Experts rank environmental factors among the leading causes of poor health around the world, along with risky health behaviors and social and economic determinants.
Preventable environmental factors are responsible for an estimated 23% of all deaths globally, according to the World Health Organization, including 26% of deaths among children under the age of 5.
Some providers have continued or expanded their efforts as the federal government’s views about the effects of climate change have shifted in recent years. In 2017, after the Trump administration pulled out of the Paris climate agreement, several of the country’s largest health systems reiterated their commitment toward environmental stewardship with or without federal support.
Yet the healthcare sector itself is a major contributor to pollution as the world’s seventh-largest producer of carbon dioxide; it’s also responsible for nearly one-tenth of all U.S. greenhouse gas emissions. Healthcare also produces large amounts of waste. The average hospital generates more than a pound of hazardous waste per bed a day, according to the World Health Organization.
The environment’s impact on public health is expected to only grow as a result of climate change. Heightened temperatures caused by greenhouse gases have led to increases in the frequency and intensity of extreme weather events, which were responsible for more than 600,000 deaths globally over the past 20 years, according to a 2015 report by the United Nations.
In recent years a growing number of providers have set audacious goals for achieving greater environmental sustainability with initiatives to massively lower their energy and water consumption, improve their waste disposal practices, and reduce their greenhouse gas emissions.
Cohen said such social determinants as housing instability and food insecurity among patients along with hospitals’ energy use were a few of the biggest areas of focus for those healthcare providers who have begun to examine how to link environmental sustainability with their population health strategies.
Arguably the most popular trend hospitals pursue involves how they purchase food. Cohen said Practice Greenhealth works with several hundred providers as part of its Healthy Food in Healthcare Program, getting them to commit to buying portions of their food supply from local and sustainable growers.
The goal of the initiative is for hospitals to create a “sustainable food system” that promotes healthy food access, diet education and economic development in low-income communities.
Among the one-third of providers in the country that follow Practice Greenhealth’s sustainable food criteria is Kaiser Permanente, which has set the goal of buying 100% of its food from local or sustainable producers by 2025. In 2017, 28% of Kaiser’s food budget went toward sustainable food, with its hospitals collectively hosting more than 50 seasonal markets and farm stands a year.
“We’ve defined the criteria of healthy food to include sustainable food,” said Kathy Gerwig, vice president of employee safety, health and wellness and environmental stewardship at Kaiser. “That’s how you begin to make it seamless.”
The pledge is part of the health system’s broader environmental stewardship effort that includes becoming carbon-neutral by 2020 by purchasing most of its energy through renewable sources, reducing water usage by 25% per square foot of its buildings, and recycling or reusing all of its non-hazardous waste by 2025.
“These are all things that in and of themselves are important environmental issues but combined create a very effective climate action strategy,” Gerwig said.