Reducing healthcare emissions in the United States in the era of federal environmental deregulation: established and emerging mitigation opportunities and concomitant benefits.

The United States (US) healthcare sector leads the world in per capita greenhouse gas emissions, contributing disproportionately to global climate change. The recent reversal of federal climate regulations has increased the need for voluntary and urgent action from the US healthcare sector. In 2022, the US healthcare sector emissions resulted in over 425,000 disability-adjusted life years lost, reflecting the direct human cost of healthcare-related greenhouse gas emissions. Climate change worsens health outcomes and disrupts access to care - these impacts fall heavily on vulnerable populations including low-income communities, indigenous populations, the elderly, and children. Three key areas for decarbonization include infrastructure, supply chains, and operations and can be accounted for and addressed through the Greenhouse Gas Protocol framework. Some established mitigation strategies include transitioning to renewable energy, reducing medical waste, adopting lower emissions anesthetics and inhalers, and implementing sustainable food management. However, current greenhouse gas inventories utilized by health systems may not yet account for the rapidly expanding landscape of technology in healthcare and its growing contribution to emissions. Emerging priorities for mitigation that are often overlooked include reducing emissions associated with medical conferences and the growing energy demands of artificial intelligence. Here, we discuss how decarbonization not only reduces emissions but also provides important co-benefits, including better air quality, climate resilience, reduced costs, and improved workforce well-being.