Understanding Perspectives on Decarbonizing the Health Sector 


Climate change is increasingly affecting people’s health—yet the health sector has a sizeable carbon footprint accounting for approximately 8.5% of U.S. carbon emissions. To address this, the NAM launched the Action Collaborative on Decarbonizing the U.S. Health Sector in 2021—a public-private partnership of health sector leaders to highlight ways to reduce the sectors’ environmental impact and strengthen its sustainability and resilience.

In early 2023, the Climate Collaborative conducted five focus groups with stakeholders across the health sector to identify knowledge gaps, attitudes, perceived barriers, and opportunities related to decarbonization. This activity engaged 30 participants, representing community based organizations, health professional educators, clinicians, learners, and patient advocacy organizations. The NAM also issued a public, complementary survey (about 250 respondents) to further engage with additional stakeholders and communities regarding their perspectives on decarbonizing the health sector. Below is a summary of the high-level findings of these engagements.

We hope that these findings help inform the work of those across the health sector who are invested in decarbonizing their organizations. The Climate Collaborative believes it is important to include the perspectives of and engage many different actors to accelerate and ensure the success of sustainability efforts. 

Key Findings

  • When survey respondents were asked about their level of support for decarbonizing the health sector, almost all (96%) indicated they were supportive — with many highlighting the sectors’ ethical responsibility to “do no harm.”  

Climate and health are inextricably linked, with the harshest impacts landing on those with the least. If we don’t continue to decarbonize, we are part of the problem not the solution. We are ethically and professionally obligated to act to reduce and mitigate the impact of climate changes as well as adapting to the changes.

  • Across the survey and focus groups, participants identified that they wanted a deeper understanding of the impact of climate change on health outcomes and actionable steps for decarbonizing at the local level — to support both individual and organizational behavior change. 
  • Participants expressed interest in having success stories, examples, and data to be able to do “evidence-based” advocacy and demonstrate the business case for decarbonization.
  • Participants often raised the issue of having competing priorities and/or the lack of time to get involved. Others expressed that their primary concern was cost and that they would not support passing on additional costs to patients — especially those already under-served by the sector. 
  • Participants frequently stated having leadership buy-in is a key facilitator of change. When those at the top (i.e., the decision-makers) make sustainability a priority, the day-to-day changes become that much easier to implement and maintain.  
  • Participants consistently pointed to the value in promoting higher levels of awareness across the sector. They emphasized the importance of consistent and tailored communication — to meet people where they are at in their decarbonization journey and how awareness and education can go a long way in shaping attitudes, perceptions, and ultimately sustainable behaviors. 

Healthy humans can’t come from contaminated environments. My whole purpose as a physician is to protect health.

I work in the manufacturing industry, and we find that the greatest leverage we have to bring about change is when our customers demand it. Similarly in health, the Climate Collaborative can bring a unified voice to all stakeholders.

  • Participants expressed interest in the Climate Collaborative driving change at a variety of levels in the system (i.e., through standards, regulation, manufacturing, etc.) and for the group to send a strong and clear message about the importance and urgency of decarbonizing. 


The funding support extended by the NAM Climate Grand Challenge’s sponsors makes work like this possible. See full list of sponsors. 

Disclaimer: The full activity overview, summary, and related analysis of the focus groups and survey was prepared by Corinne N. Berry (Founder and CEO of CB Strategy Lab, LLC). The focus groups were conducted by members of the Health Professional Education and Communication Working Group of the NAM Action Collaborative on​ Decarbonizing the U.S. Health Sector, Katie Huffling (Alliance of Nurses for Healthy Environments), Shaneeta Johnson (Morehouse School of Medicine), Teddie Potter (University of Minnesota School of Nursing), Natasha Sood (Medical Students for a Sustainable Future (former)), and Erika Strickler (University of California, Irvine (former)). Additional input on these products and activities were provided by members of the Working Group. Statements in this product do not necessarily reflect the views of all members of the Action Collaborative; the NAM; or the National Academies of Sciences, Engineering, and Medicine (NASEM). This product is intended to help inform and stimulate discussion. It is not a report of the NAM or the NASEM. Copyright by the National Academy of Sciences. All rights reserved.

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