An emerging conversation about climate change places healthcare institutions, and the buildings that house them, at an inflection point. The health effects of climate change are real, apparent, and urgent.

The 3rd U.S. Climate Assessment, published in 2014, found that climate change both amplifies existing health conditions (such as asthma, allergies, and cardiovascular disease) and threatens human health in new ways (such as the threat posed by contact with disease-carrying insects as they migrate to more temperate climates or closer to human settlements).

Two reports issued this summer underscore the significance of health as an opportunity to galvanize action on climate change: the papal encyclical released by Pope Francis in May and a report released in June by the Lancet Commission on Health and Climate Change.

The encyclical calls on all people, not only Catholics, to respond to environmental degradation and climate change from an ethical framework: It’s humanity’s responsibility to protect the poor, who are both most vulnerable to exposure during climatic events and least capable of recuperating after them.

Pope Francis’s appeal places these populations, who often find themselves in hospital emergency rooms following heat waves, floods, hurricanes, and other climatic events, in a new context. Traditionally, many health systems have confined their response to the health effects of climate change to providing services during and immediately after extreme weather events. As was documented during Superstorm Sandy, they often become ad hoc emergency shelters for the general public. However, when viewed within the larger context set out by the encyclical, their responsibility for action is much greater.

Hospitals contribute to climate change through their operational practices—they are the second most energy intensive commercial building type in the U.S., according to the Energy Information Administration’s Commercial Buildings Energy Consumption Survey. And their contribution to the 31 percent of greenhouse gas emissions attributable to power generation is proportional to their electricity usage, according to the U.S. EPA.

On the other hand, regulations require hospitals to plan for utility outages. In this way, they are a natural partner for community resilience initiatives aimed at transitioning our energy and water infrastructure from a centralized system to multiple, distributed systems. And, they hold the moral authority to both talk about the health effects of climate change and lead by example in efforts to reduce greenhouse gas emissions and enhance resiliency.

Three recent polls of physicians in the U.S. found that 70 percent of respondents had already started to see the health effects of climate change in their patients through exacerbated seasonal allergies, asthma, and chronic obstructive pulmonary disease (COPD), among other symptoms.

The Lancet Commission’s report offers a framework for the healthcare industry to raise the profile of climate change as an urgent health threat— through both physician advocacy and facility leadership. It concludes that climate change may actually be “the greatest global health opportunity of the 21st century” (emphasis added), because so many strategies aimed at reducing greenhouse gas emissions also benefit human health.

The two examples relevant to the building industry called out in both the papal encyclical and the Lancet report are energy efficiency and renewable power. Pope Francis describes them as beneficial to health, because they can help alleviate poverty. Energy efficiency reduces the day-to-day financial burden on the poor. And, renewable power is a technology that can spur economic growth and independence in poor, rural communities.

The Lancet Commission points to the specific health outcomes associated with each strategy. Replacing fossil fuel energy sources with renewable energy can lead to improved cardiovascular and respiratory health among populations downwind from legacy power plants. Energy efficiency, together with access to active transportation and green spaces, is a key feature of green urbanism.

The litany of health benefits associated with these improvements to the built environment includes the most prevalent and costly diseases facing the world today: cardiovascular and respiratory disease, cancer, obesity, diabetes, and mental illness.

There are many examples of health systems across the U.S. championing both of these strategies in the name of green building. However, more can and should be done to demonstrate the healthcare sector’s leadership in protecting their patients from the health effects of climate change. Happily, these actions will also help the industry grapple with the chronic disease epidemic facing not only our nation but the world.


Adele Houghton, AIA, MPH, LEED AP BD+C, O+M, ND, is president of Biositu LLC and is an architect and green building professional. She can be reached at