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Healthy Intersections Podcast: Healthcare’s Carbon Footprint

AI-generated illustration of a hospital w/ a wildfire in the background


If the US healthcare industry were its own country, it would be in the top 10% of all countries in greenhouse gas emissions.

AI-generated illustration of a hospital w/ a wildfire in the background
Welcome to the February, 2024 edition of the Healthy Intersections Podcast! This month, we sit down with David Introcaso, PhD, to discuss the healthcare industry’s carbon footprint. Dr. Introcaso is the host and producer of the Healthcare Policy Podcast as well as an experienced researcher.

He talks us through understanding the scope of the problem and makes excellent points about the role of policies in addressing the climate crisis. Why not require healthcare organizations to publicly report their carbon footprints and what they are doing about sustainability? How else can we decarbonize the industry? If the healthcare industry leads on sustainability, it could transform the supply chain!

Below you’ll find the video (for transcript, click the paper/microphone icon in the video player), a link to the audio, and an extensive set of notes and further reading provided by Dr. Introcaso. Please share widely!

Link to audio (also available on Spotify, Apple, Google, and more!)

US Healthcare’s Greenhouse Gas Emissions

  • US healthcare is the largest industry in the largest economy in the world. With 4% of the global population, the US accounts for roughly half of healthcare spending worldwide at approximately $4.7 trillion annually.

  • Neither EPA nor the DoE calculates healthcare’s annual GHG or CO2e emission. An academic calculated the industry accounted for 553 Mt CO2e in 2018.

  • This amount equals roughly 9% of total annual US GHG emissions & between 25%- 40%% of total global healthcare emissions. If US healthcare was its own nation, it would easily fall within the top 10% of most GHG polluting countries.

  • US healthcare is remarkably energy inefficient. In 2023, only 37 (or 0.6%) of hospitals, the largest GHG emitting industry sector, were EPA Energy Star certified for energy efficiency. (Energy Star only measures Scope 1 & 2 emissions, or 20-25% of hospitals’ total GHG emissions.)

  • Medicare and Medicaid beneficiaries are disproportionately harmed – they pay the greatest climate penalty – or those whose health HHS is moreover pledged to protect.

  • Per the NRDC & others, est. global annual health care costs exceed $800b. Per recent EPA data, the social cost (SC-GHG) of just three industry greenhouse gases (CO2, CH4 and N2O) conservatively equals upwards of $3.6 trillion annually.

  • The Lancet Countdown reports have repeatedly noted the climate crisis “continues to be framed in ways that pay little attention to its health dimensions.”  The 2023 report found less than 1% of climate-related newspaper articles mentioned the health benefits of decarbonizing.

  • Associated health harms are innumerable & unrelenting affecting everyone, everywhere, always; the climate penalty disproportionately impacts 140m Medicare and Medicaid beneficiaries & more generally racialized & economically dispossessed populations.

  • Air pollution: 95% of Americans breathe substandard air largely due to fossil fuel combustion (fine particulate matter or PM2.5); a leading cause of the global disease burden at approx. 9m annually deaths, or 1 in 5, and the cause of 58% of US excess deaths.

  • The US operates over 200 coal-fired plants (the UK has one), even if free, externalized costs make coal-fired electricity would be unaffordable, equivalent to operating a FQHC to distribute cigarettes.

  • Climate-mediated pathogenesis has been linked to virtually every organ system, causing or worsening allergies, asthma, cancers, cardio-pulmonary diseases, infectious diseases, renal disease, maternal fetal outcomes, mental health, neurological conditions,

  • 58% of infectious diseases (218 of 375) are aggravated by more than 1,000 climate hazards or pathways.

Selected Recent Publications by Dr. David Introcaso

The Social Costs of Greenhouse Gas Emissions in Healthcare Are Astounding – And We’ve Been Ignoring Them Completely, The Hill (January 12, 2024).

How US Hospitals Undercut Public Health, Undark Magazine (October 5, 2023).

Why Are Congress’s Budget Experts Failing to Address the Rise of Climate-Related Health Care Spending? The Hill (August 21, 2023).

HHS Again Suspends Disbelief: The Medicaid Program Will Ignore the Greatest Health Threat to Medicaid Beneficiaries, The Healthcare Blog (July 12, 2023).

As the Climate Crisis Intensifies, HHS Refuses to Do Its Part, The Hill (July 9, 2023).

When Will Healthcare’s Failure to Decarbonize Compel Litigation, 3 Quarks Daily (May 15, 2023).

HHS’s Environmental Justice Index Institutionalizes Climate Apartheid, STAT (March 1, 2023).

Healthcare policy in the climate crisis (United States), Ecopsychepedia (March 2023).

FYI: The Healthcare Industry is Not Decarbonizing, The Hill (January 5, 2023).

One Small Regulatory Update Can Put the Healthcare Industry on the Path Toward Decarbonizing, Health Facilities Management (November 18, 2022).

How the Inflation Reduction Act Can Help Decarbonize the Health Care Sector, STAT (September 30, 2022).

How To Solve HHS’s Failure to Address the Climate Crisis, Health Affairs Forefront (September 9, 2022).

FDA User Fee Legislation Needs to Mitigate the Pharmaceutical Industry’s Carbon Pollution, STAT (June 8, 2022).

HHS’s Failure to Address the Health Harms of the Climate Crisis Constitutes Environmental and Institutional Racism, STAT (March 28, 2022).

The World’s Most Powerful Public Health Governing Committee’s Flagrant Violation of Reality, 3 Quarks Daily (February 21, 2022).

The National Academy of Medicine’s Climate Crisis Effort Must Turn Words into Action, STAT (October 15, 2021).

Public Reporting: The First Step in Addressing the Health Care Industry’s Bloated Carbon Footprint, with Walt Vernon, STAT (June 29, 2021).

Lisa M. Lines

Lisa M. Lines, PhD, MPH is a senior health services researcher at RTI International, an independent, non-profit research institute. She is also an Assistant Professor in Population and Quantitative Health Sciences at the University of Massachusetts Chan Medical School. Her research focuses on social drivers of health, quality of care, care experiences, and health outcomes, particularly among people with chronic or serious illnesses. She is co-editor of TheMedicalCareBlog.com and serves on the Medical Care Editorial Board. She has served as chair of the APHA Medical Care Section’s Health Equity Committee from 2014 to date.

Views expressed are the author’s and do not necessarily reflect those of RTI or UMass Chan Medical School.

Lisa M. Lines
Lisa M. Lines
Lisa M. Lines



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