Are We Doing All We Can to Do No Harm? What Children’s Hospitals Are Doing and Can Do to Address the Climate Crisis

As pediatricians we are leading in climate advocacy. The AAP was the first medical organization to publish a policy statement on climate change and health recognizing the potential negative effects that the current trends in climate have on our patients’ health. It makes sense for pediatricians to be at the forefront of this issue as our patient population is vulnerable and disproportionately affected by worsening air pollution, extreme weather events, and an increasing yearly number of extremely hot days (1). In this month’s Hospital Pediatrics, Dalby et al. explore how children’s hospitals can lead the way in a greener, more sustainable healthcare system (10.1542/hpeds.2024-007817).  

As physicians we promised to do no harm. However, as clinicians working in hospitals, we  practice in places that are making significant contributions to the current climate crisis (2). Knowing the negative health effects associated with current climate trends, hospitals worsening the climate crisis feels contradictory. It is imperative to work toward a change. Hospitals consume more energy than most commercial buildings in the country, and they are a large source of waste, making them significant emitters of greenhouse gasses. The US health sector is responsible for an estimated 8.5% of national carbon emission, and it accounts for approximately 25% of global health sector emissions.   

Due to their contribution to the problem, hospitals are well positioned to become leaders in solutions. Many hospitals have created green teams and are working on sustainable initiatives (3). In 2022, the White House and Health and Human Services (HHS) launched the Health Sector Climate Pledge, which is a voluntary commitment by healthcare organizations to reduce emissions. Dalby A, et al. investigated hospital websites as windows into what larger children’s hospitals in the country are doing to track and mitigate their emissions as well as their efforts in educating families about the health effects of climate change. Investigators performed a structured search of public data concerning actions for mitigation of GHG emissions (GHGe) and education on intersections between climate change and health. Less than 50% of the hospitals had signed the HHS Health Sector Climate Pledge or had a sustainability team, and between 50 and 80% of hospitals were educating families on topics related to climate and health such as extreme heat and air pollution.  

As emphasized by the authors of this study, children’s hospitals can be active messengers to the community by providing education on topics that relate to climate and health such as prolonged allergy season, worsening asthma exacerbations with exposure to air pollutants, increased rates of prematurity, dehydration and depression/anxiety. Education efforts should also include public explanations of how their sustainability initiatives benefit health. This research brief emphasizes the need for transparent and comprehensive mitigation and education efforts. As pediatric hospitalists committed to children’s health, it is our responsibility to hold the children’s hospitals we work in responsible for a greener, more sustainable pediatric hospital system.  

References 

1. Ahdoot S, Baum CR, Cataletto MB, Hogan P, Wu CB, Bernstein A, COUNCIL ON ENVIRONMENTAL HEALTH AND CLIMATE CHANGE, COUNCIL ON CHILDREN AND DISASTERS, SECTION ON PEDIATRIC PULMONOLOGY AND SLEEP MEDICINE, SECTION ON MINORITY HEALTH, EQUITY, AND INCLUSION. (2024). Climate change and children’s health: building a healthy future for every child. Pediatrics, 153(3), e2023065505.
2. Dzau VJ, Levine R, Barrett G, Witty A. (2021). Decarbonizing the US health sector—a call to action. New England Journal of Medicine, 385(23), 2117-2119.
3. Singh H, Eckelman M, Berwick DM, Sherman JD. (2022). Mandatory reporting of emissions to achieve net-zero health care. New England Journal of Medicine, 387(26), 2469-2476.