Healing without Hurting the Planet – Partners Healthcare and Climate Change
Climate change impacts health, yet healthcare also contributes to climate change. How can Partners Healthcare ensure sustainability and prepare for climate change?
Healing without Hurting the Planet – Partners Healthcare and Climate Change
Climate change may seem removed from a medical office or hospital. Yet, it plays a big role in public health crises –from Zika to asthma, from malnutrition to cholera, from allergies to heat stroke, changing weather patterns and temperatures impact health. In fact, The Lancet (top UK medical journal) recently called climate change “the biggest global health threat of the 21st century” [1].
The most salient impact of climate change on health is through extreme weather events – heat waves in Europe, hurricanes in North America, typhoons in Asia, and more. Communities with limited resources are hit particularly hard as public health crises continue beyond the initial event through a painful recovery. Catastrophic events can impact healthcare facilities – from flooding and loss of power at Memorial Hospital in New Orleans during Hurricane Katrina to millions of dollars of research specimens lost at NYU Langone during Hurricane Sandy [2]. There are also more insidious impacts of climate change – warmer weather expanding disease-carrying mosquito habitats or airborne pollutants exacerbating allergies and asthma [2].
The healthcare industry shares blame for climate change – while trying to help patients, we pollute. Healthcare accounts for 8% of all US greenhouse gas emissions, with hospitals alone spending approximately $10B on energy annually [3]. Healthcare facilities in the US alone generate 6,600 tons of waste daily, a significant portion of which is hazardous waste which costs ~20 times more to process than regular waste [3].
Effects of climate change on health (from Climate Change and Primary Health Care [4])
Here in Boston, Partners Healthcare is a non-profit healthcare system with 2015 revenues of $11.7B [5]. They are trying to reduce their own contribution to climate change (sustainability) and prepare themselves for climate change (resilience) [6].
Sustainability: Partners Healthcare highlights both high level initiatives (reducing energy consumption by 25%) and hospital-specific ones (capturing and re-purposing lab chemicals, introducing single stream waste management, and constructing new energy-efficient facilities). They are trying to conserve natural resources and reduce their carbon footprint, but also reduce costs – while Partners does not provide numbers, energy spending accounts for 1-3% of a typical hospital’s operating budget [3]. Sustainability has tremendous financial upside for the organization.
Resilience: At the same time, the healthcare system is preparing to accommodate climate change. For instance, Spaulding Rehabilitation Hospital was rebuilt in 2013 on the waterfront in Charlestown. Learning lessons from Hurricanes Sandy (2012) and Katrina (2005), architects designed the hospital to withstand storms and sea-level rise. Critical mechanical and electrical equipment as well as backup power generators are on the roof in case of severe flooding. All patient-critical activities are on higher floors and the hospital can continue to operate in “island mode” independently for four days. All these mitigate the risk of climate change for one hospital within the Partners network. [7]
Spaulding Memorial Hospital, (from Returns on Resilience, the Business Case [8])
These early steps focus on inpatient hospitals and larger capital investments. However, Partners Healthcare is missing out a huge opportunity to promote sustainability and resilience across its outpatient network, especially among primary care physicians (PCPs).
First, PCPs share a similar mindset to climate change scientists – one where short-term costs (smoking cessation or an investment in an energy-efficient building) have long-term benefit (preventing lung cancer or lowering energy costs). Both groups struggle to convince others (patients or policy makers) to think long-term and discount the future less (10 or 30 years from now). Thus, PCPs may be more receptive to climate change initiatives and are natural advocates for sustainability to their patients and to politicians.
Second, Partners Healthcare can improve healthcare locally by asking (and teaching) primary care physicians to talk to patients about the health effects of climate change – discussing heat stroke, disaster preparedness, risk of mosquito-borne diseases, or allergens. For example, a pediatrician seeing a child with asthma can prescribe a new inhaler. However, he or she could also be provided the resources to collect information on outdoor and indoor pollutants the child may be exposed to and know how to act on that information.
Finally, efforts should be made to make outpatient practices (not just hospitals) more sustainable and resilient to reduce costs and mitigate the impact of climate change. The same sustainability efforts – energy efficiency, waste management, recycling of supplies – can apply in outpatient practices as well as hospitals. Likewise, preparing primary care offices, especially those near the shore, should be ready for storms and floods with preparedness plans and office design. These preventative measures can mitigate the impact of a storm or flood and allow facilities to re-open earlier, treat more patients, and prevent healthcare crises in Boston follow a storm.
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- Costello, Anthony, et al. “Managing the health effects of climate change.”The Lancet373.9676 (2009): 1693-1733.
- Cohen, Gary. “What Does Climate Change Have to Do With Health Care?”Forbes. Forbes Magazine, 07 Apr. 2013. Web. 04 Nov. 2016.
- Kaplan, Susan, et al.Can sustainable hospitals help bend the health care cost curve?. Commonwealth Fund, 2012.
- Blashki, Grant, Tony McMichael, and David J. Karoly. “Climate change and primary health care.”Australian Family Physician36.12 (2007): 986.
- Sandler, Michael. “Partners HealthCare’s Annual Revenue Rebounds in 2015.” Modern Healthcare. N.p., 14 Dec. 2015. Web. 04 Nov. 2016.
- “Partners HealthCare.” Sustainable Initiatives. N.p., n.d. Web. 04 Nov. 2016.
- Quint, Christina. “Partners HealthCare Redefines Resilience and Restoration in Innovative Waterfront Hospital.”Healthier Hospitals Initiative website, May6 (2014).
- Urban Land Institute: Returns on Resilience: The Business Case. ULI Center for Sustainability. Washington, D.C.: the Urban Land Institute, 2015.
This is a really creative perspective on the connections between climate change and the healthcare industry. I especially like the description of how PCP’s can relate climate change initiatives to the benefits of quitting smoking. A couple questions came to mind while reading this post. First, how does Partner’s relationship with the PCP’s work in terms of implementing sustainability efforts? I know Partner’s is closely tied to the infrastructure decisions of the major hospitals, but do they get involved down to the granular level of each PCP’s office? Also, Boston is no stranger to extreme weather events, even before the amplification of storms caused by climate change. In the past when Boston was hit with a massive snow storm how would older, less technologically advanced hospitals deal with having to operate in island mode?
Alex – Awesome post. I first heard about the work Partners Healthcare is doing when I read Paul Farmer’s Mountains Beyond Mountains as part of an undergrad course. I subsequently went on to do some volunteering at Edesia Nutrition (which I wrote my post on), a nonprofit that collaborates with Partners. In doing research on Edesia, I noticed that they have many similar challenges as those P.H. faces. One of these parallel themes is the concentration on cost. As the US government continues to face budget constraints, I assume they will have less capital to donate to organizations like Partners. Is this part of its motivation to cut operating costs? Or is this goal driven by maximizing production and ultimately its broader impact? Additionally, one point that you made that I would like to have suggested to Edesia is focusing on preventative measures. I believe Edesia could help mitigate the almost unlimited demand for its supplements in Africa by better communicating best practices for basic nutrition with the children in the areas it serves. Thanks for the interesting read!
Alex, I find this blog post great, as it points to a multitude of avenues of how care providers can reduce their effect in climate change. One aspect that you touched on, but that I believe would be worth to expand on is the role of waste in hospitals. First, millions of dollars of drugs, medical devices and consumables are thrown away each year unused. Here, a better management of expiration dates might help, like pharmacy automation systems already offer. Secondly, I assume there is a great volume of waste because of one-time-use products, like for example laparoscopic surgery instruments such as staplers. Here, the role of the sterilization department might become key in the future to make more of these instruments reusable and therefore save a ton of waste.
What do you think?