Seddon Savage MD, MS, of Concord is a physician, educator, and board member of NH Healthcare Workers for Climate Action. Heiko Pohl MD, of Lebanon is a gastroenterologist and chair of the Sustainability Work Group of the Alliance on Climate and Health at Dartmouth.

Health systems in New Hampshire have an immediate opportunity to provide leadership in global efforts to defeat climate instability and its escalating serious impacts on human and planetary health.

On March 9th the U.S. Department of Health and Human Services (HHS) renewed an earlier call for health systems to pledge to work towards key sustainability goals. While over half the health systems in Massachusetts and more than 100 health systems representing 837 hospitals across the U.S. have engaged, none in New Hampshire have yet signed the pledge.

Healthcare systems account for almost 10% of U.S. greenhouse gas emissions (GGE) and 25% of health sector emissions worldwide. As a result, U.S. health systems contribute substantially to the burden of human disease due to climate change. This is not consistent with healthcare’s mission to improve health, and it is not sustainable.

The World Health Organization calls climate change “the current single biggest health threat to humanity.” Healthcare costs due to climate instability are estimated at $820 billion annually in the U.S. and are rapidly increasing due to diverse challenges including extreme weather events; heat-related illnesses; tick and mosquito-borne diseases; mental health distress (especially among the young); and the harmful effects of poor air quality on cardiovascular and pulmonary health and birth outcomes, among others.

These challenges disproportionately impact socioeconomically disadvantaged populations. It has been demonstrated that sustainable practices in healthcare can reduce the cost of operations, as well as mitigate climate harm. As a matter of health, health equity and fiscal responsibility, it is imperative that we act now.

The HHS healthcare sustainability goals call on each health system to appoint a chief sustainability officer and develop a resiliency plan to assure continued operations in the event of an environmental emergency by the end of 2023 and to achieve a 50% reduction in greenhouse gas emissions (GGE) by 2030 and net zero emissions by 2050.

Health systems leaders in New Hampshire have voiced a range of understandable concerns about signing on: the need to address serious financial challenges engendered by COVID before focusing on sustainability efforts, a risk of incurring liability if pledged goals are not achieved, or that they are already working towards sustainability so the pledge is not necessary. But the reality is: climate change will not wait, the risks of inaction are existential, and visible healthcare leadership could be powerful in inspiring change across all industries.

Important incremental work towards sustainable practices is already being done by many committed individuals and groups within different New Hampshire hospital systems, but they are working to change huge and strongly entrenched systems. What is needed now is for health system leaders to prioritize and publicly commit their systems to achieve sustainability in a meaningful timeframe.

We urge the NH Hospital Association and all New Hampshire health system leaders to identify sustainability as a top priority and to publicly commit to achieving the HHS goals. Healthcare workers and community members can help drive these efforts by challenging their health system leaders and boards to meet the goals.

With our rich New Hampshire networking systems pulling together, we could become the first state in the U.S. to have 100% of our health systems achieve net zero emissions and substantively improve the health of our communities. The window to sustain human and planetary health is still open. The time for action is now.

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