The US healthcare system is the greatest polluter of any industrialized healthcare system in the world, responsible for 8.5% of the country’s total greenhouse gas emissions. Between 2010 and 2018, the US sector’s emissions rose 6% – a correlation associated with increasing demand and investment.
If it does not rapidly transform itself, aligning growth and development with an ambitious decarbonization pathway, it could triple its climate footprint between now and 2050.
It must do this in spite of the stresses that COVID has put upon it, in the knowledge that the climate crisis is a health emergency in itself that will dwarf the impacts of the pandemic.
For one of the largest health systems in the US, Providence, inaction is not an option. Rooted in its commitment to “strive to care wisely for our people, our resources and our earth,” the Catholic health system says it “bears significant responsibility to mitigate the impact of its operations.”
“Our commitment to health and justice requires our action toward building a climate-resilient, decarbonized health system,” says the organization, which is responsible for 52 hospitals, more than 1000 clinics, and 120,000 employees across seven states.
Whilst in the throes of the global pandemic it announced, on the 50th anniversary of Earth Day, that it was to become carbon negative by 2030. The decision, they said, was propelled by evidence that pollution and climate change harm health and disproportionately affect those in under-resourced communities. “We knew the need for swift climate action was certain,” the organization said.
Providence’s Chief Advocacy Officer, Ali Santore is currently leading Providence’s ambitious climate negative goal. “Environmental sustainability can’t be a side hustle that one person works for in one part of the organization,” she explains.
“It needs to be embedded in everything that we do. We own or operate almost 40 million square feet of real estate. Our physical footprint and our responsibility to climate is immense.”
As part of this transformation, Providence created the WE ACT framework, a mnemonic that’s designed to eliminate 80% of their estimated carbon emissions from Waste; Energy and water; Agriculture and Food; Chemicals; and Transportation.
A 2020 study found that almost all – 80% – of healthcare’s emissions can be attributed to the indirect (scope 3) emissions, about half of which is the supply chain, with pharmaceuticals and chemicals having the most impact on pollution. The same study concluded: “the health care sector’s outsize environmental footprint can be reduced without compromising quality.” To do this, it recommended the sector “reduce harmful emissions…decrease unnecessary consumption of resources, decarbonize power generation, and invest in preventive care.”
Straight out of the gate, Providence is addressing all of the above. From construction contracts and energy power purchasing agreements, to the types of chemicals used and the food supplied to hospitals, “we are working on large system change at the executive level,” says Santore.
“Any time a decision is made across our system, care for our planet and environmental sustainability is factored into that decision making,” she adds.
Examples include ensuring sustainable and socially responsible food purchasing practices are written into contracts with their major vendors. “We have contracted with a large third-party vendor that is both committed and contractually obligated to help support our efforts to reduce waste, choose lower carbon intensive foods, and support local and sustainable foods. This means less meat and dairy,” according to Santore.
They’ve also successfully transitioned to lower-emission anaesthetics “in four states and growing”, achieving an 83% emissions reduction, which has saved Providence $1.79 million a year. “We have a group within Providence called Team 298, because nitrous oxide is 298 times more potent and damaging to the environment than CO2, so we’re always looking at ways to reduce leaks of the gas across the system,” says Santore.
Going carbon negative entails re-examining all aspects of the supply chain. Reducing meat and dairy from catering suppliers is part of this transition. Image: Unsplash.
While Santore is confident Providence will be carbon negative by 2030, she admits the task is “challenging and complex.” “We work in a very resource and capital-intensive industry. There are demands for capital across the system. We must ensure the safety of our patients is prioritized when looking at capital investments. We have to make sure that equipment is working and we have staff to care for our patients, particularly now when we’re seeing a fifth wave of the pandemic within our hospitals in the US.”
There are “competing priorities around capital,” explains Santore, “but we have made it clear that long term investment in the environment – what we call a win for the triple bottom line – is the most important thing. It’s a win for the community and ultimately, if done right, it can be a win financially in the traditional bottom-line sense.”
According to Santore, “there’s only so much that the leadership can do.” For Providence, it’s equally important to ensure there’s an understanding across the organization about the importance of climate action so that every member can be an environmental and sustainability ambassador and move this forward,” says Santore.
“We have to bring the whole organization along with us because no one leader can make this happen. There are hundreds of thousands of decisions that get made every single day across our healthcare system. How we ensure the environment is front and centre in that decision making process is a key component of this work,” she adds.
To help do this, Providence is growing “grass roots movements across the system,” forming “green teams” within its hospitals that design bespoke programs for things like composting and recycling schemes.
Ali Santore, Providence’s Chief Advocacy Officer.
“I wish I could say it was easy,” says Santore, but “it’s in [Providence’s] DNA to run towards a problem and address it in our community.” The healthcare provider has been operating for 175 years, grounded in its five core values of Compassion, Dignity, Justice, Excellence and Integrity.
“As we look at health equity, and addressing health disparities, you cannot do that with integrity if you don’t also address the impact of climate, in institutionalizing and advancing these health inequities,” says Santore.
“We all know the impacts of climate change are disproportionately felt by the poor, vulnerable and underserved communities. We say all the time we are here to be a champion for the voiceless and we can’t do that in a real way without addressing climate change.”
“It’s not just a lofty goal that we have, and it’s not just something that we talk about. We see it in our communities with those that don’t have access to stable housing, or air conditioning: they’re the ones that are in our hospitals when we have these extreme heatwaves. Those that don’t have access to heating systems are the first through our doors. We want to address this problem on the front end, get upstream in confronting climate change as the major driver of health disparities. For us, this is personal because this is about our value of justice,” says Santore.
“Ultimately, this is about our patients, our communities. Because our environmental crisis harms health, we are invested in a call to action to address our climate crisis.”
Santore concedes that the road to decarbonization and resilience “can be daunting and overwhelming,” but argues that “even the smallest efforts can make a big difference.”
“Together, we have the power to transform the healthcare system, to address this crisis, and be a partner in caring for our planet,” she concludes.
Healthcare’s Race to Zero and Race to Resilience will be a key theme at this year’s Climate Week NYC. Visit www.climateweeknyc.org or follow #ClimateWeekNYC to receive regular news and keep up to date with Climate Week NYC 2021.
For more information about how to transform the health sector globally, promoting environmental health and justice, please visit Health Care Without Harm, a partner to the Race to Zero.
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