Health Care and the Climate Crisis: Preparing America's Health Care Infrastructure

The U.S. health care system is responsible for an estimated 10 percent of national greenhouse gas emissions, which cause extreme weather events and contribute to worse health outcomes. Providers, suppliers, and other actors in the health sector have a role to play in curbing emissions and ensuring they are appropriately prepared for increasing climate-related events that will inevitably disrupt operations. Efforts to curb emissions or prepare the health infrastructure have yet to match the potential consequences, but ultimately such steps will improve health outcomes and provide cost-saving opportunities throughout the pipeline.

Beginning in March 2022, Committee on Ways and Means Chair Richard E. Neal sent out a request for information (RFI) to hospitals, health systems, and other facility-based health providers to better understand how climate events have impacted the health sector, as well as steps the health care industry is taking to address its role in mitigating the climate crisis.

In total, the Committee received and analyzed responses from 63 providers across the country, representing health systems, dialysis companies, nursing home corporations, and community health centers, among others. 14 of the total 63 respondents were classified as “climate innovators” – providers the Committee had previously engaged with and targeted for their existing climate programs. The Committee also solicited responses from 13 trade associations representing members that spanned the continuum of care. These providers care for millions of patients each year and the trade organizations represent over 25,000 facilities nationwide.

Health Care and the Climate Crisis: Preparing America’s Health Care Infrastructure includes an overview of the role the U.S health system plays in the climate crisis. Part One provides an overview of the problem, description of Chair Neal’s 2022 Request for Information (RFI), and summary statistics from an analysis of survey respondents. Part Two examines how the climate crisis and the prevalence of extreme weather events impact health care organizations. Part Three describes how health care organizations are assessing their climate impact and working to reduce their respective carbon footprints. Part Four summarizes findings and provides a discussion of implications. Part Five is an appendix with survey methodology, limitations, and supplemental tables.

  

                                   

Findings from this RFI paint a picture of a U.S. health care system only beginning to feel the damaging effects of climate-related weather events that will inevitably continue to disrupt operations across the continuum of care and exact a severe financial toll. But one thing is obvious from the RFI respondents: The climate crisis knows no bounds. All providers are vulnerable, and the time to prepare is now, rather than after operations have been compromised and residents of affected areas have nowhere to go for care. Failing to prepare health care systems and supply chains for extreme weather events has the potential to result in more death and suffering in the years ahead. And failing to establish the infrastructure and process to measure, track and reduce health sector GHG emissions will exacerbate and accelerate the climate impact on the health system. The federal government has a clear role to play in both of these areas, providing supports that get the beginners on the road to action and help those with work underway to advance these shared objectives more quickly. The overall takeaway is that much more work must be done – by the federal government and health care facilities – to achieve the dual goals of protecting our health systems from extreme weather and reducing the harmful effects of climate change on populations across the U.S. and abroad.

Key Findings

  • Sample overview: Respondents to the RFI included 63 providers across the country, representing, health systems, dialysis companies, nursing home corporations, and community health centers, among others.
    • 14 of the total 63 respondents were classified as “climate innovators” – providers the Committee had previously engaged with and targeted for their existing climate programs.
    • The Committee also received responses from 13 trade associations representing members that spanned the continuum of care.
  • Extreme weather events & risk: Due to the accelerated rate of extreme weather events across the country, a majority of respondents (54 out of 63) said they had experienced at least one such event in the last five years – with more than half experiencing five or more events in the last five years. In many cases, the cost of repairing damages from extreme weather events totaled in the millions, as some providers said they struggled to recover years later. Despite the near universal interruptions to operations, only a little more than a third of respondents said they had implemented formal climate action or preparedness plans (CAPPs) to limit organizational risk in the face of future weather events. Still, most respondents acknowledged the importance of preparing for climate-driven natural disasters and pointed to ways federal, state, and local authorities could provide support in the coming years.
  • Carbon footprint: Respondents reported a diversity in experiences grappling with carbon emissions.  Some respondents reported having long-established and public sustainability goals; clear tools to measure their scopes 1, 2, and 3 emissions; and data showing millions of dollars in cost-savings associated with the measures. Others had yet to create sustainability goals. Those who had clearly defined goals, measures, and outcomes related to curbing their respective carbon emissions provided insights in the ways targeted interventions could reduce costs. Still, even for respondents who had well-formed climate programs in place, barriers persist – from defining and accurately measuring scope 3 emissions to raising the start-up funds for capital improvement projects.