Advancing Health Equity Through Climate-Smart Changes: Health Care's Call to Action

Fall 2021
hpFall21 Advancing Health Equity through Climate-Smart Changes -a

CEO of CommonSpirit Health

We are living in a pivotal moment. This new decade has been characterized by tragedy and tension, from the global pandemic to nationwide social upheaval. At the same time, our collective experience has taught us lessons sure to spark critically needed change for years to come. Among the issues justly elevated in our political and public health discourse is health equity, or the inherent right we all have to reach our full health potential, regardless of our social status or circumstances.

As we move forward, ministering to our communities effectively means being part of the effort to eliminate health disparities that persist along racial, ethnic and economic lines. This will require recognizing the inextricable link between health inequities and climate change — and examining our role as health care providers in addressing both.

We are providing health care from a faith-based tradition, and, on a fundamental level, we must appreciate our planet — our home — as a gift bestowed upon us. Caring for Earth is part of caring for the people who live here. Among the measures we can take to improve health equity: we can use our resources wisely, act as stewards for environmental justice and make health care a force for healing and regeneration.

By taking steps to address climate change, we can serve not only those who come to us for care, but also those in our communities and all who are part of the fragile ecosystem of our shared home.

Simply put, climate change is a public health problem. The surge in dangerous heat waves and extreme weather, worsening air and water quality, and threats to food production put human health at risk. If global temperatures continue to rise, every child born today will face more climate-related infectious diseases, increased heart and lung damage and reduced access to food and safe drinking water.

It’s important to note that these environmentally driven health impacts will continue to disproportionately affect vulnerable and underserved populations, including Black and indigenous communities and other communities of color.

For example, as of 2018, Black people in the United States were 40% more likely to have asthma than white people, according to data from the Office of Minority Health at the U.S. Department of Health and Human Services (HHS).1 A Princeton University study shows that Black people also are 75% more likely than white people to live near commercial facilities in the U.S. that produce noise, odor, traffic or emissions that directly affect the population.2

Additionally, low-income Americans are much more likely to suffer from the devastation caused by natural disasters due to poor infrastructure and lack of insurance coverage. Black and Hispanic communities are especially vulnerable to extreme heat and flooding because they often are clustered in neighborhoods in damage-prone areas with fewer resources to recover from disasters, according to an analysis of data from the National Oceanic and Atmospheric Administration and the Centers for Disease Control and Prevention (CDC). In fact, the CDC finds that in the 10 counties considered most vulnerable to disasters, eight are made up of mostly Black and Hispanic residents.3

The numbers clearly demonstrate why, in many ways, paving the way for health equity starts with environmental justice.

And, though climate undeniably impacts health, we cannot ignore the health industry’s impact on climate. Health care institutions are some of the largest contributors to climate change today, as outlined in the Journal of the American Medical Association. The U.S. health care system contributes 10% of the nation’s carbon emissions and 9% of harmful non-greenhouse air pollutants. That’s more than any other industrialized health system in the world.4

Thus, in the health care sector, we are very much at the center of the climate crisis. We are charged with treating its effects on our communities, but we must also step up our leadership through innovative climate-smart policies, practices and public health investments. After all, an investment in the health of our planet is an investment in the health of our patients.

CommonSpirit Health is making these investments now and seeking bolder actions in support of the nation in meeting its climate goals under the Paris Accord. I am representing CommonSpirit and the health care industry as co-chair of America Is All In, a coalition of representatives from state and city governments, tribal nations, businesses, and educational, cultural, faith and health organizations, seeking to build a more just and resilient economy that addresses the threat of climate change. Together, we advocate for meaningful policies that will put the U.S. on a path to cut its emissions in half by 2030 (from 2005 levels) and reach net-zero by 2050; make investments in the clean energy sector, including creating good-paying jobs; and deliver justice to communities most harmed by climate pollution.

CommonSpirit is doing its part to make targeted, meaningful changes to address climate change and reduce our environmental footprint — initiatives spearheaded by Sr. Mary Ellen Leciejewski, OP, our system vice president of environmental sustainability. While the task ahead can feel daunting, we are excited about the opportunities before us. In addition to our current goals, which will take us through this decade, we are beginning to develop a climate action plan that outlines our system goals for 2030 and beyond.

Achieving these goals requires incremental changes that add up, particularly as we scale across our 140 hospitals and more than 1,000 care sites in 21 states. Step by step, we’ve made progress toward our sustainability goals — and contributed to efforts across the industry — through internal initiatives and vendor partnerships. Here are some examples of our approach and what we’ve been doing to reduce waste, energy consumption and greenhouse gas emissions:

Vendor Partnerships
CommonSpirit partners with vendors as they develop and launch their sustainability initiatives and services. We dove in early as a partner in NewGen Surgical’s "Small Change, Big Impact" environmentally preferable purchasing program, for example. Through the program, we identified and made a single product line change — to surgical needle counters — that within two years, reduced our plastics use by more than 10 tons. The impact continues to grow.

We also were one of the first health systems to work with Stryker’s Sustainability Solutions division, which provides reprocessing and remanufacturing services for single-use medical devices. Through Stryker Sustainability, devices from our facilities are collected, inspected, cleaned, tested, sterilized and packaged for repeated safe clinical use. To date, this initiative has diverted 25 million pounds of waste from CommonSpirit and other partners from landfills.

Reducing Waste
CommonSpirit prioritizes internal initiatives and vendor partnerships that align our product purchasing, recycling and waste management with our environmental goals. These include a new, sustainable approach to managing sterilization wrap. Working with Iron Mountain, we’ve created a program to recycle sterilization wrap from our facilities in a safe, cost-effective manner, while eliminating unnecessary landfill and plastic waste. As the program matures, we plan to work with a processor that will use resin from the recycled materials to create other products, such as recycle bins, bed pans and distribution totes. This will give a second life to materials that otherwise would have become waste.

This summer, we began piloting a program that allows us to transform disposables into reusables. For example, we are supporting patients during transfers by introducing reusable gait belts, which use antimicrobial technology and can be washed repeatedly without losing efficacy. The initiative will roll out across the entire CommonSpirit enterprise over the next several months. Through this initiative, we will avoid sending an estimated 30 tons of waste to landfills each year.

CommonSpirit also looks for business partners that work to bolster social and environmental justice in their communities. Dignity Health California Hospital Medical Center in Los Angeles, which is part of CommonSpirit Health, has a partnership with Homeboy Electronics Recycling to collect and recycle small electronics, such as telephones, headsets and other devices. The company provides on-the-job training and employment for people who have been incarcerated or involved with gangs. Beyond managing waste more responsibly at California Hospital, the Homeboy partnership allows us to support community members overcoming systemic barriers and transforming their lives.

Decreasing Energy Consumption and Greenhouse Gas Emissions
Understanding the state of our current facilities — and what we can do to improve them — is a key step in reducing our environmental footprint. In 2020, CommonSpirit began the process of retro-commissioning our acute care facilities, which involves evaluating, documenting and improving the operation of the building systems. The five contracted retro-commissioning vendors are working on a number of sites with the goal of implementing low- or no-cost changes that can show an immediate impact on energy reduction and lowering utility costs. This type of program has the potential to reduce utility usage and decrease utility spending by 5% to 8%.

CommonSpirit also continues to explore and expand our use of sustainable energy resources, including solar energy. In 2019, we agreed to participate in a solar power initiative with Salt River Project, a community-based, nonprofit public power utility in Phoenix. Through their Sustainable Energy Offering, we acquired 4.2MW of Salt River Project’s solar farm, with our portion of the system scheduled to come online January 1, 2022. This agreement will offset more than 12,600,000 kWh of electricity that we use annually with clean, renewable energy — as well as roughly 6,000 MTCO2e (metric tons of carbon dioxide equivalent) of our greenhouse gas emissions. We also plan to use solar energy in other locations, including California and Minnesota.

Alone, none of us has the capacity to curtail the threat of climate change. It will take a whole-of-society approach, each one of us doing our part. Health care can make a tremendous difference — but we must act now. We need to leverage the purchasing power of our sector to invest in clean energy and sustainable products to support the transition to a healthy, equitable economy.

I invite the leaders of all U.S. hospitals to join CommonSpirit in this work by signing up for Health Care Without Harm’s Health Care Climate Challenge and committing to action on steps to reduce your environmental footprint, build community resilience and advocate for equitable climate solutions.5

Ultimately, all sectors and all levels of government must work in collaboration to curb climate change and improve the health of all Americans. Together, we can all advance climate action for a healthier future.

LLOYD H. DEAN is CEO of Chicago-based CommonSpirit Health. Dean was previously president and CEO of Dignity Health and guided its alignment with Catholic Health Initiatives to form CommonSpirit. He is a past chair of the Catholic Health Association Board of Trustees.

  1. "Asthma and African Americans," Office of Minority Health, U.S. Department of Health and Human Services, https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=15.
  2. "Racial Disparities and Climate Change," Princeton Student Climate Initiative, https://psci.princeton.edu/tips/2020/8/15/racial-disparities-and-climate-change.
  3. "Climate Impacts: Population of Top 10 Counties for Disasters: 81% Minority," ClimateWire (June 8, 2020), https://www.eenews.net.
  4. Dr. Jodi D. Sherman et al.,"Reducing Pollution from the Health Care Industry," JAMA 322, no. 11 (September 17, 2019): 1043-1044, https://doi.org/10.1001/jama.2019.10823.
  5. "Health Care Climate Challenge," Health Care Without Harm, https://healthcareclimatechallenge.org/.

Advancing Health Equity through Climate-Smart Changes: Health Care's Call to Action

Copyright © 2021 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.