Sustainability series

Health care's role in environmental and health equity

Improved sustainability and efficiency have significant and wide-spread impacts far beyond a hospital’s walls
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Editor’s note: This article is the first in a series on the impacts of climate change and climate events on hospitals and health care facilities and related planning, preparedness and response efforts.


The severe impacts of climate change in every region of the country are apparent. In 2021, the Federal Emergency Management Agency recorded more than 100 emergency and disaster declarations, including severe flooding from Hurricane Ida in the South and Northeast, wildfires throughout the Western United States and ice storms in Texas that paralyzed the state’s utility infrastructure.

While these extreme weather events result in more immediate response and recovery needs, they also have longer-term health consequences. Air pollution, infectious diseases, and food and water supply impacts are just a few of the health challenges that communities can face after experiencing climate-related disasters.

However, the effects of climate change are not consistent across communities. Vulnerable populations — such as low-income communities, communities of color, the elderly and children — suffer the most serious consequences. This link between climate events and disparate health impacts and outcomes is an important health equity issue, and one that will only become more significant as the frequency and severity of climate-related threats continue to increase.

Studies have shown that the U.S. health care system accounts for up to 10% of total greenhouse gas emissions and toxic pollutants through the supply chain and operations. But these impacts mean that hospitals and health care systems can also play a significant role in fostering both environmental and health equity at the community, national and global scales.

The U.S. Environmental Protection Agency has identified three scopes of greenhouse gas emissions that make up an organization’s carbon footprint. The most relevant, from a health care facilities standpoint, are Scope 1, direct emissions from onsite combustion and mobile sources, and Scope 2, indirect emissions from purchased electricity and steam.

Through sustainability and energy performance programs and projects, health care facilities managers have an opportunity to address these direct and indirect emissions. In addition, the impacts of this work have repercussions outside the physical facilities themselves by improving the environment, mitigating the effects of climate change and targeting community health issues.

Improved energy performance, building decarbonization, water conservation, climate action plans and recycling programs are just some of the ways that health care facilities managers can address environmental and health equity. Although the more immediate and tangible benefits of these initiatives will be improved energy efficiency and resiliency, the broader and longer-term community health and environmental gains are equally important.

Health care systems will continue to grapple with the threats and impacts of climate-related events in the coming years, but the challenges will also bring opportunities. Health care facilities managers, with their on-the-ground perspectives and deep understandings of the inner workings of facilities, will be essential in sustainability efforts as they set examples, forge new paths and find creative solutions to the situations they will confront.

Learn More

On Dec. 7, The American Hospital Association Community Health Improvement and the American Society for Health Care Engineering are hosting a workshop called “Applying a Health Equity Lens to Environmental Issues: Lessons for Community Health Planning and Facility Sustainability Strategies.”

This free, interactive conversation will convene a diverse panel of community/population health and sustainability/facilities management experts to examine environmental impacts, health disparities, and community health and environmental stewardship strategies. Register here.

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