How U.S. Hospitals Undercut Public Health

Healthcare in the United States and its Energy Inefficiency

Health care in the United States — the largest industry in the world’s largest economy — is notoriously cost inefficient, consuming substantially more money per capita to deliver far inferior outcomes relative to peer nations. What is less widely recognized is that the health care industry is also remarkably energy inefficient. In an era of tightening connections between environmental destruction and disease, this widely neglected reality is a major cause behind many of the sicknesses our hospitals treat and the poor health outcomes they oversee.

Sustainable Development Goals (SDGs)

1. Goal 3: Good Health and Well-being
2. Goal 7: Affordable and Clean Energy
3. Goal 13: Climate Action

Energy Inefficiency in U.S. Hospitals

• The average energy intensity of U.S. hospitals is more than twice that of European hospitals, with no comparable quality advantage.
• In recent years, less than 2 percent of hospitals were certified as energy efficient by the U.S. Environmental Protection Agency’s Energy Star program, and only 0.6 percent, or 37 in total, have been certified for 2023.
• In 2018, the U.S. health care industry emitted approximately 610 million tons of greenhouse gases (GHGs), representing 8.5 percent of U.S. GHG emissions that year, and about 25 percent of global health care emissions.

Impact on Global Carbon Budget and Public Health

• If U.S. health care were its own country, it would rank 11th worldwide in GHG pollution.
• Air pollution from U.S. emissions accounts for an estimated 77,000 excess deaths annually in the U.S. alone.
• Emissions from the U.S. health care system lead to the loss of more than 400,000 years of healthy life among Americans.

Vulnerability of Medicare and Medicaid Beneficiaries

• Medicare beneficiaries, who are 65 and older and more likely to suffer chronic lung disease, are particularly threatened by bad air quality.
• Children, 46 percent of whom are Medicaid beneficiaries, are especially vulnerable to the health effects of climate change.
• Racialized and economically dispossessed groups are disproportionately exposed to higher levels of particulate air pollution.

The Need for Change

• The health care industry’s environmental disregard can be explained in part by what three bioethicists recently termed “lifeboat ethics framing.”
• U.S. health officials often exhibit narrow, clinically focused tunnel vision when it comes to health care emissions and the climate crisis.
• It is in the health care industry’s financial interests to decarbonize, as solar and wind energy are now the most affordable sources of generating electricity.

Conclusion

The health care industry’s energy inefficiency and contribution to the climate crisis have significant implications for global public health. Urgent action is needed to address these issues and align with the Sustainable Development Goals. Health care institutions should lead the way in implementing immediate changes to their energy-use practices and advocating for broader policy action to mitigate environmental destruction.

About the Authors

David Introcaso, Ph.D., is a health care research and policy consultant.

Eric Reinhart, M.D., is a political anthropologist of law and public health.

SDGs, Targets, and Indicators Analysis:

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 7: Affordable and Clean Energy
• SDG 13: Climate Action
• SDG 15: Life on Land

The article discusses the connection between the health care industry’s energy inefficiency and its impact on public health and the environment. This aligns with SDG 3, which focuses on promoting good health and well-being. The article also highlights the industry’s contribution to greenhouse gas emissions and the climate crisis, linking it to SDG 7 (affordable and clean energy) and SDG 13 (climate action). Additionally, the mention of environmental destruction and its consequences for health relates to SDG 15 (life on land).

2. What specific targets under those SDGs can be identified based on the article’s content?

• Target 3.9: By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination.
• Target 7.2: By 2030, increase substantially the share of renewable energy in the global energy mix.
• Target 13.3: Improve education, awareness-raising, and human and institutional capacity on climate change mitigation, adaptation, impact reduction, and early warning.
• Target 15.1: By 2020, ensure the conservation, restoration, and sustainable use of terrestrial and inland freshwater ecosystems and their services.

The article emphasizes the need to address the health care industry’s contribution to air pollution and its impact on public health, which aligns with Target 3.9 under SDG 3. The call for decarbonization and the use of renewable energy sources corresponds to Target 7.2 under SDG 7. The mention of the climate crisis and the need for policy action relates to Target 13.3 under SDG 13. Finally, the emphasis on environmental destruction and its consequences for health connects to Target 15.1 under SDG 15.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Indicator: Number of deaths and illnesses attributed to hazardous chemicals and air, water, and soil pollution and contamination.
• Indicator: Share of renewable energy in the global energy mix.
• Indicator: Education and awareness levels on climate change mitigation, adaptation, impact reduction, and early warning.
• Indicator: Conservation, restoration, and sustainable use of terrestrial and inland freshwater ecosystems.

The article does not explicitly mention specific indicators. However, the identified targets can be measured using indicators such as the number of deaths and illnesses attributed to hazardous chemicals and pollution (related to Target 3.9), the share of renewable energy in the global energy mix (related to Target 7.2), education and awareness levels on climate change (related to Target 13.3), and the conservation and restoration of terrestrial ecosystems (related to Target 15.1).

Table: SDGs, Targets, and Indicators

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Source: undark.org

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