HEALTH CARE WITHOUT HARM

Reston, VA   |  www.noharm.org

Mission

Health Care Without Harm is a non-profit international advocacy organization whose mission is to transform health care worldwide so that it reduces its environmental footprint and becomes a community anchor for sustainability and a leader in the global movement for environmental health and justice.

Ruling year info

2002

Principal Officer

Gary Cohen

Main address

12355 Sunrise Valley Dr Suite 680

Reston, VA 20191 USA

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EIN

52-2358837

NTEE code info

Alliance/Advocacy Organizations (C01)

IRS filing requirement

This organization is required to file an IRS Form 990 or 990-EZ.

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Programs and results

What we aim to solve

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Our programs

SOURCE: Self-reported by organization

What are the organization's current programs, how do they measure success, and who do the programs serve?

Leadership

In order to foster green and healthy hospitals, leadership is essential at all levels. This means making environmental health, safety and sustainability key organizational priorities. This can be achieved through education, goal setting, accountability, and incorporating these priorities in all external relations and communications. It amounts to a major change in the culture of the organization, be it an individual hospital, health system or ministry of health.

Population(s) Served

Toxic chemical exposures begin before birth and continue throughout our lives. Many of these chemicals have been linked to serious illnesses, including asthma, infertility, learning disabilities, Parkinson’s disease and cancer.

The health care sector is a major consumer of chemicals including those well documented to cause serious impacts on health and the environment. Thus, a sector whose mission it is to protect human health is contributing to the burden of disease.

By addressing chemical exposure in health settings, the health sector can not only protect patient and worker health, but also actively demonstrate the safe management of chemicals thereby leading by example.

Population(s) Served

Hospitals generate millions of tons of waste each year. Unfortunately, health care waste management is still poorly funded and implemented. The combined toxic and infectious properties of medical waste represent an underestimated environmental and public health threat. A recent literature review came to the conclusion that over half the world’s population is at risk from the health impacts of healthcare waste.

Burning of medical waste generates a number of hazardous gases and compounds, including hydrochloric acid, dioxins and furans, and the toxic metals lead, cadmium, and mercury. The disposal of solid waste produces greenhouse gas emissions, including methane, a greenhouse gas twenty-one times more potent than carbon dioxide.

Properly managed, healthcare waste should not cause any adverse impacts on human health or the environment. Medical waste management is complex and success is in large part dependent on changing the habits of hospital staff.

A variety of non-burn technologies are available that can safely disinfect, neutralize or contain the wastes for landfill disposal. Information on alternative treatment technologies and waste Management is freely available.

Population(s) Served

Greater energy efficiency and transitioning to clean, renewable energy sources, such as solar and wind, can both significantly reduce greenhouse gas emissions and protect public health from the myriad impacts of climate change, including increased heat-related illnesses, the expansion of vector borne diseases, increased droughts and water scarcity in some regions and storms and flooding in others.

Moving away from fossil fuels also brings with it the health and economic co-benefit of reductions in hospital admissions and treatments for chronic illnesses such as asthma, lung and heart disease caused by the pollution created from the extraction, refining and combustion of coal, oil and gas.

The health sector consumes significant amounts of fossil fuel energy, although there are no adequate figures for most countries. Health-care facilities can also significantly cut greenhouse gas emissions and energy costs over time by using alternative forms of clean and renewable energy – such as solar and wind energy, and biofuels that do not undermine public health.

Population(s) Served

Much healthcare delivery in developing countries takes place in settings where there are inadequate or non-existent municipal water or treatment facilities. This lack of water and sanitation infrastructure is a major problem that directly impacts hospitals and health care systems – either overburdening them with more disease in the population, or because they cannot count on basic water, sewage and waste disposal services to carry out their mission, or both.

When water is amply available, hospitals are often prodigious consumers in various facets of their operations. Overall, there are few reliable global water consumption benchmarks in healthcare.

In general, health facilities can conserve water resources by closely metering water use, installing water-efficient fixtures and technologies, growing drought-resistant landscape, and making sure that leaks are quickly repaired. For even greater impact on overall usage, hospitals in a number of countries are harvesting rainwater. Others recycle water for process purposes

Population(s) Served

Transportation is a major source of air pollution throughout the world, creating significant health impacts, particularly in urban areas. Exposure to carbon monoxide, sulfur dioxide, and nitrógeno dioxide can cause respiratory illness and alter the lung’s defense systems.

The health sector – with its fleets of ambulances, hospital vehicles, delivery vehicles, and staff and patient travel – is a transportation-intensive industry. Air pollution impacts from health care are concentrated near large-scale hospital facilities.

Shifting to hybrid technologies, all-electric vehicles, as well as compressed natural gas or some bio-fuels all have the net impact of reducing emissions for fleet vehicles such as ambulances and vans. Encouraging hospital staff and patients to use bicycles, public transportation and carpools can also help reduce the air pollution emissions related to health care facilities.

In summary, transportation choices have a huge impact on the communities within which hospitals are situated.

Population(s) Served

The globalization of a western diet based on excessive saturated fats, refined carbohydrates and processed foods, together with increasingly sedentary lifestyles, are contributing to epidemics in obesity, diabetes and cardiovascular disease in many countries.

Health-care facilities in many countries are major consumers of food and can therefore model and promote health and sustainability through their food choices. A growing number of health-care facilities in developed and developing countries that purchase and serve food to patients and workers are reducing their environmental footprint and improving patient and worker health by making changes in hospital service menus and practices. These include limiting the amount of meat in hospital meals, cutting out fast and junk food, composting food waste, buying locally and sustainably farmed produce – thereby promoting local, sustainable production, producing their own food onsite, and holding farmers’ markets for local producers to sell healthy food to the community.

By promoting and supporting nutritious, localized sustainable food systems, hospitals can both reduce their own immediate footprint while supporting food access and nutrition, thereby helping to foster the prevention of disease, a reduction in the health sector’s environmental health impacts and contributing to a longer-term reduction in the population’s need for healthcare.

Population(s) Served

Pharmaceutical waste can be found in trace amounts in soil and groundwater throughout the world. This waste comes from a variety of sources, including hospitals.

Levels of pharmaceuticals in the environment are likely to rise in years to come, as the global demand for pharmaceuticals grows.

In countries and hospitals where there are an abundance of pharmaceuticals, health systems can play an essential role in reducing pharmaceutical waste by reducing the amount of drugs prescribed, and by addressing the waste problem in their own facilities and at the policy level.

Population(s) Served

The built environment influences health. A host of contemporary environmental health problems – climate change, toxic pollution, biodiversity loss and more – can be linked to the production and maintenance of the built environment.

As development accelerates in many regions, the production of buildings becomes more resource intensive, stressing local and indigenous building material supplies and methodologies beyond their sustainable capacities.

The health sector has the potential, through its market power, to influence the construction industry to develop safer, more resilient, greener and healthier building products and systems.

The significant environmental and health impacts associated with hospital buildings have led to the creation and adoption of a wide variety of “green building” tools and resources related to healthcare.

Population(s) Served

Hospitals and health systems purchase a broad diversity of products ranging from chemicals, electronics and plastics, to energy, pharmaceuticals and food.

Creating and implementing green and ethical purchasing policies can play a central role in implementing many of the goals of the Green and Healthy Hospitals Agenda.

The health sector spends huge amounts of money on purchasing goods. Healthcare purchasing results in a significant environmental impact and can also have significant human rights impacts.

By harnessing its tremendous purchasing power in many countries, the health sector can impact the supply chain, compelling manufacturers to provide safer, more environmentally sustainable products, produced under healthy working conditions and in accordance with international labor standards.

Population(s) Served

Where we work

Our results

SOURCE: Self-reported by organization

How does this organization measure their results? It's a hard question but an important one.

Number of members in our global network representing more than 25,000 hospitals and health centers

This metric is no longer tracked.
Totals By Year
Type of Metric

Output - describing our activities and reach

Direction of Success

Increasing

Context Notes

By the end of 2017, our global network boasted more than 1,000 members in 51 countries on 6 continents who represent the interests of over 32,000 hospitals and health centers.

Goals & Strategy

SOURCE: Self-reported by organization

Learn about the organization's key goals, strategies, capabilities, and progress.

Charting impact

Four powerful questions that require reflection about what really matters - results.

1. Protect Public Health from Climate Change: Reduce health care's carbon footprint, foster climate resilient health systems, mobilize the health sector to address climate change as a public health issue, and advocate for solutions that accelerate a transition to clean, renewable energy.

2. Transform the Supply Chain: Establish and globalize procurement criteria and leverage health care's purchasing power to drive policies and markets for ethically produced, healthy, sustainable products and services.

3. Build Leadership for Environmental Health: Inspire, mobilize and support health care's leadership to promote environmental sustainability, human rights, and the right to health in order to achieve large-scale transformational change.

Research and Innovation: We identify and pilot opportunities for health care to implement innovative, economical, science-based solutions to environmental health problems.

Implementation and Capacity Building: We educate, build implementation tools, train health care professionals and scale-up solutions across our networks, the health sector and in the communities it serves.

Policy and Market Changes: We aggregate the influence and purchasing power of hospitals, health systems, health professionals and organizations to drive the marketplace toward sustainability and advocate for policies that will create worldwide change.

Achieving our mission requires a keen focus on how change is made, within a single healthcare institution, across a health care system, and among the disparate healthcare systems that comprise the global sector. HCWH has a vast network of health care partners, representing more than 25,000 hospitals and health centers worldwide.

The hospitals and health systems we work with use our research, connections, and solutions to make changes at an institutional level, deploying innovations such as transitioning to renewable energy, using safer chemicals, and sourcing healthier food for their patients and employees.

Using the network we have built, we scale adoption of good environmental practices and leverage the community of hospitals and health systems to share strategies and learn from each other. We also work through and with international venues and organizations such at the United Nations Development Programme, the World Health Organization, and the World Bank to leverage large scale change across a number of sustainability initiatives.

Additionally, we aggregate the various incremental changes into more collective impacts, such as using the purchasing power of our network of hospitals to alter supply chains and supplier behavior or using their collective political clout to influence policy decisions.

Buildings - HCWH developed LEED certified standards for U.S. hospitals, which have enlisted 300 hospital architectural projects, impacted 40 million square feet of health care construction, and been adopted as national guidelines in both Australia and China.

Chemicals - HCWH's work began more than 20 years ago through the fight to eliminate the market for mercury thermometers in the U.S., ultimately winning a global treaty phasing them out by 2020. Since then, we continue to work to transform the market toward safer alternatives to products with harmful chemicals including formaldehyde, PVC, antimicrobials, flame retardants, and perfluorinated compounds.

Climate and Health - Established in 2014, the Health Care Climate Council is an advocacy network of 18 leading U.S. health systems committed to driving health care policy leadership on climate and energy issues and rebranding climate change as a public health issue. In addition, HCWH developed the Climate Resilience Framework and Toolkit for the U.S. Department of Health and Human Services in collaboration with the Obama White House. The Toolkit charts a path for U.S. hospitals to redesign their buildings and supply chains to address the realities of climate change. And, HCWH partnered with the Word Bank to publish the Climate-Smart Healthcare report, establishing a framework for health systems in every country to become leaders in addressing climate change.

Food - In the past three years, HCWH redirected more than $60 million in food purchasing to local and sustainable foods across hundreds of U.S. hospitals, setting the stage to move a significant percentage of the $12 billion health care spends annually on food.

Green Procurement - HCWH also partnered with the World Bank to developa framework for driving the World Bank's $12 billion in annual health spending in low- and middle-income countries towards climate-resilient healthcare infrastructure. Moreover, HCWH has developed a strong partnership with the United Nations Development Programme to establish criteria for sustainable procurement in health that can be scaled up across the UN system, national health ministries, and our global network representing more than 25,000 hospitals and health systems worldwide. And, in May 2016, HCWH and key health system partners in the U.S. launched Greenhealth Exchange, a for-profit mission-aligned purchasing cooperative designed to aggregate demand in the health care sector for low-carbon, toxic-free products, services and technologies.

Waste - Since 1994 more than 4,500 medical waste incinerators have been closed in the United States as a result of HCWH's efforts to convince hospitals to switch to safer, cost-effective, non-burn waste treatment technologies. HCWH was also instrumental in building the market for medical reprocessing to $500 million annually.

Financials

HEALTH CARE WITHOUT HARM
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Operations

The people, governance practices, and partners that make the organization tick.

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HEALTH CARE WITHOUT HARM

Board of directors
as of 8/2/2019
SOURCE: Self-reported by organization
Board co-chair

Charlotte Brody


Board co-chair

Aparna Bole

Laura Anderko

Georgetown University

Raheem Baraka

Baraka Community Wellness

Aparna Bole

University Hospitals

Charlotte Brody

Blue Green Alliance

John Cleveland

Innovation Network for Communities

Gary Cohen

Health Care Without Harm and Practice Greenhealth

Tory Dietel Hopps

Dietel Partners

Denise Fairchild

Emerald Cities Collaborative

Kathy Gerwig

Kaiser Permanente

Blair Sadler

Institute for Healthcare Improvement

Miriam Shark

Miriam L. Shark Consulting, LLC

Susan Vickers

Dignity Health