Both as an organization and as an idea, Health Care Without Harm sounds like a no-brainer. After all, “first, do no harm” is a fundamental principle of medical ethics, and isn’t medicine’s whole purpose to do the opposite of harm?
But organization founder and executive director Gary Cohen recalls that in the 1990s, it was discovered that hospitals were responsible for upwards of 10% of the emissions of two separate, dangerous pollutants: mercury and dioxin. “Here you’ve got a sector that’s committed to patient health, and yet it’s poisoning kids with mercury,” recalls Cohen.
Cohen, who had years of experience working on toxic chemical issues, founded Health Care Without Harm to change that. And to hear him tell it, they have. The dioxin pollution from hospitals came from medical incinerators. “When we started there were probably 5,000 or so incinerators. Now there’s 60,” says Cohen. Mercury was in large part due to increasingly outdated thermometers, sold by group purchasing organizations that could be convinced to stop. “We were able to basically completely eliminate the market for mercury in the U.S,” he says
With all that done, the group’s mission has now expanded to encompass everything from healthier food (sometimes with on-site farmers markets) to fighting climate change–laudable goals that, still, seem an even farther cry from treating patients. “That’s been the traditional view,” Cohen admits. “The focus on individual patients and clinical care that’s kept a little box around this.” But he argues that the same logic that got hospitals to eliminate mercury and dioxin applies. His organization is pushing not only to rebrand climate change as a public health issue, but to get hospitals to see their mission as one of broad, public health. “The ultimate thing is not just to green the health care sector, but it’s to reorient the health care sector to address the conditions in our homes, in our communities that are making people sick in the first place,” says Cohen.
So far, 800 hospitals have enrolled in his organization’s Healthier Hospitals Initiative. His goal is to sign up 2,000, a third of all hospitals in the U.S. In its first year, the initiative’s participants managed to recycle 50 million pounds of materials and keep another 61.5 million pounds of construction waste out of landfills. These are testaments to the success of the campaign, certainly, but also touch on the areas where financial incentives and environmental goals align. “Anyone who’s doing health care and not doing waste reduction is leaving money on the table,” says Cohen.