Toward a Climate-Ready Health Care System: Institutional Motivators and Workforce Engagement

Climate Change

Policy Points:

  • The US health care system faces mounting pressure to reduce greenhouse gas emissions and adapt to the impacts of climate change; motivated institutions and an engaged health care workforce are essential to the development, implementation, and maintenance of a climate-ready US health care system.
  • Health care workers have numerous profession-specific and role-specific opportunities to address the causes and impacts of climate change.
  • Policies must address institutional barriers to change and create incentives aligned with climate readiness goals.
  • Institutions and individuals can support climate readiness by integrating content on the health care implications of climate change into educational curricula.

Climate change is increasingly recognized as a preeminent health threat.1, 2 It has numerous direct and indirect health impacts and exacerbates health inequities.1-3 Recent health-related activity on climate change has focused on public health research, climate mitigation policy and advocacy, and efforts to improve sustainability at health care institutions.4-6 Much of this work is being done on an ad hoc or volunteer basis and is often focused on the role of specific professionals such as doctors, nurses, and epidemiologists or single-issue or single-item institutional sustainability initiatives.

The need for a climate-ready health care system, defined as one that minimizes greenhouse gas (GHG) emissions and is prepared for and resilient to the impacts of climate change on facilities and patients, is becoming increasingly apparent. Recent climate-related natural disasters and the development of climate readiness initiatives by the US Department of Health and Human Services (HHS) have made the urgency of this issue clear.1,7 Achieving a climate-ready health care system will entail a substantial reframing of incentives and activity throughout the health care system.

Moving the US health care system toward a climate-ready posture will depend on two key factors: creating motivation for institutions to overcome existing barriers and become climate ready and engaging the US health care workforce in achieving climate readiness. Experience with previous systemic changes in US health care suggests that achieving large-scale transformation depends on aligning the actions of millions of health care workers with new goals and that to do so institutions must be incentivized to achieve these goals and provide avenues for their staff to engage effectively. Historical experience with achieving Health Insurance Portability and Accountability Act (HIPAA) compliance and implementing electronic health records (EHRs) provides important lessons for policymakers, health care leaders, educators, and health care workers as they seek to address the escalating impacts of climate change.

In the following perspective, we explore opportunities to move the US health care system toward climate readiness through institutional motivators, efforts to address barriers to action, and broad-based engagement of the health care workforce.


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  2. Intergovernmental Panel on Climate Change (IPCC).Climate Change 2022—Impacts, Adaptation and Vulnerability: Working Group II Contribution to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press; 2023.
  3. USGCRP. Fourth National Climate Assessment. U.S. Global Change Research Program; 2018:1-470. Accessed November 10, 2023.
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  7. 2021 Climate action plan. U.S. Department of Health and Human Services. 2021. Accessed November 10, 2023.

Dresser C, Johns Z, Palardy A, McKinnon S, Breakey S, Viamonte Ros AM, Nicholas PK. Toward a Climate-Ready Health Care System: Institutional Motivators and Workforce Engagement. Milbank Q. 2024;102(2):0116.