The Case for Decarbonization – Why Healthcare Must Lead the Climate Response

Healthcare systems are at a pivotal crossroads. As climate change accelerates, the sector faces a dual challenge: maintaining mission-critical operations while reducing its significant environmental footprint.

Hospitals and medical centers are among the most energy-intensive building types, driven by the need for tightly controlled indoor air environments that support infection control, patient safety and 24/7 operations. Yet, this very intensity positions healthcare as a powerful leader in the global decarbonization movement.

A Moral and Strategic Imperative

At its core, healthcare is about protecting and improving human health. Climate change, with its cascading effects on air quality, disease patterns and extreme weather events, is one of the greatest threats to public health in the 21st century. Decarbonization—reducing greenhouse gas emissions from building operations and construction—is not just an environmental responsibility; it is a moral obligation aligned with healthcare’s mission.

Grassroots initiatives like the Health Care Climate Challenge, led by Global Green and Healthy Hospitals, are mobilizing health systems worldwide to take measurable action on climate mitigation, resilience and leadership. In the U.S., programs such as ASHE’s Energy to Care are helping hospitals track and reduce energy use, demonstrating that sustainability can go together with operational efficiency and cost savings.

But the case for decarbonization extends beyond ethics. It is also a strategic opportunity. Hospitals face rising utility costs, aging infrastructure and increasing scrutiny from regulators, investors and communities.

With the right systems and training, facilities teams can maintain high-performance environments while significantly lowering energy use. By prioritizing sustainability, healthcare organizations can:

• Reduce operational costs through energy and water efficiency.
• Enhance resilience against power outages and climate-related disruptions.
• Strengthen brand reputation as forward-thinking, community-focused institutions.
• Align with ESG goals and attract sustainability-minded partners and talent.

Policy Pressure and Market Momentum

State and federal policies are accelerating the shift. In New York, for example, decarbonization legislation is compelling healthcare systems to modernize their infrastructure. Federal incentives and utility grants—such as those offered by New Jersey’s Clean Energy Program—are helping offset the upfront costs of energy upgrades and increasing resiliency of the structure by reducing its dependency on the grid.

These pressures are reshaping the role of healthcare facilities in the climate conversation. No longer passive energy consumers, hospitals are becoming active participants in grid stability and climate resilience. Some, like Newark Beth Israel Medical Center, are installing Combined Heat and Power (CHP) plant to reduce reliance on the grid and avoid brownouts. While these systems require dedicated staffing or outsourcing, they offer long-term benefits in reliability and cost control.

Cultural Change and Leadership Alignment

Decarbonization is not just a technical challenge—it’s a cultural one. Success depends on alignment across leadership, staff and patients.

This cultural shift must be supported by data. Metering and tracking energy use across systems enables facility managers to identify high-impact opportunities and measure the return on investment. It also empowers organizations to make informed decisions during renovations or equipment upgrades—moments when integrating energy-efficient systems is most cost-effective.

A Call to Action for Healthcare Leaders

For healthcare executives and facility managers just beginning their sustainability journey, the advice is clear: start now, even with small steps. Incorporate energy-efficient systems during renovations. Invest in metering and controls that provide actionable insights. Design new buildings with future electrification and decarbonization in mind.

The hospitals that act today will be better positioned for tomorrow’s regulations, incentives and expectations. Those that delay may face higher costs later—whether through carbon taxes, energy volatility, or reputational risk.

Up Next in Part 2: We’ll explore the how of decarbonization—practical strategies for reducing emissions through smart design, material selection, and energy systems that support both sustainability and patient care.