How can the U.S. build a healthcare system that will withstand the ever-increasing threat of extreme weather events? How can hospitals be the last buildings standing – a place of refuge for the community – during a climate emergency? 

Earlier this week, the White House organized a high-level roundtable with some of the nation’s leading hospitals to discuss exactly these questions – how we can embed climate resilience and environmental sustainability into our U.S. healthcare system? 


At that meeting ten of the most influential hospital systems discussed the challenges they face in addressing climate change and the need to invest political and financial resources into our health care infrastructure. The meeting was an inspiring counterpoint to the climate change denial and gridlock we’re seeing from Congress these days. The sentiment in the room was that climate-resilient U.S. health care system is within our grasp and we had already built the scaffolding and momentum to make it happen. 

What is clear is that we can’t build a climate resilient and sustainable health care system without first having a new, national conversation. And hospitals need to lead it. 

Rather than a political debate about climate change, we need to reconsider what it means to provide care while facing the next Katrina or Sandy. Health care is a 24-hour a day, 7-day a week industry and we depend on hospitals to protect and care for us when disaster hits. And so the question is, how do we build resilient health systems – and by extension, resilient communities – that can weather the coming storm?  

It starts with anticipating the unexpected. It’s looking like 2014 has been the hottest year in recorded history, continuing a global trend towards dangerous heat and weather extremes. Climate change has created a new norm of heightened public health risk, and health care needs to adapt to meet that challenge. 

When designing our facilities, we need to consider how things like emergency management, energy efficiency, and community coordination impact our ability to provide care. When the power grid goes down and back-up generators fail, renewable energy should be available on-premises. When water systems become unavailable, reserves for drinking and sanitation need to be at the ready. All critical electrical equipment should be placed on high floors in case of flooding. Hospitals should work with local suppliers to ensure that there is no shortage of crucial resources. By weighing health outcomes through the climate change lens we will be better prepared to manage patient care in the face of environmental disasters. 

We’re seeing efforts like these around the country. Health care leaders are recognizing that resilient health systems are not just buildings that can withstand harsh weather. They are new models of care: effective planning can lead to better patient outcomes and reduced operational costs. Implementing climate mitigation and resilience strategies can reduce strain on facilities when faced with extreme weather, and many infrastructure changes – such as improved energy efficiency – lead to long-term savings that can in turn be invested in patient care. 

But it is not enough that hospitals alone weather the storm. We need to ensure the communities we serve are equally prepared. The community as a whole needs to survive. 

When we talk about the impacts of extreme weather, we are really talking about how those disasters affect the health of individuals and communities. During a weather related disaster, people turn towards their hospital as a place of refuge, but those hospitals need to be supported by (and support) a broader community-driven response that minimizes strain across the entire system and ultimately ensures the health and wellbeing of the community members. 

Driven to provide better care and support for their patients and communities, hospitals around the United States are rethinking how they need to prepare for extreme weather. We’re seeing the start of a movement. And it’s clear we need this movement now more than ever. A new report from Yale and George Mason University found that Americans by and large are unaware of the health related consequences of climate change or that climate change affects different populations in different ways

Many leading health systems, such as those participating in the Health Care Climate Council, are already building successful climate mitigation and resiliency strategies into their operations and among the communities they serve. And we’re getting support. During the meeting, the Administration released a new guide for health care providers, design professionals, and policymakers to promote continuity of care before, during, and after extreme weather events. 

We need to push forward with that momentum. We need more transparency, commitment, and conversations around effective planning. We need to improve our own operations and work with community leaders to prepare for the worst an unstable climate has to throw at us. 

And when a disaster does hit, we need to be at the center of the response.

Cohen has been a pioneer in the environmental health movement for thirty years. He is president and co-founder of Health Care Without Harm and Practice Greenhealth and he was instrumental in bringing together the NGOs and hospital systems that formed the Healthier Hospitals Initiative. The White House presented him with the Champion of Change Award for Climate Change and Public Health and the Huffington Post named him a Game Changer in Healthy Living.