Dear Dr. Burks and UNC Health Leadership,
We are health professional students, trainees, residents, and fellows of medicine, nursing, occupational therapy, physical therapy, speech therapy, public health, social work, and dentistry, who are deeply concerned about the escalating consequences and impacts of climate change and health care-generated environmental degradation on us, our children, and our patients now and in the future. The health care sector is responsible for 8.5-10% of heat-trapping greenhouse gas emissions in the United States and a similar proportion of air pollution.(1) The UNC Health System continues to generate approximately 63 tons of waste daily. As a major contributor to climate change, UNC Health must take immediate and bold steps to mitigate its impact on public health.
As trainees, we have implemented climate-conscious changes within our limited spheres of influence. We have appointed a Chief Sustainability Officer to the Student Health Action Coalition, our student-run free clinic, to adopt climate-conscious clinical operations. We have integrated climate-relevant material into the medical school curriculum, established a Planetary Health scholarly concentration within the School of Medicine, conducted waste audits, and completed the Planetary Health Report Card (2) for UNC for the past four years.
Likewise, UNC clinicians and other staff have taken preliminary strides in addressing climate impacts. One notable example is the elimination of desflurane anesthesia, a high-intensity and high-cost greenhouse gas that has been largely replaced with effective alternatives, reducing UNC Health costs by approximately $46,000 per year without compromising patient care.(3) Other sustainability efforts have been initiated piecemeal throughout UNC Health, but in the absence of top-level guidance, current scaling capacity is limited.
These preliminary efforts are an excellent start but more work is needed. UNC Health must build on its progress to establish itself as a national leader in climate-conscious healthcare. We call on UNC Health to take action in 2025 by implementing the following:
- Apply for The Joint Commission's Sustainable Healthcare Certification (4) by collecting data on and taking action to reduce at least three types of greenhouse gas emissions. Significant greenhouse gas emissions reductions at UNC Health in purchased electricity, energy use, waste disposal, and anesthetic gas have laid the foundation for this certification.
- Quick wins: Launch a series of easy-to-implement, cost-reducing projects, such as converting to LED lights, instituting computer sleep software, and encouraging the appropriate use of dry-powder or soft-mist inhalers over metered-dose inhalers.
- Greenhouse gas inventory: Create a permanent, regularly updated inventory of UNC Health’s greenhouse gas emissions for accountability and tracking progress toward institutional goals.
- Financial model for sustainability: Develop a financial model that tracks the costs and returns of planetary health projects to ensure resource efficiency and sustainability.
- Leadership commitment: Appoint a senior executive to lead a Sustainability Committee responsible for coordinating the above work.
Reduced operational costs (5), increased employee satisfaction, retention, and recruitment (6), and demonstrated support of their missions to improve public health (7), are just some of the benefits of these efforts. Other NC healthcare systems have committed to addressing and publicly reporting sustainability goals. Novant Health has committed to reduce greenhouse emissions by 90% by 2050 (8), while Advocate Health, formerly Atrium, has pledged to reduce emissions by 50% by 2030 and achieve net zero emissions by 2050 (9). Duke University Health System and all of its buildings on campus and around the Triangle area are included in the newly announced addition to the Duke Climate Commitment (10).
Addressing climate change is an environmental imperative, a public health priority, and an opportunity to streamline and reduce costs of health care delivery. By leading in sustainability, UNC Health can protect the wellbeing of North Carolinians today and for generations to come. We welcome the opportunity to discuss how we can support UNC Health in making sustainability an immediate priority and would like to meet with Dr. Burks and other leadership to expedite this work.
Signed,
Signatories
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For UNC health professional alumni, former or current Health System faculty, and staff (to endorse above trainee letter):
UNC medical, public health, and other health professional students, graduate students and trainees have taken the lead on addressing the connection between climate and health over the last few years. Per their letter to UNC Health leadership dated [date of delivery], they have led climate-health curriculum efforts, created a Chief Sustainability Officer position for the SHAC clinic among other efforts. They are now calling on faculty, alumni, and health system leadership to amplify and integrate this work across departments and the UNC Health System. We also note that UNC Health Chapel Hill is the only academic medical center with top tier NIH funding that lacks a sustainability program.
We applaud the work and commitment of students and trainees as well as that of our fellow institutions. We wish to partner in these efforts, and ask you to do the same.
References:
1. Eckelman MJ, Sherman J. Environmental Impacts of the U.S. Health Care System and Effects on Public Health. Ahmad S, editor. PLOS ONE. 2016 Jun 9;11(6):e0157014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900601/
2. Planetary Health Report Card. PHRC. https://phreportcard.org/
3. Unpublished data from UNC Health.
4. Sustainable Healthcare Certification | The Joint Commission. www.jointcommission.org. https://www.jointcommission.org/what-we-offer/certification/certifications-by-setting/hospital-certifications/sustainable-healthcare-certification/
5. Kaplan S, Sadler B, Little K, Franz C, Orris P. Issue Brief Can Sustainable Hospitals Help Bend the Health Care Cost Curve? 2012. https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_issue_brief_2012_nov_1641_kaplan_can_sustainable_hosps_bend_cost_curve_ib.pdf
6. Shah A, Gustafsson L. U.S. Health Care Workers Want Their Employers to Address Climate Change. Commonwealthfund.org. 2024 Jan 24; https://www.commonwealthfund.org/publications/issue-briefs/2024/jan/us-health-care-workers-want-employers-address-climate-change
7. Levine R. Climate Change and Health Equity Strategy Supplement December 2023. 2023 Dec. https://www.hhs.gov/sites/default/files/hhs-climate-change-health-equity-strategy-supplement.pdf
8. Anastassia Gliadkovskaya. Novant Health’s new sustainability goals target net-zero emissions, supplier engagement. Fierce Healthcare. 2022. https://www.fiercehealthcare.com/providers/novant-health-sets-new-environmental-sustainability-goals
9. Atrium Health Environmental Sustainability Office. Environmental Sustainability. Atrium Health. https://atriumhealth.org/about-us/environmental-sustainability
10. Duke Today. October 16, 20204. Already Looking Ahead to Next Steps: 2050 Climate Goals will be broader, more nuanced, and based on science. https://today.duke.edu/2024/10/already-looking-ahead-next-steps?utm_source=newsletter&utm_medium=email&utm_content=Carbon%20goal%202.0%3A%20next%20steps%20for%20Duke&utm_campaign=dukedaily2024_10_23