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2021 Care Without Carbon: The Road to Sustainability in US Health Care

Inaugural Yale University Sustainability in Health Care Symposium

Presented by the Yale Program on Health Care Environmental Sustainability (Y-PHES)

Part 1: Sustainability frameworks for the US health care sector.
May 27, 2021, 11:00 am-3:30 pm EDT
Presented with the Yale Center for Business and the Environment.

Part 2: Lessons from the Greener NHS Initiative: challenges and opportunities on the road to net zero health care.
June 3, 2021, 11:00 am-3:30 pm EDT
Presented with the University College London Energy Institute, the Lancet Countdown and the Northeastern University College of Engineering.

Part 3: Lessons from the Nordic sustainable health care experience.
June 10, 2021, 11:00 am-3:30pm EDT
Presented with the Nordic Center for Sustainable Healthcare.

For the symposium recording and presentation slides please contact Mauro Diaz-Hernandez.

2021 Symposium Summary

Health systems around the world are turning their attention to greenhouse gas mitigation and resilience. Globally, health care is responsible for nearly 5% of total global greenhouse gas emissions. Nationally, US health care is responsible for 8.5% of US greenhouse gas emissions and similar fractions of toxic air emissions. Disease burden stemming from US health care pollution is on the same order of magnitude as medical errors, but is presently unaddressed.

As mandatory carbon reduction looms on the horizon for all sectors, this three-part symposium provides an overview of the current state of health care sustainability accounting, and seeks global lessons that can be adopted by the US health care delivery sector to guide mitigation and resilience strategies. Broadly, attendees can expect to be able to:

  • Explain current needs for health care organization sustainability accounting
  • Review different global framework tools for environmental and social performance accounting
  • Describe international health care system sustainability exemplars and their applicability to the US system
  • Discuss how health care organization sustainability accounting supports the development of data-driven interventions, mitigation targets and timelines


Part 1: Sustainability frameworks for the US health care delivery sector

This session will review the current state of sustainability accounting frameworks to help health care leaders prepare for near- and long-term sustainability efforts that address their most important environmental impacts, risks and opportunities.

Under the President Biden administration, and internationally, the pace to address the climate change is quickening. Corporate Social Responsibility (CSR) (a.k.a Environmental, Social and corporate Governance (ESG)) is now recognized by a majority of investors and many large non-profit entitites as a fundamental component of an organization's value. Health care organizations are central figures in the climate crisis, both as large polluters and as frontline responders to the impacts of extreme weather and other environmental factors. However, very few health care organizations have CSR programs that align with the well-developed frameworks utilized in other sectors. This may change in the near future as US health care organizations are likely to be affected by mandatory CSR reporting; Catholic health care systems comprising one fifth of all US hospital beds increasingly heed the call of Pope Francis to prevent suffering by protecting the health of our environment; and as environmental determinants of health begin to increasingly pressure the financial performance of health care providers that utilize value based payment models.

Part 2: Lessons from the Greener NHS Initiative: challenges and opportunities on the road to net zero health care

Using the NHS as a case study, this session will provide an overview of how carbon accounting can be performed for a health care system, how mitigation strategies are developed, and what obstacles can be anticipated.

The National Health Service (NHS) England is the world’s largest health care delivery organization, and has the most robust health care carbon accounting effort in the world. In 2020, the Greener NHS Initiative was launched, committing the organization to achieving ‘net zero’ carbon emissions by 2040. This target is set across all emissions in Greenhouse Gas Protocol Scopes 1, 2 and 3 and includes, estates and facilities, transport and travel, medicines, and medical and non-medical supply chains.

Part 3: Lessons from the Nordic sustainable health care experience

This session will review the Nordic path toward sustainable health care delivery, including origins and drivers, innovation, and tracking progress. Content will be drawn from Nordic hospitals, government agencies, and industry.

The Nordic region has a long tradition of sustainability leadership in the health care sector. The content draws from the Nordic White Paper on Sustainable Health care, a regional roadmap for achieving the UN Sustainable Development Goals. Topics covered include: (i) Sustainability holistically embedded in hospital operations, which includes architecture, supply chains resource use, waste management, and governance; (ii) Innovative health care solutions developed by local companies, such as digital health solutions, sustainable medical technologies, lower-emission health care programs, and circular economy; (iii) Linkages between hospital and urban infrastructure through services such as district heating, district cooling, public transportation; and (iv) Culture, politics and legislations that have driven the regional sustainability agenda; and (v) Sustainability reporting frameworks and performance review.

Topics covered


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