or paid for it. What makes it so important to continually highlight the health benefits of ESG work is that we benefit the communities we serve. Improving the health of our patients and the community is something we can all rally around, regardless of our individual feelings about climate change.
What successes have you had in your organization related to decarbonization, and what do you attribute to those successes? How have these skills helped your organization in unexpected ways?
As ChristianaCare develops work around ESG structure and governance in our 2023 fiscal year, the goal for the year was to identify outcome measures and key initiatives for the long-term sustainability of our strategy.
Outcome measures include:
- Using 100% renewable energy by 2025.
- Cutting operational emissions in half by 2030.
Some of the key initiatives are:
- Develop a climate resilience strategy.
- The results of implementing decarbonization activities.
- Find project funding opportunities.
- Be transparent and account for progress.
In November 2022, aligned with those goals, we signed the agreement White House-HHS Health Sector Climate Action Plan.
Creating a robust governance structure for ChristianaCare’s ESG effort has been a great success, fueled somewhat by the unexpected passion of so many of our caregivers.
This year we established a new Environmental Sustainability Care Committee, which brings the dedication and expertise of our care providers directly into the improvement process. The policy is part of our overall ESG governance framework. It taps into the energy of our caregivers, helping them connect with a purpose that closely aligns with their values and instills an even greater sense of pride in working for ChristianaCare. In turn, it helps us to encourage and retain active participation.
One of the Committee’s first activities was the launch of the Eco-Champion initiative, which enables individual carers to serve as leaders in their units to generate ideas and organize efforts to promote sustainability. We are already accepting ideas around waste reduction and community gardens that highlight the benefits of investing in broad opportunities for involvement.
What do you know now that you wish you knew before you started this job?
There is a wealth of knowledge and expertise available in your community from people who want to work and help make a difference, whether that be from government, higher education, or the local environment.
You don’t have to start your work from square one. That said, in order to align your work with people outside of your organization, you also want to make sure that you maintain your independence – strike a balance. What you don’t want to do is push out more requirements, rules, and regulations.
How do you encourage other health care organizations to get involved if they are not involved in addressing decarbonization already?
The environment in which people live has a huge impact on their health. We know that clinical interactions only account for about 20% of a person’s health outcomes. After all, our mission is about health and safety.
Sometimes it’s a big time, but it’s always the same. If we dig deep, if we tackle something strong, we can change the trajectory. While the big picture is long-term, there are short-term benefits – cost savings, engaging with caregivers in the overall project, and demonstrating your organization’s commitment to improving the health of your community.
The best place to start is with a great and reputable record. Decide where you are before you think about where you want to go. Passionate about your employees. Even a small group of committed members can help the organization with them.
Keep the focus on equity. For ChristianaCare, we have integrated our sustainability and equity through aspiration in our five-year strategic plan to end disparities. Remember that often underserved and under-reserved communities live in the most environmentally exposed areas.
Tap into the knowledge and experience of your community. Work with partners to address negative drivers.
More Resources from the National Academy of Medicine
COAL COMMENTARY CI. Learn more about the basics of carbon accounting through an online series marked with related resources and real-world examples.
Key actions to reduce greenhouse gas emissions. Read a short list of key actions for hospitals and health systems to reduce greenhouse gas emissions.
More from the Health Leaders Interview Series
Participate in the Health Leaders Interview Series
Everyone! The health sector is making strides in sustainability. Hear from health leaders in the new @theNAMedicine Climate Collaborative series of lectures covering pathways to climate action: nam.edu/ClimateCollaborative #ClimateActionforHealth