2015: Health Care in the Age of Climate Change

After two weeks of intense negotiations, the world’s governments have signed a landmark global treaty that – for the first time in history – will commit nations to reducing their greenhouse gas emissions. 

And while the world followed the Paris climate negotiations with intense interest, time and again throughout this past year, we have seen the health sector use its position as a moral leader to take action on climate change. 

In June, the Obama Administration held a Summit on Climate Change and Health where the Surgeon General became a spokesperson for the issue. This was followed in the summer by the Clean Power Plan, which was framed as a strategy to prevent asthma in America’s children and cut health care costs as well as carbon emissions. In Britain, the prestigious Lancet Commission released a report that described climate change mitigation as the greatest public opportunity of the 21st century.

And in Paris just these past two weeks, an unprecedented alliance of doctors, nurses, and other health professionals representing over 1,700 health organizations, 8,200 hospitals, and 13 million health professionals came together to call on governments to reach a strong climate change agreement that protects public health. The health sector also committed to leading the way toward climate solutions, promoting low carbon health care, climate resilient health systems, and health care leadership in support of policies that combat climate change. 

Throughout 2015, we’ve seen climate change challenge the health sector to redefine its mission and scope.

What is health care for in a world where residents in Beijing are advised to stay indoors because the air is so poisoned it’s too dangerous to go outside? What is health care for in a world where millions of people in Pakistan get flooded out of their homes and where environmental refugees wash up on the shores of already stressed public health systems? What is the role of health care in addressing the enormous reliance on fossil fuels, which contributes to 7 million deaths every year and costs nearly $3 trillion in health care costs?

Our imperative to address climate change will transform health care in fundamental ways over the next two decades. But what will this look like?

First, our health care facilities need to be places of refuge during the coming storms and rising tides of climate change. They need to be designed and operated with on site power so they can continue to operate when the grid fails in an extreme weather event. 

Clinicians need to be prepared for the shifting burden of diseases and be able to address surges of people that suffer respiratory and heat related illnesses. The health sector in developing countries will need to access funds to build resilience into its facilities and supply chains. Imagine thousands of clinics in Africa and Asia powered by renewable energy, where medicines are refrigerated by solar power and vehicles are powered by biodiesel that is produced locally.

Second, health care can lead in reducing its reliance on fossil fuels and help transform the economy toward a low carbon future. Health care is 18% of the entire U.S. economy and 10% of the global economy. By leveraging its purchasing power, hospitals and health systems can support low-carbon technologies and products, sustainable agricultural products to feed their patients and employees, and remove toxic chemicals from their supply chains. In this way, they create health not only in clinical practice but as economic engines in the communities they serve. They can become anchors for community wealth creation as well as community health. They can move upstream and reduce the very illnesses linked to our reliance on fossil fuels and toxic chemicals in the communities they serve.

In the lead up to COP21, 60 health care institutions from 16 countries representing over 8,000 hospitals adopted a 2020 Health Care Climate Challenge to dramatically reduce their greenhouse gas emissions and exercise leadership on climate change. In this way, they are forging a new social contract with society, publicly acknowledging their responsibility to heal the environment as core to their mission.

Finally, health leaders can amplify their voices as respected messengers in society and advocate for policies that will rein in climate change and help re-brand it as the medical emergency that it represents. In Paris, Dignity Health, one of the largest U.S. Catholic hospital systems, announced that it was divesting from coal in its portfolio, demonstrating that fossil fuels are out of alignment with the mission of health care. Dignity has joined other institutional investors worth $3.4 trillion in committing to divest from coal and other dirty energy sources and will likely provide political space for other hospital systems to follow their lead.

Ultimately, the only way we are going to solve this crisis is developing a just price on carbon that reflects the full public health and social costs of our reliance on fossil fuels. In that policy fight, the health sector can bring its moral clout to bear to ensure that health costs related to fossil fuels are reflected in the price of carbon.

In this new era of climate change, health leaders need to become human rights advocates, defending peoples’ right to clear air, clean water, healthy food, and adequate shelter as the fundamental conditions for health. These rights are already being violated by our addiction to fossil fuels and toxic chemicals and the situation is only going to become more dire. 

Health care needs to renew its commitment to its core mission, understanding that it is impossible to support healthy people on a sick planet. Health leaders need to become healers not only within their institutional walls but in the communities they serve and for the Earth that sustains us all.

Gary Cohen is President and Co-Founder of Health Care Without Harm.