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Climate Change

Nicole Ortiz

Healthcare Brew delivers the latest news and trends in healthcare.

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Recent years have highlighted how extreme weather events are becoming 

, which means patients are experiencing increased health risks like heat-related illnesses, mental health struggles, respiratory issues, and more.

 from the Commonwealth Fund ranked states to determine how prepared they were for extreme weather events and their role in contributing to greenhouse gas emissions. The healthcare research foundation analyzed publicly available federal and state data between 2020 and 2024 to show how states stacked up in categories including 

 11,755 people worldwide had died as a result of natural disaster in 2019, with 95 million additional people impacted, at a cost of almost $130 billion. And a 2023 study projected that if there were an electrical grid failure in Phoenix, Arizona, during a two-day heat wave, nearly 800,000 people would 

 for heat-related illness and nearly 13,000 people would die in the city.

In May, a group of health organizations including the American Public Health Association, Physicians for Social Responsibility, and 

 signed an open letter urging “leaders at every level take swift action to address the health impacts of climate change and reduce the pollution driving it.”

“What I hope the scorecard helps health systems understand is that they need to be leveraging their voice in these policy decisions on clean energy because it both affects their operations and it affects the health of their populations,” Lisa Patel, executive director of environmental and health group the Medical Society Consortium on Climate and Health, told us.

 To get to the good news first, Vermont, New York, Washington, New Jersey, and Maine all had top scores in the study, meaning these states are at a lower risk of environmental hazard, have cleaner and greener energy policies, and emit lower emissions across healthcare.

West Virginia, Kentucky, Louisiana, Florida, and Mississippi all scored among the lowest.

Arizona, Nevada, and New Mexico see higher temperatures and worse air quality, with Arizona topping the latter list, something that surprised Northeastern University Associate Professor of Environmental Engineering Matt Eckelman, who was also an author on the study.

“For a long time, we’ve known California has had the most serious air pollution issues in the nation,” he told Healthcare Brew. But when it came down to population density and air quality index numbers, he said, “Arizona came out even worse.”

As far as states that are at a higher risk for environmental hazards like floods, hurricanes, and severe winter weather, Florida and South Dakota scored the worst while West Virginia, Wyoming, and North Dakota had the highest greenhouse gas emissions per capita.

 Already, hospitals in some states are taking measures to better prepare for extreme weather.

 showed the preparedness of Florida health systems, like Tampa Bay General Hospital and its new 

, which helped provide a barrier against flooding. On the other side of the country, California-based Kaiser Permanente is 

 with community awareness and support. And nonprofit Americares recently 

 it would award grants to clinics and community health centers across the country to combat extreme heat.

“For new facilities, this is the best opportunity there is to plan for the future, to make sure that not just the hospital, the physical building, but all the systems that support the hospital, including all the access and connected infrastructure, are also protected,” Eckelman said.

Without preparations in place, hospitals have to take measures like evacuating patients or closing entirely—in addition to “disruptions in the supply chain,” like what happened last year with 

—all of which “really does impact their bottom line,” Lovisa Gustafsson, VP of the Making Health Care Affordable program at the Commonwealth Fund, who also contributed to the study, said.

 across healthcare and federal agencies focusing on climate change, which can complicate tracking efforts and 

for states most impacted by climate change.

“We as healthcare providers are seeing the impacts of climate change today, right now,” Patel said. “We need to take climate change out of the realm of politics, understand that this is about the health and well-being of our communities, and empower our health leaders to act.”

global warming climate change abstract art spiritual mind watercolor painting illustration design hand drawing

Commonwealth Fund ranks which states are best, worst for health and climate change preparation

Regions prone to extreme weather events like heat waves, hurricanes, and severe winter weather scored the worst.

 showed hospital executives are still holding strong to sustainability-related commitments regardless of 

. University of California, Irvine (UCI) Health is embodying that with its new all-electric hospital, set to open Dec. 10.

 is the first all-electric acute care hospital of its size in the country, featuring renewable solar park structures, electric instead of gas for utilities like heating and hot water systems (which also extends to water used in sterilization and humidification), and even all-electric appliances in its kitchen, Joe Brothman, UCI Health’s director of facilities and general services, who has overseen portions of this new project, told Healthcare Brew.

And electricity isn’t the only sustainable feature at the 350,000-square-foot, 144-bed hospital, Brothman said.

The hospital also has rainwater collection built into its landscaping that uses recycled water, bird-friendly glass, around 87% outdoor water reduction and about 38.5% indoor water reduction, and energy efficient equipment for lighting along with other building components.

“It’s a significant cost to make this all-electric [hospital], but we do anticipate, in the long run, that we will have a cost savings, especially with the rising costs of natural gas,” Brothman said.

A big impetus behind this project has been reducing healthcare’s impact on the community, Brothman said.

“Hospitals, typically, are significant burdens on the local community with their output, both with carbon emissions and with waste,” Brothman said. “This hospital is going to be different.”

 analyzing how health systems impact the environment concluded their global greenhouse gas emissions are equivalent to that of 514 coal power plants.

On top of that, Brothman noted, California is particularly keen on environmental initiatives, especially as the state often bears the brunt of climate change-driven 

“We wanted every aspect of sustainability. Our priorities here at UCI Health is to model environmental stewardship, and we wanted this [hospital] to be an example of that in all aspects,” Tony Dover, energy management and sustainability officer at UCI Health, told us.

A rendering of a single-occupancy hospital room with sliding glass doors.

According to Madhura Dhayagude—assistant VP with engineering consultancy WSP and an energy and sustainability consultant on the UCI project—the project beat expectations and stretched goals.

Engineers aim to meet the American Society of Heating, Refrigerating, and Air-Conditioning Engineers’s 90.1 standards, which is an industry guideline for measuring energy use, and the new hospital saw a 43.7% reduction over that number, she said. Further, the builders set out to achieve a minimum 160 energy use intensity (EUI), which measures how energy efficient a building is (a lower number means it’s more energy efficient), and achieved 110 EUI when including the solar panels atop its parking garage.

The hospital is also on its way to a platinum 

, a tiered sustainability certification, which would make it the sixth hospital in the country to receive this designation (the highest possible), she added.

Ultimately, having an all-electric hospital is a solid step in sustainability goals, but if execs aren’t looking to Scope 3 supply chain emissions, then it’s not making as significant of a difference, Tinglong Dai, Bernard T. Ferrari business professor at Johns Hopkins University, told us.

“[Hospitals] may be switching to all-electric operations, but if their suppliers, if their vendors are still creating a lot of emissions, it probably will not matter as much as is advertised,” he said.

 published in Health Affairs, about 82% of emissions were Scope 3, which are those that come from indirect sources like manufacturers and suppliers. Comparatively, only around 7% make up the Scope 1 emissions that come directly from hospital operations.

To take things to the next level, Dai added, hospitals should look at emissions created by utility suppliers, transportation deliveries, where drugs are made, where medical devices come from, software and hardware vendors, and whether they’re using data centers for AI.

Dover said UCI tracks and reports Scope 3 emissions for employees’ commutes, business travel, and waste. Some vendors and suppliers the health system contracts with “prioritize sustainability,” he added, and UCI Health is “collaborating with [suppliers] to identify opportunities to reduce emissions,” such as by reducing packaging waste and cutting transportation-related carbon emissions.

Though, Dai said, moving things around with manufacturers could ultimately hurt a hospital’s bottom line and shift too much of the focus away from its main priority—which is, of course, serving patients.

“A lot of things are really completely outside [a hospital’s] control. Most hospitals have no clue about the sources of supplies,” he said. “If we do not have that kind of transparency, it’s very difficult for us to make any informed decision. But that’s precisely what most hospitals, most health systems, are facing.”

A 3D rendering of a gray modular 6-floor building.

UCI Health’s new all-electric hospital reinforces system’s commitment to sustainability

The facility focuses on reducing its direct carbon emissions by cutting reliance on fossil fuels.

While the federal government has made clear that issues like 

 have been deprioritized, that hasn’t stopped some hospital leaders from continuing to pursue those goals.

In fact, according to the latest sustainability benchmark report from Health Care Without Harm and Practice Greenhealth, the opposite may be true. The health sustainability nonprofit’s annual report found that among almost 493 hospital partners, there’s been a reduction of roughly 185,000 metric tons of greenhouse gases and more than $203 million in annual savings due to sustainability initiatives.

, our partners are still deeply committed to their sustainability strategies,” Sarah Irwin, associate director of sustainability solutions at Practice Greenhealth, told us. “Some of our partners might be doing that in slightly different ways than they did before…but the work is still happening—and in fact, they’re doubling down.”

For Washington-based nonprofit Providence Health, Beth Schenk, chief environmental stewardship officer, told us the health system is approaching sustainability through mitigation, procurement, resilience, and advocacy.

“[We’re] working to address the problems that we can to help move healthcare to a way of operating that’s more compatible with a healthy planet,” she said.

Providence’s 51 hospitals and 1,014 clinics adhere to its WE ACT framework, which focuses on creating sustainable initiatives around waste, energy and water, agriculture and food, chemicals, and transportation. Each facility has been rated on a scorecard annually since 2019 based on data collected from 150+ categories tied to the five themes in the framework.

In 2020, the environmental stewardship team set a goal of becoming more carbon negative by 2030 and cutting between 3%–5% of emissions per facility each year, reaching a 23% cut in its hospitals so far. Schenk confirmed the health system is on track to achieve both goals. This has resulted in $32 million in savings associated with the stewardship programs for 2024 and $40 million for 2023, she added.

Having “accurate, transparent, verifiable data in order to justify and defend different requests for expensive finances, how are we going to measure our progress, etc.” was an important part of committing to these goals, she said.

, Providence has reduced Scopes 1, 2, and 3 carbon emissions—which include emissions an organization directly and indirectly emits—by 18% since 2019 and has saved $15 million annually in conservation efforts. For reference, a 

 of multiple databases found healthcare made up between 15% and 50% of Scopes 1 and 2 emissions and 50% to 75% of Scope 3 emissions—that accounts for between 4% and 5% of all greenhouse gas emissions worldwide.

This also aligns with what Practice Greenhealth found: Among its partners that reported 2024 Scope 1 and 2 emissions, there was an 8.7% decrease overall.

Providence’s post goes on to state that 100 of its facilities run fully on renewable energy and 85% of its hospitals have deactivated “wasteful” nitrous oxide piping. Further, business travel has operated at a 50% reduction since 2019, according to the post.

Reducing plastic use features heavily in the Greenhealth study, too, with almost 50% of its partners saying they’ve made efforts to reduce plastic use in their facilities.

The Ohio State University Wexner Medical Center, for example, has a partnership with medical reprocessing manufacturer Stryker’s Sustainability Solutions, which reprocesses devices like cables, catheters, and pulse oximeters, saving $1.4 million between July 2023 to July 2024.

According to Ohio State’s Environmental Sustainability Consultant Cecil Okotah, since the program was implemented in 2021, the university has saved close to $4 million and been able to divert almost 60 tons of waste from landfills between 2018 and 2024.

Practice Greenhealth estimated 20%–25% of hospital waste is plastics in 2024, but less than 5% is actually recycled, according to a 

The university also has sustainability initiatives to decrease energy use in its facilities, increase composting and recycling efforts, and implement 

For Practice Greenhealth, the more data it can get from hospital partners the better, as that can serve as a roadmap for other institutions. Especially since partners can be at any stage, from “extremely new” to “fairly mature,” Irwin said.

Hospitals that are newer to sustainability initiatives then get the opportunity to learn from veteran teams and see how they can implement what’s already proven to be effective, she said.

As for one of the areas that needs the most continued attention? Irwin said transportation is where she thinks there’s “more that we can be doing and supporting” since it’s so far-reaching—encompassing everything from daily commutes to the Scope 3 emissions from materials being flown or driven to a facility—and the data tends to come from third-party resources.

For Schenk, moving into a place where more institutions take sustainability “seriously” is an integral next step in implementing industrywide change.

“We’re here for health,” she said. “I think in healthcare we have even more of an obligation to not to cause harm and also to be ready and planning and responding to the harm that is underway.”

Green Heartbeat symbol. Symbolic green heart pulse isolated on white background. World Environment Day and Earth Day Concept. Green ecology Concept.

Health Care Without Harm trend report suggests sustainability is still important to hospital leaders

Despite changes in the federal government, some health systems are committing to sustainability initiatives and reaping cost-savings.

Trend report suggests sustainability is still important to hospital leaders

Recycling plastics is already difficult for the average household to figure out—so just imagine how tricky it gets at a hospital or other medical facility, where less than 5% of plastic is recycled.

 from London-based sustainability consultancy Systemiq and Bristol-based environmental researcher Eunomia found there are 2.1 million metric tons of single-use plastics used in healthcare across North America and Europe, resulting in 9.3 million metric tons of greenhouse gas (GHG) emissions. This is an estimated $56 billion in total costs per year, Systemiq partner and plastics lead Yoni Shiran said in an accompanying webinar.

If things remain the same, the researchers estimate this could grow to 2.9+ million metric tons of plastics at $76 billion per year by 2040, a 35% to 40% growth rate.

According to the study, seven categories make up the majority of all plastic waste in healthcare: fluid bags and tubing, gloves, device packaging, rigid devices, PPE, wipes, and pharmaceutical packaging.

“Put simply, without systemic change, the negative impacts of single-use plastics in healthcare will become more severe, will put more pressures on public budgets, on waste streams, and climate outcomes,” Shiran said.

 That being said, Shiran added, there are solutions that won’t negatively impact patient health.

. This economic model calls for keeping products and materials in use through reuse and recycling (or “

” in healthcare) to cut down on excess waste.

By implementing this strategy, the researchers estimate a potential 53% reduction of single-use plastics, a 55% cut in GHG emissions, and a 24% decrease in costs by 2040. For example, Shiran pointed to Chicago-based Northwestern Memorial Hospital, which began recycling nonhazardous IV bags in a recent partnership with manufacturer Baxter International, collecting 170,000+ bags and cutting plastic waste by 6 tons, according to a 2023 Baxter press release.

 To get stakeholders on board, the study outlines a framework for next steps:

Create an environment where behaviors and policies change.

Provide the right data to guide stakeholder investment.

Invest in low-carbon options and circularity projects.

Find proper funding to bring these solutions to fruition.

The report echoes what health sustainability nonprofit Health Care Without Harm said in an April 2024 

 that called for limiting plastic production and eliminating unnecessary plastic use.

“Solutions are possible because technical solutions do exist. It’s about creating the right environment to enable them and to scale,” Shiran said.

“We don’t have to choose between patient safety and sustainability,” he added.

Pile of Microcentrifuge Tubes - Medical Plastic

New study analyzes plastic waste in healthcare, suggests potential solutions

Researchers estimate plastic waste could increase 35%–40% by 2040 if things remain the same.

When talking about climate change-related health issues, 

And for good reason: There’s been an increased risk of illness or death from extreme heat in recent years, and heat is the leading weather-related cause of death in the US, according to the National Weather Service.

That’s why nonprofit Americares, which brings health programs and supplies to communities impacted by disaster and inequity, announced plans to expand its protection efforts for patients dealing with extreme heat.

In an Aug. 21 press release, the organization shared it will award grants to 13 free clinics and 

 (CHCs) so they can purchase supplies to help patients confront extreme heat, including air conditioners, ice packs, reusable water bottles, and more. The grants are part of an extension of the Climate Health Equity for Community Clinics program, which provides extreme heat and 

These are the facilities receiving funding:

Albuquerque Health Care for the Homeless in New Mexico

The Broad Street Clinic in Morehead City, North Carolina

Coachella Valley Volunteers in Medicine in Indio, California

Community Health of South Florida in Miami

Miami Rescue Mission – Doral Clinic in Florida

Muncie Mission Ministries in Muncie, Indiana

Sonoma County Indian Health Project in Santa Rosa, California

St. Clair Community Health Clinic in Pell City, Alabama

Volunteers in Medicine in Wilkes-Barre, Pennsylvania

Further, in collaboration with CVS Health, Americares is planning to award an additional eight grants to healthcare facilities primarily in Arizona, Florida, Georgia, New Mexico, and Texas to secure supplies when there’s extreme heat in the forecast.

The 18-month-long pilot program will tap into weather data in an effort to cut down on patients needing hospital-level care for heat-related illness. According to CDC data, almost 120,000 emergency department visits were associated with health-related illness in 2023, double the record between 2018 and 2022.

“As heat waves become more frequent and intense, we’re taking action to protect those most at risk,” Americares SVP of Programs and Chief Medical Officer Julie Varughese said in a statement. “Healthcare providers at safety net clinics see firsthand how the environments where their patients live and work exacerbate existing health disparities.”

Graphic of a thermometer showing a very high temperature

Americares provides grants to help 13 clinics, community health centers combat extreme heat

As temperatures climb due to climate change, patients are at an increased risk for heat-related illness or death.

Since January, the Trump administration has taken a red pen to 

 across the healthcare industry, with one analysis from 

 finding that NIH grant awards have decreased by $2.3 billion since the start of the year.

Now, couple that with other targeted areas, 

. While experts told us it’s still too early to say how these research and 

 might impact patients or the healthcare industry overall, they said there could be long-term impacts to environmental health research cuts.

“On the one hand, perhaps health systems are going to see 

 nudging them toward exploring reusable and reprocessable products. And on the other hand, it might inhibit innovation,” Emmie Mediate, chief program officer at health sustainability nonprofit Health Care Without Harm (HCWH), told us.

The research world tends to move slowly, Mediate said, meaning the full impact of staffing and research cuts likely won’t be known for quite some time.

For instance, Mediate pointed to the Low Income Home Energy Assistance Program, which helps people from low-income households keep heat and air conditioning on during peak use months. Every staffer in the department was laid off on April 1.

“One of the reasons it’s hard to assess the impact is, in a devastating way, we’re going to have to wait until the summer when we have extreme heat days that we see around the country to really be able to quantify what those impacts are on folks’ health,” she said.

As parameters for grants have changed since January, Robert Wright, chair of the department of environmental medicine at New York-based Mount Sinai and a pediatrician, told us it’s all about adapting. This includes looking to the private sector for grant funding and focusing research applications on specific phenomena that can lead to health issues, such as weather events and causes of climate change like air pollution or heat waves.

Further, Mediate said she feels optimistic health systems are making the right moves to independently address climate change regardless of 

 on a federal level. In HCWH’s data program that tracks health systems’ environmental efforts, the group received 492 submissions this year, up from 476 in 2024 and 413 in 2023. And almost half of those applicants said climate change was identified as a “business risk requiring regular reporting,” a 38% increase from applicants who said the same last year, she said.

“Folks are really incorporating this into their risk planning, into their strategic planning, and understanding that if you’re not thinking about environmental sustainability…you’re kind of behind the curve in terms of what it means to be doing good business,” she said.

Climate change’s role in healthcare can be seen in how extreme weather like 

 have correlated to increases in illnesses like asthma, cardiovascular disease, and stroke. In 2022, 44.2 million people in the US had been diagnosed with asthma, according to data from the American Lung Association, a 48% increase from 1999.

Wright has worked on various initiatives that study how environmental factors impact health, in particular among children. One area he’s been studying is how environmental chemicals might lead to childhood obesity, a topic Department of Health and Human Services Secretary Robert F. Kennedy Jr. has been 

“I think there are clear signs that children’s environmental health actually might be of higher priority than it has been in the past to NIH,” Wright said.

But since diseases linked to environmental factors take a long time to incubate in a patient, he added that it might not be possible “to see perceptible increases for a while.”

Wright said he also anticipates wait times for grants (which are 

) will extend from about 1.5 years to up to 2.5 years.

“That’s a pretty significant increase in what was already a fairly slow process,” he said. “It’s not just the slashing of the funding. It’s going to be increased inefficiencies that go forward. It’s going to delay the onset of grants and research that is actually going to have a pretty significant impact.”

Photo collage of earth on ripped $100 bill.

Experts outline potential long-term impacts of environmental health research, staffing cuts

Funding for research was already slow, but recent layoffs and grant cancellations could make for an even longer process.

Cassie McGrath

Another year gone means another opportunity to look back on all the biggest trends in healthcare.

For the hospital sector, this included implementing 

 and climate challenges, and a shift in provider/patient interactions, experts around the country told Healthcare Brew.

Here’s the rundown on the year from leading hospital execs.

This interview has been lightly edited for length and clarity.

Roberta Schwartz, EVP and chief innovation officer, Houston Methodist

[This year] was probably one of the first years of a little bit of return to normal on the business. We came out of Covid in 2022, and 2023 was a very big recovery year. A lot of us are using large amounts of travelers, large amounts of fill-in staff. We were still hiring large amounts of people to stabilize organizations.

[This year is the first] that I can compare to a pre-pandemic era.

Greg Wilmot, president and CEO, NeighborHealth

I think 2024 was a challenging year, and those challenges were: a lot of new demand, a lot of pressure to provide access, and [hospital systems are] still recovering to have sufficient capacity to respond to that demand. There are also some significant financial pressures on hospital systems and healthcare providers. Reimbursement for healthcare services has not kept up with the rising labor costs of healthcare, as well as the rising medical costs of healthcare, and so a lot of unanticipated financial challenges [are] facing many healthcare providers because the math is not working.

Many more folks are doing their day-to-day work, particularly in healthcare, through a smart device, communicating more virtually than in person or through phone. Emerging EHR [electronic health record] tools that allow for easier engagement between healthcare institutions, healthcare organizations, and the patient and vice versa have been really important, and we’re definitely seeing an emerging trend in expectations from consumers to be able to have easier interactions with their care provider through virtual meetings.

Stephanie Dowart, CEO, Altius Healthcare Consulting Group

[This year] was a year where not only healthcare, but the country as well, saw inflation. When you’re seeing the inflation in supplies such as pharmaceuticals and your medical supplies as well as the salary escalation, hospitals were really grappling with those increased expenses. The labor shortages made it worse, and then the supply chain disruptions really made that all come sort of to a pinnacle. The good news is all of that was a great opportunity for some of the technological advances that we’re starting to see with artificial intelligence.

However, all of that brought another trend, which is a focus on cybersecurity and threats. With all of the technology and all the data that’s out there now, there were a lot 

There are two pieces [on climate and healthcare] that we saw. One, a bigger focus on emergency preparedness and understanding where the gaps were in their plans to prepare and respond to 

, respond to fires, respond to climate issues.

Health equity and access is a trend that’s also occurring. There is an increase in how can we actually respond to those as a healthcare community, and what do we need to do to make sure that we’re able to have services, whether they’re remote or telehealth?

Female technician examining diagnostic image.