Wellness and Sustainability

By Janet Brown Director of Facility Engagement and Director of Content and Outreach, Healthier Hospitals Initiative on July 9, 2012

Health care needs to look at the “cause of the cause” when creating more sustainable hospitals.

Data from the U.S. Centers for Disease Control and Prevention show that approximately 75 percent of all health care costs are for the treatment of chronic diseases. By addressing the root causes, participants can reduce the burden that these diseases place on individuals and on society.

Dr. Richard Jackson, Professor and Chair of Environmental Health Sciences at the UCLA School of Public Health, explained in his 2012 CleanMed keynote address that “public health needs to look at the cause of the cause.” For example, if a person is hit by a car and killed, that death is recorded as the result of an accident. Dr. Jackson asked us to look closer: Why was the person hit by the car? Was there a way to walk along the road safely? Was there a sidewalk? He would argue that the cause of death was the poor design of the community or the lack of a place to walk in an area without the risk of being hit by a car.

Dr. Jackson (showing images as he spoke) talked about the design and construction of American roads, housing, and communities and how design and construction decisions have a long-term impact on health. The results are startling—rising health care costs, the obesity epidemic, cancer rates, dwindling landfills, contaminated waterways, learning disabilities, and chemicals found in cord blood of newborn babies, among many others. We can take this evidence—the science, the research, the personal experiences—and look to the source or “the cause of the cause,” to use Dr. Jackson’s phrase. Rather than continuing to take action such as cleaning a river, treating cancer, or taking diabetes or cholesterol medication, can we identify the cause of the cause and learn how to prevent the outcome?

This notion of looking for the cause of the cause is a familiar application in sustainability and the Healthier Hospitals Initiative. For years, I implemented recycling and waste programs as the Waste Manager at Beth Israel Medical Center in New York; I worked to clean up messes every single day. It’s like Sisyphus and his rock: push the rock up the hill each day, watch it roll back down the hill at the end of a long day, and then push it back up again. This Greek myth, which embodies how punishing such a useless act can be and how it can lead to extreme frustration, is an analogy of the health care system model today and its many “first steps” toward sustainability. As a waste manager, I was faced each day with a pile of new material: reports about pharmaceuticals in the water, rising autism rates, brominated fire retardants in the bloodstream, rate of juvenile diabetes. Many of these outcomes result in treatment with medication, which then ends up in the drinking water.

“We see [the HealthyAtTenet wellness] program as supporting our overall sustainability initiative by improving the health of our employees and their spouses, which not only leads to lower medical claims but also is an important part of our engagement activities.“

—Melinda Lokey, Director of Sustainability, Tenet Healthcare

Can we make decisions in manufacturing and purchasing that could prevent waste and keep toxic materials from entering the waste stream? Rather than avoiding consumption of mercury-contaminated fish, we could avoid purchasing mercury or even prevent mercury from entering waterways altogether. Instead of recycling, we could purchase reusable goods to prevent the generation of new material. We could avoid toxic chemicals like DEHP, brominated fire retardants, perfluorinated compounds, formaldehyde, meat, sugar-sweetened beverages, and unneeded components of surgical kits. We could avoid coal-fired power plants through green energy procurement or renewable energy sources, and we could consume less energy altogether. These acts of prevention could result in a safer environment, reduced costs, and healthier people.

By enrolling in the Healthier Hospitals Initiative, facilities demonstrate that they “get it.” They are joining a community and working together to take action; they understand that sustainability prevents problems and is a prescription both for maintaining health and for controlling the excessive use of natural resources at the expense of public health, now and in the future.

Melinda Lokey, Director of Sustainability for Tenet Healthcare, explains: “The HealthyAtTenet wellness program includes wellness challenges in the areas of nutrition, exercise, and work/life balance,” Lokey says. “We see this program as supporting our overall sustainability initiative by improving the health of our employees and their spouses, which not only leads to lower medical claims but also is an important part of our engagement activities.”

Lokey continues, “Based on successful completion of the challenges, employees earn credits and are rewarded with incentives when they reach various levels. An annual health assessment is required for all incentive levels, and an annual physical is required for the top two incentive levels. Benefits-eligible employees can earn from $150 to $600 in incentives based on the number of credits earned throughout the year. The program also includes the Tenet Personal Health Team, whose members provide lifestyle and wellness coaching, along with chronic condition management.”

Enrolled hospitals are learning more on the Healthier Hospitals’ blogs and forums, accessing case studies and how-to guides, and making a commitment to positive changes. In short, through the Healthier Hospitals Initiative, hospitals are attempting to address “the cause of the cause.”

Health care systems and facilities that have joined HHI

  • Advocate Health Care
  • Bon Secours Health System
  • Dignity Health
  • HCA Healthcare
  • Inova Health System
  • Kaiser Permanente
  • MedStar Health
  • Partners HealthCare
  • Tenet Healthcare
  • Catholic Health Initiatives
  • Vanguard Health Systems
  • Gundersen Lutheran Health System
  • Aria Health (System)
  • Boulder Community Hospital
  • Bradley Hospital
  • Johns Hopkins Health System
  • Martha Jefferson Hospital
  • Meriter Health Services
  • Norwalk Hospital
  • San Luis Valley Regional Medical Center
  • St. David’s North Austin Medical Center
  • Valley Hospital
  • University Health Network
  • UT Southwestern Medical Center
  • Palomar Health–Downtown Campus
  • Palomar Health–Palomar Medical Center
  • Palomar Health–Pomerado Hospital
  • South Seminole Hospital
  • Ridgeview Medical Center

For More Information

Learn more and enroll in this free initiative at www.healthierhospitals.org. Listen to the introductory archived webinar at www.practicegreenhealth.org/webinars/introducing-healthier-hospitals-initiative.