Urban medical institutions play an important role in fostering and safeguarding public health through a wide and critical array of spaces and services. But how well do their physical campuses support this mission of public health?

In the context of climate change specifically, the reality is alarming. In fact, the healthcare sector is a major contributor to the climate crisis, with an impact equivalent to nearly four percent of global net carbon emissions, according to Health Care Without Harm, an international nongovernmental group focused on environmental and social justice.

What can be done to help reduce the industry’s climate impact? The planning and design process offers a number of opportunities to effect change and address the climate crisis. For example, implementing more efficient and sustainable building systems can lead to meaningful reductions in carbon emissions for campuses with intensive operational energy use and extensive land-area footprints. Design teams can work to promote other essential climate-related demands of the coming decades, too, including supporting alternative transportation options and managing stormwater to protect communities against flood events.

With these goals in mind, here are three strategies for architects and urban designers trying to make an impact through planning and designing:

  1. Energy efficiency and utility management. In the commercial office and multifamily sectors, designers have long pushed clients toward higher levels of energy efficiency through the use of solar arrays and other onsite power generation, and highly energy efficient mechanical systems, fixtures, and appliances. In order to advance public health from an environmental and climate justice standpoint, design teams must also encourage healthcare clients to adopt these forward-looking building systems and utility management practices across their campus. On the building scale, specifying efficient LED lighting, low-flow fixtures in washrooms, or even modern MRI machines and laundry equipment can provide significant energy savings and a positive impact on an institution’s carbon footprints.

The technology and design of mechanical, electrical, and plumbing (MEP) systems can work to minimize local emissions and reduce energy and resource use, as well. For example, greywater reuse systems treat used water with chlorine and ultraviolet light and then recycle it for flushing toilets and similar functions, cutting down on water consumption.

  1. Active design and transit alternatives. Over the past decade-plus, the core principles of active design, such as locating stairs to encourage physical movement, have gained widespread acceptance as a means for using architecture to support public health. To improve public health outcomes and reduce carbon emissions in the urban medical campus context, approaching active design at an even broader scale has been shown to offer another useful strategy.

For example, master planning initiative or building initiatives should consider opportunities for locating patient programming and primary entries within walking distance of a transit hub or transit stop (roughly 10 minutes has been recommended by numerous planning groups such as the Institute for Livable Cities). In addition, designing safe and accessible pedestrian routes both on and around healthcare campuses and hospital complexes can create natural incentives for transit use and reduce emissions from private vehicles, which lowers the overall carbon footprint of activity associated with the medical campus and promotes healthy behaviors for patients and the entire community.

  1. Planning for severe weather events. With extreme flooding now more common in urban environments, working to reduce carbon emissions (mitigation) is not enough to safeguard medical campuses and their surrounding communities against the acute effects of climate change. The strategic location, scale, and landholdings of many medical campuses offer a canvas for solutions that can improve their ability to withstand extreme flood events. Choosing the most effective solutions depends on a variety of factors including climate, hydrogeology, and existing building siting and characteristics, as well as local policy and utility management practices.

In general, however, design teams should prioritize upgrades to on-site water retention and detention through the creation of robust and resilient stormwater systems—an approach that allows for low-impact mitigation against severe weather by absorbing and channeling rainfall and groundwater away from vulnerable areas such as building entrances, public plazas, and pedestrian rights of way. For the new research campus for the Children’s Hospital of Philadelphia (CHOP; Philadelphia), Cooper Robertson developed a solution to address not only current conditions but also future challenges, using a combination of green roofs, rain gardens, and underground cisterns that enable the collection, conveyance, and retention of 85 percent of the stormwater generated on the site.

By taking a holistic approach to the urban medical campus, it’s possible for design teams to address multiple and wide-ranging, yet interconnected, challenges at the same time. Climate change, resiliency, and public health are tightly linked, and when creative design solutions take all three issues into consideration, the entire community will see the benefits.

 Anjulie Palta is an associate at Cooper Robertson (New York). She can be reached at apalta@cooperrobertson.com.