One thing about the ongoing crises of climate change and inequities in the health care system has become clear: the problems are inextricably linked and leading CEOs are working to combat both.
“Climate change is a meta-problem underlying other problems and a threat multiplier, making those problems worse. It’s here now and making it harder for us to deliver high quality care to patients and communities,” said Renee N. Salas, MD, Faculty, Harvard Global Health Institute. “We have an enormous responsibility to address climate change as a prescription for health equity to ensure that we prevent the headwinds inhibiting us from delivering high quality care.”
At the 2022 Health Evolution Summit, Salas participated in the Main Stage discussion, Climate Care: Setting the Health Care Leadership Agenda. The session also included Admiral Rachel L. Levine, MD, Admiral, U.S. Public Health Service & Assistant Secretary for Health, U.S. Department of Health & Human Services; David Ricks, Chair & CEO, Eli Lilly and Company; Andrea Walsh, President & CEO, HealthPartners. George Barrett, founder of the Overtone Group and former Chairman & CEO of Cardinal Health facilitated the conversation.
“We need rapid action in terms of both preparing the health system in the United States for the impacts of climate change, and working on reducing their emissions,” Levine said.
Lessons from sustainability work and the current pandemic
The executives suggested that CEOs can look to lessons learned in working toward sustainability and pandemic response that can be applied to the climate and equity crises as well.
Specifically, Walsh pointed to the reality that climate and equity work need to be both a board room issue and a breakroom issue, the awareness that many employees are already keenly interested in sustainability and climate and want to know what they can do help. Walsh also noted the classic business adage that ‘what gets measured can be improved.’ For many CEOs, simply determining what to measure when it comes to climate and equity are challenges in their own right. The final lesson Walsh highlighted is the importance of instituting both attainable and stretch goals to drive progress.
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“We are at the beginning,” Walsh said. “We have a lot of work to do.”
The current COVID-19 pandemic also holds lessons applicable to climate and equity work.
Levine listed three: the fact that humans are all interconnected such that any decisions individuals, organizations or government agencies make can impact families, communities and potentially the whole world, the critical need for public health infrastructure at the state and federal levels to coordinate and collaborate, and the depth and breadth of disparities exposed during the pandemic.
“Climate change will disproportionately — and already does disproportionately — harm communities that are disadvantaged and there is much evidence to support this,” Levine said. “They are already under financial strain. They already have had a higher risk for COVID 19. So we have to bring this equity lens to our public health actions and our societal actions as we deal with climate change the way we have been dealing with COVID-19.”
Public-private partnership needed
In January of 2021, the Biden Administration issued an Executive Order on tackling the climate crisis at home and abroad that required HHS to establish the Office of Climate Change and Health Equity, which Levine described as “a major signal on the importance of addressing the threats that climate change poses to health.”
The Office, established in August 2021, exists within the Office of the Assistant Secretary for Health and its work consists of three main areas, Levine said. First, the aim is to build the resilience of communities, especially vulnerable communities, to withstand the impacts of climate change.
Second, the work involves harnessing infrastructure initiatives to combine actions on climate change and health equity. Third, HHS is working with the Administration, Veterans Affairs, Department of Defense and the private sector to reduce greenhouse gas emissions because the health care sector accounts for approximately 8.5 percent of U.S. carbon emissions.
Following the establishment of that office, on Earth Day 2022, HHS launched a pledge to invite health systems, life sciences companies and suppliers to reduce emissions and incorporate climate considerations into future plans.
“Since so much of American health care comes from the private sector, it is critical that the private sector is centrally involved,” Levine said. “We can influence behavior, and we have regulatory levers, but we cannot accomplish all that needs to be done alone.”
The opportunity ahead: A more conscious generation
While acknowledging that the health care industry has not traditionally functioned well at preparing for events that seem to be abstract and far away, Barrett noted that the U.S. has an emerging generation that is much more conscientious about equity and climate change.
Leveraging that generation and engaging the current workforce begins by demonstrating the impact of climate on equity. “Once people begin to see how it is impacting their day-to-day, you draw them in,” Salas said.
Achieving that buy-in for the next generation will require amending medical school curriculum as well as training the current generation of clinicians so they are appropriately trained to care for patients under new conditions, Salas added.
“Therein lies the potential,” Walsh said. “It is a way employers can differentiate themselves in terms of appeal to the younger workforce.”
Ricks noted that leaders are increasingly under pressure to address climate change and equity from the workforce.
“People expect us to be responsible and that’s good,” Ricks said. “Some of those visible things you can do, which at the end of the day are fractions of a percentage of your total impact but are highly visible, can make a bigger impact than I originally thought.”
Moving from anecdote to evidence
Much the way that health care organizations, policymakers, and researchers advanced and disseminated science very quickly to establish an evidence-based path forward in the pandemic, health care needs to consider the science when developing strategies for addressing climate change and advancing health equity.
“We have to make sure that we’re moving from the anecdotal to the observational to the data-driven on this work and that we have good, clear data,” Barrett said.
As daunting as addressing climate change is, Walsh urged other CEOs to start with small steps that lead to larger steps that, in turn, can drive engagement of leaders, teams and communities. Barrett added that at this point any step is a positive step.
Likening the work to lowering a patient’s blood pressure, where a 5-10 percent reduction is not satisfactory, Salas said CEOs must strive to make a lasting impact.
“We can use the health sector to catalyze societal-wide transformational change,” Salas said. “We have to make sure that as we do this, our eyes are on that prize. We are optimizing these levers because we touch everything, which means we can catalyze change in everything.”
