Healthcare Organizations Increasingly Concerned About Their Own Climate Change Impacts

Healthcare systems around the world have a unique perspective on the human impacts of climate change, and within the sector there is a rapidly growing desire to better understand and reduce the sector’s own contributions to the problem.

“There’s tremendous attention on this, because research has shown that healthcare accounts for approximately 5 percent of global warming contributions in the US and Canada,” largely through generation of greenhouse gases (GHGs) and waste, explains Nathan Ayer, EarthShift Global’s Director of Research.

Nathan and Technical Sustainability Analyst Zeynab Yousefzadeh recently completed a study for the University of Toronto’s Institute of Health Policy, Management and Evaluation, “Scan and Synthesis of Current and Future Climate Accountabilities for Canada’s Health Sector.”

“We found many healthcare organizations are making commitments to reduce their emissions and trying to figure out what levers they can pull, and many are developing internal life cycle assessment (LCA) capabilities because there’s a lot of LCA research being done to answer those questions,” says Nathan. “Data is critical to the LCA research and data gaps can be a major issue, so suppliers and manufacturers are increasingly being asked for numbers as organizations try to get out ahead of the curve.”

While this is an encouraging development, Nathan points out that a piecemeal bottom-up LCA approach may not be optimal for problem-solving. “It’s a bit of a wild rush for LCA in healthcare” he says. “With limited resources we should be more strategic, and work out how to target research to provide answers to the larger group and meet the big needs without everyone having to do their own study.”

Nathan notes that Scope 3 supply-chain impacts are dominant in healthcare, which suggests that systemic action will be crucial; Figure 1 shows relevant findings from the UK’s National Health Service’s groundbreaking 2021 carbon footprint assessment. “Hospitals have onsite emissions from things like energy generation, incineration, and anesthetic gases, but the biggest part of their footprint is Scope 3, including GHGs and all the disposables they buy. There’s a lot of analysis being done to get a handle on the biggest contributors and find alternatives to single-use items.”

Figure 1 - Contribution of different sectors to the greenhouse gas emissions of the NHS England, 2019, from “Health care’s response to climate change: a carbon footprint assessment of the NHS in England.” (“MDIs” refers to metered-dose inhalers)

Some of that work on reuse has been led by New York University professor and consultant Dr. Cassandra Thiel, who will be the featured presenter at a free July 18th, 2024 EarthShift Global webinar on the present and future of healthcare LCAs. (Click here to register.) 

“Surgical procedures require supply packets that contain everything a surgery team might need in the surgical theatre. LCAs of surgical procedures show that, when surgery happens, supply packet items that don’t get used and even unopened packets are also disposed of. Hospitals tend to go above and beyond so people don’t have any doubt about safety, but there’s evidence that they don’t need to. Part of what Dr. Thiel will discuss is how certain practices that seem to be protecting people from infection may not be necessary to achieve the same health outcome,” says Nathan.

More broadly, Nathan and Zeynab’s report notes that the UK’s National Health Service (NHS) “has become the global standard for addressing GHG emissions from health care operators, with its commitment to achieving net-zero health care operations [by 2040].”

In the conclusions to its carbon footprint assessment, the NHS states, “as health systems respond to the increasing health impacts of climate change on global populations, they both contribute to the problem, generating 4–5% of global greenhouse gas emissions, and have a central role to play in the solution….[I]t is important that any mitigation efforts actively seek to generate health co-benefits, reduce environmental impacts, and maintain or improve quality of care. Only then will health systems comply with their duty to first, do no harm.”

While the US health system is based in the private sector without any central management, the federal Department of Health and Human Services has seen strong response to the 2022 launch of its Health Sector Climate Pledge, a voluntary commitment by private sector healthcare organizations to climate resilience and emissions reduction that includes cutting greenhouse gas emissions by 50 percent by 2030 and achieving net zero emissions by 2050. As of April 2024, HHS reports signups from over 1,180 federal and private sector hospitals, representing over 15% of U.S. hospitals.

That trend, along with the need for higher-level strategic insight, is creating more opportunities to learn from an Organizational LCA (O-LCA), which looks at the total of an organization’s inputs, outputs, and impacts, states Nathan. “Researchers at the University of Waterloo recently completed an O-LCA for a hospital in Canada, and I expect it will be a tool that a lot of hospitals and health authorities will look to. Bottom-up LCAs are useful but don’t give insight into the biggest issues. O-LCA can give an overview of pressure points, and address the real work — what are the sources and where are the opportunities to reduce them?”

Is your healthcare organization seeking a clearer perspective on its impacts and avenues for improvement? EarthShift Global’s experienced team can help — contact us.