By Jenny Keroack and Winslow Dresser, Health Care Without Harm

More frequent and severe natural disasters caused by climate change are impacting businesses across the U.S. The health sector is no different. As health care organizations seek to preserve 24/7 access to care and keep their staff and facilities safe, their resilience innovations can serve as a model for other industries.

Practice Greenhealth’s Environmental Excellence Awards found that over one-third of participating health systems were impacted by an extreme weather event in 2024. Another survey found that 75% of health care leaders around the world have noticed climate change-related events impacting their abilities to deliver quality care. 

Due to these threats to the health care industry’s mission and financial sustainability, many organizations have piloted efficient and renewable energy upgrades that protect patients and staff by decreasing a facility’s environmental pollution and reliance on outside energy sources.

Learning From the Health Sector's Climate-Smart Approach

Health Care Without Harm, an international organization helping  the health sector respond to the medical emergency of climate change, recommends that resilient health systems and communities include three interrelated categories: health care facility resilience, public infrastructure resilience, and community health resilience. 

Health care organizations have addressed all three categories through community-focused emergency preparedness planning and site improvements that increase energy efficiency and leverage renewable energy, offering valuable lessons for any business seeking to avoid operational disruptions in the face of climate change.. 

Reliable Energy in a Crisis

Many health care organizations are required to have backup power but can choose between options such as diesel generators, natural gas, or onsite renewable energy. Diesel generators are a common form of backup power — about 85% of commercial buildings and critical facilities rely on diesel — but they cause local air pollution, can be expensive to operate, and are vulnerable to fuel delivery disruptions. One analysis found that even under the best maintenance and care, diesel generators are only 80% likely to provide power for the duration of a two-week grid outage.

That's why many health care organizations are switching to proven onsite renewable energy generation systems like solar, geothermal, and combined heat and power to protect patients and staff. For example, Greenwich Hospital’s combined heat and power system enabled it to continue normal operations throughout Hurricane Sandy in 2012. Staying open also allowed the Connecticut hospital to protect its staff, sheltering 150 staff members overnight during the storm. 

An All-Hazards Approach

Health care emergency preparedness requirements emphasize an all-hazards approach that includes considering how actions and plans respond to a wide array of threats. Using this paradigm, many health care organizations have found strategies to ensure resilience investments are effective against a range of natural disasters.

Following Hurricane Sandy, NYU Langone implemented resilient design features, including highly efficient air filtration systems. These investments paid off during the 2023 Canadian wildfires, when the filtration systems reduced patient and staff exposure to toxic particulate matter.

Benefits on Blue Sky Days

Health care organizations have thought creatively about how resilient design features can be an opportunity to support clients and staff even on ordinary days. For example, Kaiser Permanente’s 2-megawatt solar array on parking lot canopies and the top deck of its Ontario, California hospital parking garage will provide emergency backup power, as well as much-needed shade for patients and staff. 

Sustainable design features can also benefit patients when they're outside a hospital’s campus, extending into the community. Boston Medical Center uses its solar panel array to support vulnerable patients directly, piloting a replicable and innovative program that offers patients monthly energy credits to help them stay cool during heat waves, warm in the winter, and have cleaner air to breathe during wildfire and other air pollution events. 

Ripple Effects of Resilient Design

Opening a new facility is a great opportunity to consider state-of-the-art sustainable design features. Colorado-based Pueblo Community Health Center integrated sustainability and resilience into its plans for a new health care facility in Pueblo’s underserved East Side neighborhood in 2020. The business case for these investments was strong, showing renewable and energy-saving measures are expected to pay off through lower utility expenses in 7 - 8 years.

The new clinic opened in January 2022 and was the first healthcare center in North America to be identified by the New Buildings Institute as a net-zero facility.  Pueblo Community Health Center’s net-zero achievement inspired the local Urban Renewal Authority to designate an urban renewal district surrounding the clinic, sparking revitalization in its community. 

Protecting Staff With Real-Time Data

The health sector’s approach to climate resilience goes beyond site improvements and includes community engagement, collaboration between health care organizations to plan for evacuations and other joint efforts, as well as support for staff preparedness and resilience. 

One example with broad applicability to other industries is a technology-driven approach to staff safety and staffing planning. For example, Loma Linda University developed a custom GIS map displaying the residential locations of all employees overlaid with real-time wildfire evacuation zones across Southern California. During an active wildfire event, the GIS map empowered the university to make informed staffing decisions, ensure operational continuity, and proactively support affected employees. 

Considering Costs and Opportunities

In deciding which resilience investments to pursue, businesses should weigh not just the upfront costs but also the financial risks of inaction. Some health care organizations have learned this lesson the hard way, incurring severe financial losses due to natural disasters. 

For example, the air filtration system and other resilience investments at NYU Langone were made after Hurricane Sandy caused extensive damage and shut down operations, leading to an estimated $400 million in lost revenue.

In addition to lost revenue due to canceled services, losing inventory can also be costly. During a heat wave that coincided with a prolonged power outage in New Orleans, CrescentCare Community Health Center lost over $250,000 in refrigerated medicines and vaccines because their gas-powered generators failed. CrescentCare responded by installing a solar microgrid with a backup battery system to help ensure that the health center can remain operational during natural disasters and power outages. This investment also helps reduce utility expenses. 

While the upfront investments can be significant, there are key federal tax credits that support this work in the near term.

The Combined Work of Climate Resilience 

Across the country, health care organizations have leveraged the all-hazards approach along with clean and resilient design features to better serve their patients and protect their staff, offering innovative approaches that can and should be replicated across sectors.

For more information on health sector climate resilience, check out the Climate Resilience for Health Care Toolkit and Health Care Without Harm’s Introduction to Climate Resilience. 

Health Care Without Harm is an international organization dedicated to providing resources, knowledge, and inspiration for the health care sector to help reduce its environmental impact. They have been advocating for the environment and our health since 1996. Since its inception, the nonprofit has grown to lead and partner in groundbreaking initiatives in more than 86 countries. Gary Cohen, Co-Founder and Board Member of Health Care Without Harm,  is a Commissioner on HAA’s National Commission for Climate and Workforce Health.

Jenny Keroack is Director of Program Strategy and Management for Health Care Without Harm. She previously served as a policy advisor to the Secretary of the Department of Health and Human Services (HHS), senior leader in the HHS Office of Climate Change and Health Equity, and Medicare policy analyst at the Centers for Medicare & Medicaid Services, leading initiatives including the Catalytic Program on Leveraging the Inflation Reduction Act and the Secretary’s Initiative on Protecting Farmworkers from Extreme Heat and Wildfire Smoke.

Winslow Dresser is Health Care Without Harm's Associate Director of Climate Solutions. His background in environmental conservation and resilience includes serving as associate field director for the Trustees of Reservations, where he oversaw the stewardship of conserved lands across Massachusetts and worked to build an organizational culture around safety, efficiency, and collaboration.

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