Focus on climate resilience, planning experts urge health systems

November 1, 2023

To address the risks climate change poses to medical facilities, to care providers and to the communities they serve, health systems need a climate resiliency plan, advises Christina Vernon Sanborn.


"No organization is exempt from climate threats, so everyone has a need to think about how climate is going to impact their ability to deliver care," said Sanborn, associate principal and senior decarbonization specialist at the environmental engineering firm Mazzetti. "Proactive planning, as with all things, reduces the cost and improves recovery times when disruptive events do occur."

Sanborn and two others with expertise in climate change resiliency planning shared their insight during a CHA webinar Sept. 20. The three offered advice and encouragement on how the health care sector can respond to global warming and its impacts, such as heat waves, flooding, wildfires and drought. The webinar was part of CHA's observance of the Feast of St. Francis, known as the patron saint of ecology.

Single biggest threat
Sanborn noted that the United Nations has identified climate change as "the single biggest health threat facing humanity" and has said that the risks of a warming planet are disproportionately felt by the most vulnerable and disadvantaged.

She also pointed out that a federal agency has created a pledge around addressing climate change. That pledge from the U.S. Department of Health and Human Services' Office of Climate Change and Health Equity calls for signatories to drastically reduce greenhouse gas emissions by 2030 and for them to create and release a resiliency plan by the end of this year. Health systems encompassing more than 800 hospitals already have signed the pledge. Many of the signatories are CHA members, including Ascension, CommonSpirit Health, Providence St. Joseph Health and SSM Health.

A good climate change resiliency plan, Sanborn said, should be driven by an evaluation of the threats to a health system — its business operations, facilities and staff — as well as to the communities served, with a particular focus on vulnerable residents. The plan should cover preparing for those threats, absorbing their impacts, recovering after a disruptive event and adapting to change, she added.

"In the end, the goal is to have not just a document, but a living document that is continuously adapting to new information and takes into account all of the human and physical systems that you've evaluated," Sanborn said.


Five steps
Patrick Marchman, principal with consulting firm KM Sustainability, went over five steps for health systems to create a framework for how they will adapt to and build resiliency to the impacts of climate change. The first four steps are:

  • Understand exposure.
  • Assess vulnerability and risks.
  • Investigate options.
  • Prioritize and plan.

Marchman stressed that health care systems don't have to start from scratch in their planning. He noted that nationwide there are thousands of existing plans that touch on potential aspects of climate change, such as flooding and emergency preparedness, from various jurisdictions and organizations. Reviewing those plans can be a starting point, he said, for a more specific plan for a hospital or health system.

He also pointed out that specialists in disaster preparedness generally agree that every dollar spent on mitigation saves much more in the long run. For example, he said, the federal government's rule of thumb is that every $1 spent to mitigate damage from disasters such as hurricanes and earthquakes saves $6 in potential repairs and response. He noted that many government agencies, including the Federal Emergency Management Agency, have funding earmarked for climate change preparedness that health systems might be able to tap.

The fifth and final step is to take action on the plan that's been created, Marchman explained. As part of that, he said, health systems should have an "accountability mechanism" to ensure they follow through. Those mechanisms could take several forms, such as posting the plan online to let the public review it and setting up a means to monitor its progress internally.

"It's good to keep in mind the real objective," Marchman said, "which is to develop more resilient systems — that is, to develop the kind of systems that can not only bounce back, but maybe in some cases even thrive in adverse conditions."

Human element
Durell Coleman, founder of DC Design, a firm that helps create solutions to social challenges, stressed that health systems should include in their resiliency planning assessments of the impacts climate change will have on humans. Specifically, he said, systems should be aware of how their patients, their staffs and the various populations, especially those with few resources, will be affected and what they can do to help fortify those groups.



It requires community engagement to do that assessment, Coleman said, so the various stakeholders can share what assets they have or lack, what they are experiencing and what concerns they have. Coleman's firm does that sort of engagement in various ways, including in-person forums and online interactions.

Health systems that listen to community stakeholders in their climate change resilience planning, along with those who address business continuity and patient and staff needs, have much to gain, Coleman said. For one thing, they will be able to anticipate what situations might arise outside their doors in the event of a climate disaster. For another, they will be seen as allies in the wider effort to mitigate global warming's threats.

"If we do all the pieces together, we can not only create a fortified set of assets on the hospital or health system side," Coleman said, "but we can also create a fortified community and that is what's going to enable everyone to survive these events with the best possible outcomes."

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White House releases climate resilience framework

The White House in late September released a 30-page National Climate Resilience Framework, which it calls a comprehensive approach to addressing the projected risks and impacts of climate change.

The framework identifies "key values, priorities, and objectives to help expand and accelerate nationally-comprehensive, locally-tailored, and community-driven resilience strategies."

Its core objectives are to:

  • Embed climate resilience into planning and management.
  • Increase resilience of the built environment to both acute climate shocks and chronic stressors.
  • Mobilize capital, investment, and innovation to advance climate resilience at scale.
  • Equip communities with information and resources needed to assess their climate risks and develop the climate resilience solutions most appropriate for them.
  • Protect and sustainably manage lands and waters to enhance resilience while providing numerous other benefits.
  • Help communities become not only more resilient, but also more safe, healthy, equitable and economically strong.

The framework notes that access to essential services such as health care is vital to making communities resilient to climate threats. It states that "investments in a community's health care system — including in medical supply chains, health care facilities, and outreach networks — will improve not just the overall health and well-being of community members during normal operations, but also their capacity to mitigate, adapt to, and recover from the compounding impacts of extreme weather events and long-term climate stresses."

— Lisa Eisenhauer

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