Confronting climate change to protect health

Author: Brian Chesebro, M.D., medical director, Environmental Stewardship, Providence Oregon; Department of Anesthesiology, Providence Portland Medical Center

Our Providence vision is “health for a better world.” This inspiring vision crosses every scope and scale, including planetary health. Yet too often, kinship with our planet is lacking or overlooked.

Earth Overshoot Day, the date on which we’ve consumed more than the Earth can replenish in a year, continues to move earlier in the calendar. In 2020, we depleted the Earth’s annual budget on Aug. 22. This is unsustainable. As consumption continues to deplete environments and drive up carbon emissions, our health will suffer.

How climate affects our health

The health impacts of climate change are alarmingly apparent. As carbon builds in our atmosphere, we will continue to struggle against a variety of health impacts, ranging from heat-related illness and traumatic injuries to food/water insecurities and forced migration with geopolitical conflict.

In Oregon, we see the results of prolonged heat and drought contributing to longer, more severe wildfire seasons with greater destruction and hazardous air quality, for which our health pays a steep price. During the Oregon wildfires in September 2020, emergency room visits in the Portland area for breathing problems increased by 140%. Similarly, ED visits for thrombotic events such as strokes, heart attacks and pulmonary embolisms increased by 33%. In addition, mental health can become more tenuous as people deal with loss of life, security and natural resources.  

Understandably, all of this can feel overwhelming. Yet there is hope … and much we can all do, individually and collectively.

What Providence is doing

As an industry, health care is a significant source of carbon emissions and is responsible for 4.4% of global totals, with the United States contributing the earth’s highest per capita health care emissions. The environmental impact of health care has serious consequences, on par with the impact of preventable medical errors. Clearly, our responsibilities for both weigh heavily on our ethos to “do no harm.”

As such, Providence recognizes climate change as one of our most significant public health priorities. Last year, Providence committed to becoming carbon negative by 2030, meaning we will remove more carbon from the atmosphere than we emit. This is important, difficult work that touches every caregiver, department and community we serve.


Through Providence’s environmental advocacy WE ACT framework, we’re working to incorporate environmental measures and metrics in our clinical and administrative cultures.  Including environmental cost assessment into our value analyses will ensure we operate as sustainably as possible. Clinical caregivers are accustomed to patient safety and quality initiatives – environmental stewardship metrics also should be included in our assessments of quality and value.


Environmental stewardship is justice

While climate change is a global problem and we all contribute, suffering is greater in vulnerable communities where degrees of exposure, susceptibility and disparity are greatest.  The injustice is compounded as these poor and vulnerable populations often contribute the fewest emissions and pollution, yet disproportionately bear the brunt of the health impacts.

Our Providence commitment to justice extends to environmental stewardship, as we continue to step forward to address environmental injustice.

Through action, we create hope

We must all become environmental health advocates, both within and beyond Providence. We all play a part in the solution. Broad action must be taken at every level – locally, nationally and globally. The recent U.S. action to rejoin the Paris Climate Agreement is especially encouraging and necessary.

As Providence caregivers, we should:

  • Build and nurture a culture of stewardship and sustainability. At times, our individual efforts may seem insignificant, but our numbers are large and our collective actions add up to impressive totals. 
  • Mitigate wherever we can. Look carefully for opportunities to reduce, reuse, repurpose and recycle. Consider adopting environmental stewardship quality metrics and projects to fold into our current quality improvement programs and value analyses.
  • Adapt to protect and thrive. As an anchor institution, we must partner with our communities to anticipate environmental health and infrastructure risks. Careful, equitable planning is critical to building resilience in the most vulnerable.
  • Advocate relentlessly. As trusted caregivers in our communities, we can multiply awareness about the environment and health to inspire action among others. In doing so, we hold ourselves and others accountable to improve the quality of care we provide through continuous focus on environmental stewardship.


With climate change, our moral obligations lie both within our local communities and across the globe. Our responsibilities cross generational and socioeconomic lines, as our actions today shape the health and well-being of future generations and populations. We are facing an existential threat that demands a strong global commitment to justice and our planet. Nothing less will suffice.

For more information
Contact:  Brian Chesebro, M.D.

Providence information/resources:

Additional details about WE ACT:

Other resources:

About the Author

The Pulse content team focuses on bringing you the latest in clinical news from our world-class medical providers and physician leaders.

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