The healthcare industry is one of the most carbon-intensive service sectors in the developed world. It’s responsible for approximately 4–5% of global greenhouse gas emissions and would be the fifth-largest emitter on the planet if it were a country. The U.S. healthcare system alone is responsible for 25% of these global emissions and contributes more than any other country in the world.
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The healthcare industry is also responsible for approximately 4–5% of toxic air pollutants, which largely stem from fossil fuel combustion. What’s more, is that researchers are finding direct correlations between air pollution and respiratory diseases such as asthma. This came to the forefront during the coronavirus pandemic when people who lived in areas with high air pollution became high-risk for developing severe cases of COVID-19.
What’s clear is that there needs to be a more integrated approach to environmental sustainability within the U.S. healthcare system. To dive into this incredibly important topic, we sat down with Jocelyn Gan who is an energy and sustainability specialist at NYU Langone Health. NYU Langone has committed to substantial sustainability goals, including reducing 50% of their carbon emissions by 2025. In our interview, she shared insights into why the healthcare sector needs to integrate sustainability into its operations and how climate change is inextricably linked to global public health.
Our conversation has been edited for length and readability.
Sustain.Life: For someone not in healthcare world, why is sustainability such a big issue?
Jocelyn Gan: Healthcare institutions have a unique sustainability lens because addressing environmental and social determinants of health is directly aligned with our core mission of taking care of patients and communities. Sustainability is about going beyond the four walls of any hospital—it's about taking care of our air, our water, and our city infrastructure. It’s also about being cognizant of what the environmental determinants of health are and how we may influence them. In urban areas, we see higher rates of asthma in certain areas with higher air pollution. To us, sustainability means reducing air pollution through the adoption of cleaner or zero carbon modes of transportation to alleviate asthma symptoms of community residents.
Sustain.Life: What role does climate change play in global health?
JG: Climate change is a global health issue. Extreme heat events, COVID-19 and other respiratory conditions, the spread of vector-borne diseases—these, and many others, are all health issues that are impacted by the health of the physical environment. COVID-19 really revealed how important our air quality is when it comes to how susceptible someone is to developing severe symptoms. There is a study by researchers at the Harvard University School of Public Health that found that higher levels of PM 2.5 were associated with higher COVID death rates. “The results of this paper suggest that long-term exposure to air pollution increases vulnerability to experiencing the most severe Covid-19 outcomes,” the authors wrote. We can also see this correlation in our Department of Population Health’s City Health Dashboard, which compiles data on the physical environment, health outcomes and social and economic factors.
Sustain.Life: Tell us about the U.S. Health Care Climate Council that NYU Langone participates in?
JG: In 2019, we became the first and only New York City-based member of the U.S. Health Care Climate Council, a national leadership body of health systems committed to protect their patients and employees from the health impacts of climate change. This platform allows us to leverage our voice, alongside 18 other health systems, to drive innovative climate solutions as well as policy and market transformation. Internally, this means we foster conversations on the importance of climate action on a larger scale.
Sustain.Life: What are you doing specifically at NYU Langone to tackle sustainability?
JG: We have very rigorous institutional standards. Especially from an infrastructure perspective, sustainability is incorporated into our design guidelines to build more resilient and healthy buildings. We also invest in upgraded infrastructure and smart building automation systems, and purchase environmentally safe furniture without toxic chemicals as part of our participation in the Practice Greenhealth’s Safer Chemicals Challenge.
After Hurricane Sandy, NYU Langone began overhauling its infrastructure with an emphasis on resiliency and pursued the USGBC PEER certification for our Manhattan campus. It’s the world’s first certification program that measures and improves power system performance and electricity infrastructure. It illustrates how sophisticated your electricity infrastructure must be in the case of extreme climate events. NYU Langone’s Manhattan campus was the first campus in the world to become Platinum LEED and PEER certified, and we’re looking to pursue these certifications in future projects.
Sustain.Life: What are some of the primary sustainability challenges that hospitals face?
JG: Hospital waste is extremely complicated, with many types of waste streams that are disposed of differently. Some is recyclable, some is incinerated, some is re-processed depending on regulations or what we believe to be the best way to protect human health and the environment. On average, hospitals generate 29 pounds of waste per bed per day according to Practice Greenhealth.
Unfortunately, there's no easy solution. It really comes down to source reduction and reinforcing the right behaviors with end users. You need to make sure your waste and recycling receptacles are conducive to enabling these behaviors and making sure people are disposing of waste the right way through education and training. It’s a team effort.
Sustain.Life: Can you talk more about source reduction at NYU hospitals? How is that managed?
JG: Source reduction is always the priority when we talk about waste management. When you look at an operating room, for example, there is a lot of waste generated during preparation and during procedures. All of this waste is considered contaminated. Opened supplies must be disposed of properly and reusable supplies must be sterilized or reprocessed. So it’s really important that we only bring in supplies that we need. To do this, we standardize and review all of our physician preference cards, which list supplies requested for each procedure type. This way there’s nothing extra that is opened and unused. These cards are frequently reviewed since some of the requested items may no longer be needed as procedures, tools, and techniques evolve. We eliminated more than 45,000 physician preference cards since 2017, which allows for standardization of material use leading to less waste.
Sustain.Life: Is there anything else you’d like to share about NYU Langone’s commitment to sustainability?
JG: As your organization's footprint grows, it’s incredibly important to expand your sustainability goals as well. This is something we are thinking about every day.
We already have carbon reduction goals for our scope 1 and 2 emissions, and scope 3 is the next natural step for us to explore. How can we encourage low-carbon transportation? And how can we consider embodied carbon when we design a new space? Even though it’s more challenging, I think the healthcare industry will take the lead on tackling scope 3 emissions.