Climate Equity is Health Equity
Environmental, Social, and Governance (ESG) is the latest trend, and for good reason. As hospitals strive to be more socially responsible, they need to take into account their environmental sustainability, their impact on racial and economic equity, social determinants of health, and equitable representation within their governing structures. It’s central to so many business development plans, in fact, that the US Securities and Exchange Commission (SEC) is considering requiring companies to disclose their ESG commitments, particularly in the environmental arena.
The government is shifting its focus towards the E in ESG as well, addressing environmental justice in the recent Inflation Reduction Act. With renewed interest in the environmental impacts and responsibilities it’s worth reviewing just how impactful climate is on human health – especially in terms of health equity and justice – as well as what steps hospital systems could take to have an immediate impact.
The link between environment and health
The link between environment and health is well-documented and wide-ranging. From the food and water we consume every day to the increasing rates of climate disasters, that link is inescapable. So far the strategy for environmental health hazards has been to attempt to fix problems after they occur – but what if the strategy was one of upstream prevention instead?
Contamination of drinking water is terrifyingly common. Just ask the winner of this year’s Bernard Lown Award for Social Responsibility. Dr. Mona Hanna-Attisha is a pediatrician who helped blow the whistle on the Flint water crisis, which was poisoning thousands of Flint, Michigan residents with lead. Lead poisoning is incredibly harmful to the brain and central nervous system, especially in children. The Flint water crisis has been devastating. For years, residents have had to buy purified bottled water to do everything from cook to shower. But it was not unique.
Years before Flint, Washington DC had their own lead-contaminated water crisis. Right now in Tennessee, 53 school systems have lead-contaminated water. Industrial and hazardous waste has made its way into the California school system’s drinking water. And in Hawaii, residents are finding themselves in a similar situation to Flint residents, begging their government to recognize the rising rates of new chronic conditions are due to drinking water contamination.
Instead of investing in $24 billion in fossil fuels, what if that money went towards ensuring safe drinking water and fixing the infrastructure that caused these crises in the first place?
With water, there is the opportunity to purchase purified, bottled water. With air, there is only one option. Low levels of air pollution have been shown to damage health and increase health care costs. Studies have shown that air pollution disproportionately impacts people of color in the US. Polluted air does more than just wreck the respiratory system. It also increases the risk of heart disease and has been linked to dementia and Alzheimer’s.
The same pollutants air also contribute to extreme weather. Between regular wildfires, extreme heat, and freezing temperatures, people coast-to-coast are feeling the health effects of climate change already. Rapidly rising rates of natural disasters also pose an equity risk, making recovery difficult for individuals who were already vulnerable to begin with. All of these consequences can be tied back to emissions.
The 3 trillion dollar healthcare industry contributes an estimated 8% of the country’s greenhouse gas emissions. Much of it is non-negotiable energy usage – hospitals can’t exactly turn the lights and machines off every night. Instead, they could ensure the source of their energy is clean while they work to reduce their energy demand wherever they can.
What if hospitals and large health care systems switched to clean energy and reduced their contribution to the emissions smothering us every time we inhale?
Studies over recent years show that plastic is linked with adverse health outcomes, damaging the immune and endocrine systems in particular. The pollution caused during the production of plastic is, like most other healthcare issues, also an equity concern. The harm does not stop there though, as plastics break down into microplastics and work their way up the food chain until they’re circulating in our bloodstream. Even our youngest are not immune.
Plastic pollution in healthcare settings can be a complicated topic. On one hand, the health and safety of both patients and providers needs to come first. On the other, the healthcare sector needs to prioritize population health and long-term wellbeing. In a sterile system reliant on single use plastics for safety, it can seem daunting to even broach the subject of how to reduce waste. However, an estimated 85% of hospital waste is non-hazardous and offers a significant starting point.
Healthcare without harm includes environmental health
It’s not new information that impoverished and less privileged people will suffer the most from these climate threats. Whether it be flooding on the east coast or wildfires on the west coast, the poorest among us will suffer the most. The overlap between classism and racism means minorities will continue to face the brunt of the damage and harm.
Climate change kills people. Between water contamination, air pollution, heat, and disasters, it has immediate health consequences. We in the healthcare sector owe our patients – and ourselves – a clean environment that does not contribute to disease and suffering. The vast majority of people in the healthcare sector entered the field with the explicit goal of helping others in need. The scale of the problem means systemic, upstream changes are necessary.
What hospitals can do
Hospital systems have the unique position of making real, impactful change right now:
- Divesting from fossil fuels
- Investing in public health-based infrastructure like clean water and donating air conditioners to vulnerable community members
- Shifting to clean and renewable energy to reduce their emissions
- Reducing waste and single use plastics
By focusing on social responsibility through an ESG framework, hospital systems may be able to have a greater impact on preserving the health of their patients and future generations.