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It’s a paradox: Even as health care providers treat health issues triggered by climate change–such as more asthma patients among vulnerable groups and extreme heat driven symptoms and illness–health care facilities contribute to the problem. In the U.S., health care accounts for 8.5 percent of the nation’s carbon emissions. Globally, U.S. health care is responsible for a quarter of the world’s health care emissions

But, UC’s academic health centers are making gains in lessening their environmental footprint, which benefits nearby communities along with the planet overall. From the exam room to the operating table to the cafeteria, UC academic health centers are reducing not just greenhouse gases, but also waste as part of the University’s broad, measurable program to increase sustainability at health locations and campuses.

Carrie L. Byington, M.D., executive vice president of University of California Health, says these sustainability initiatives are significant.

"Reducing the impact of our health care operations on the environment is a means to address health equity in the state and is critical to fulfilling our public service mission of improving the health of all Californians,” says Byington. 

As part of sustainability work across UC’s health system, a growing number of initiatives are targeted toward a combination of environmental goals, social considerations and needs of medically underserved communities. In one notable example, the UC Davis Health student-led Second Breath program diverted more than 700 pounds of waste from the landfill in just six months by sending excess medical supplies to community organizations working with medically underserved people. At UCLA, the schools of medicine and nursing are updating their curriculums to include climate change, environmental justice, health equity and the social determinants of health.

Policies gain momentum, practices earn recognition

The sector’s environmental stewards are taking note of UC progress in its health operations sustainability: In 2022, UC academic health centers again have earned awards—in more than 10 categories—from Practice Greenhealth, which gives the industry’s top honors for sustainability based on a stringent framework for achieving environmental impact. In 2021, Health Care Without Harm recognized University of California Health as a Health Care Climate Challenge Champion for achievement in mitigation, resilience and community leadership.

Byington recognizes the importance of the climate resiliency work and appreciates the accolades for faculty and staff across the academic health centers, which help sustain the momentum. “The programs at our academic health centers are decreasing our carbon footprint, while also creating best practices to share with other organizations,” she says. “It is rewarding to see the national recognition for our system’s work."

The University has pursued sustainability-related action since the 1970s and established a systemwide Presidential Policy for green building design and clean energy standards in 2004. A UC Health sustainability section was added to UC’s Sustainable Practices Policy in 2018. In 2022, UC Health committed to further climate action by joining the Biden administration’s nationwide Health Care Sector Climate Pledge as well as the National Academy of Medicine’s Climate Collaborative, dedicated to decarbonizing the U.S. health sector and strengthening its sustainability and resilience in the face of climate change. 

All of UC’s health locations work toward systemwide goals. UC Davis Health, UC San Diego Health, UCI Health and UCSF Health were recognized by Practice Greenhealth for their efforts in multiple areas in 2022. UC Davis Health received the organization’s highest honor–the Top 25 Environmental Excellence Award–noting it as one of the top hospitals nationally for environmental sustainability. Practice Greenhealth also recognized UC Davis Health in its Circle of Excellence Awards in Climate, Food, Green Building, Sustainable Procurement, Transportation, and Water. UCI Health received Practice Greenhealth Circle of Excellence Awards for both Climate and Energy for reducing the carbon of its scope 2 emissions to zero. 

UC Davis Health, UC San Diego Health and UCSF Health earned Practice Greenhealth awards for their efforts to reduce the impact of the surgical environment. Seema Gandhi, M.D., professor of anesthesia and medical director of sustainability at UCSF Health has spearheaded UC systemwide efforts to decrease emissions from anesthesia gases. Not only has she played a key role in bringing science and evidence to eliminate desflurane from an institution where it was invented but has also created an electronic tool to optimize anesthesia gas usage.

Gandhi’s work has been recognized nationally, and she has received numerous awards and grants, including from America’s Essential Hospitals to disseminate her mitigation efforts nationally. She describes her outlook for the next year, “I am excited to work on reducing waste from nitrous oxide across the UC system by conversion from a piped source to a cylinder-based system. This conversion will decrease nitrous oxide-based emissions by 80 percent at UCSF Health. I thank my departmental chair for his support and leading the way for health systems and anesthesia departments across the country to work toward decommissioning piped nitrous.”

UC academic health centers have been recognized by Practice Greenhealth in multiple years for advanced sustainability programs, high scores and achievements in categories ranging from climate and energy to purchasing, sustainable food practices, green building, transportation and water use. For example, UC Davis Health is on track to meet its 2030 sustainable food purchasing program goals. UCI Health has launched an organics pre-consumer waste-to-animal feed program; reduced greenhouse gas emissions associated with anesthetic gases by more than 60 percent; and hosted Climate Resilience Planning workshops with a focus on diversity, equity and inclusion. To mitigate its impact on the environment, UCLA Health implemented a variety of programs, including expanding its nationally recognized reusable isolation gown program to testing sites and clinics while also increasing the number of EV fleet vehicles that transport staff and patients. UC San Diego Health avoided 7 tons of waste and saved $800,000 through FDA-approved reprocessing of single-use-medical devices.

Sustainability with a higher purpose

UC’s health facilities are well on their way to achieving many of the goals formalized in UC’s Sustainable Practices Policy.

At the same time, UC’s health experts are increasing the focus on the wide-ranging impacts of climate change on society and health equity–which are becoming ever more apparent with each extreme weather event. Leading the way in this area is the UC Center for Climate, Health and Equity.

The center was launched through a partnership between UC Health and other systemwide initiatives, including the UC Office of the President’s Sustainability Office, UC Global Climate Leadership Council, UC Global Food Initiative, UC Center for Climate Justice and UC Global Health Institute’s Center for Expertise on Planetary Health.

“Addressing the effects of climate change on health and equity is the next critical need for our societies. Through the Center, we’re building a transformational research program that generates insights essential to solutions, coupled with a world-class education hub for all health professionals—underscoring UC expertise,” says UCSF Professor of Medicine Arianne Teherani, Ph.D., who is a founding co-director of the newly established center. 

“Equally important is that we share our knowledge, insights and best practices broadly to help lead the way forward in actions to improve health equity in the face of the increasing health impacts of climate change,” continues UCSF Professor of Medicine Sheri Weiser, M.D., MPH, also a founding co-director of the center, “We will apply our research findings to UC health systems, practices and policies, to ensure our providers are responsive to the climate-related needs of our patients and communities.”