Climate footprint
Can hospitals fix this on their own, or does the carbon live in what they buy?
US health care produced about 553 million metric tons of carbon dioxide equivalent in 2018, roughly 8.5 percent of national emissions and more than the aviation industry. Most of that comes from purchased goods and energy, not direct facility operations, and hospitals score only average on energy efficiency.
The problem
The health sector is both a climate-risk responder and a contributor to emissions, which creates a strategic contradiction for hospitals and suppliers. Facilities must remain resilient during climate-driven emergencies while reducing the supply-chain and energy footprint created by the care delivery model itself.
The recommendation
Make decarbonization part of health-system stewardship and enterprise risk management. The recommended strategy is to prioritize supply-chain emissions, facility efficiency, resilience investments, and climate-weighted procurement so hospitals can reduce harm while protecting continuity of care.
The footprint
How big health care's climate impact is, whether it is rising, and the public-health harm it does.
Where it comes from and the levers
Which activities drive the emissions, whether the fix lives upstream in the supply chain or on-site, and how efficient the buildings themselves are.
Health sector emissions by source category
Global health sector shares by category, Health Care Without Harm and Arup, 2014 data. Listed categories do not sum to 100 percent.
Read it this way Energy and facilities at 53 percent dwarfs every other listed category, including food and transport combined, so building-level energy use is the largest single lever among the categories shown. This is a global estimate on 2014 data using a different model than the US 8.5 percent headline figure, and the five categories do not sum to 100 percent, so activity outside this breakdown exists too. Use this chart to see where the footprint or climate harm sits, then connect the evidence to the recommendation to prioritize supply chain, facilities, and resilience rather than symbolic sustainability projects.
Caveat This breakdown is a global estimate on 2014 data from a different model than the US 8.5 percent headline, so the two are not directly comparable. The five listed categories capture the largest reported shares and do not sum to 100 percent.
⊞ data table⬇ CSV
| Source category | Share of sector emissions % |
|---|---|
| Energy and facilities | 53 |
| Food and agriculture | 9 |
| Transport | 7 |
| Pharmaceuticals and supply chain | 5 |
| Anesthetic gases | 0.6 |
Health Care Without Harm and Arup, Health Care's Climate Footprint · 2014 · source
Where health care's carbon lives: supply chain versus direct operations
82 percent of sector emissions come from purchased goods and services. Direct facility operations are the complement, 18 percent.
Read it this way The 82 percent flowing through purchased goods and services versus 18 percent from direct facility operations means most of the emissions lever sits with what hospitals buy, not what they burn on-site. Since this is a two-way split of the same estimate, procurement decisions like device and pharmaceutical purchasing carry more climate weight here than facility retrofits alone. Use this chart to see where the footprint or climate harm sits, then connect the evidence to the recommendation to prioritize supply chain, facilities, and resilience rather than symbolic sustainability projects.
Caveat The 82 percent supply-chain share is from Eckelman and Sherman 2020. The 18 percent direct-operations figure is the complement (100 minus 82).
⊞ data table⬇ CSV
| Segment | Share of sector emissions % |
|---|---|
| Purchased supply chain | 82 |
| Direct facility operations | 18 |
Eckelman and Sherman, Health Affairs 2020, Health Care Pollution and Public Health Damage · 2018 · source
Why this matters
An estimated 82 percent of sector emissions come from the purchased supply chain, devices, pharmaceuticals, and other goods and services, versus 18 percent from direct facility operations, and in a separate global breakdown energy and facilities still account for the largest single reported category, 53 percent, among listed activities. Hospitals also average a middling energy-efficiency score, 50 out of 100, suggesting room to improve on-site performance even though it is not the dominant lever.
Recommended actions
- Prioritize procurement standards for devices and pharmaceuticals as the largest lever, given the 82 percent supply-chain share.
- Pursue hospital energy-efficiency upgrades as a secondary but still material lever, given the average ENERGY STAR score of 50.
- Treat the 8.5 percent headline as a modeled estimate subject to revision, not a directly measured figure, whenever it is cited.
- Track sector emissions growth against other industrialized nations' pace, since 2010 to 2018 US growth outpaced peers.
- Report the public-health cost, disability-adjusted life years, alongside the emissions figure, since the harm compounds rather than sitting separate from it.
The recommendation
Therefore, make decarbonization part of health-system stewardship and enterprise risk management. The recommended strategy is to prioritize supply-chain emissions, facility efficiency, resilience investments, and climate-weighted procurement so hospitals can reduce harm while protecting continuity of care.
Demographic slice none. sector-emissions data has no patient-demographic dimension.
Sources