Climate change impacts, such as extreme weather events, worsening air and water quality, rising sea levels and changes in the distribution of vector-borne diseases threaten human health and well-being.1 Since 1880, the average global temperature on Earth has increased by at least 1.9° F, with a majority of warming occurring since 1975.2 In the past decade, nine of the ten hottest years on record occurred, with the average global temperature in 2021 recorded as the sixth warmest.3 We are committed to reducing air pollution and climate-changing emissions, both of which have negative impacts on human health—especially on vulnerable populations. Our climate resilience strategy includes energy efficiency and clean energy, green transportation and tree planting initiatives, as well as industry collaboration to reduce healthcare emissions.
1Salas, Renee N.; Lester, Paige Knappenberger; Hess, Jeremy J.; “The Lancet Countdown on Health and Climate Change: Policy Brief for the United States of America 2021”, 20 October 2021, accessed 9 September 2022, lancetcountdownus.org/wp-content/uploads/2021/10/USA-2021-English-Lancet-Countdown-Policy-Brief.pdf
2NASA Goddard Institute for Space Studies, “GISS Surface Temperature Analysis (GISTEMP)”, 2022, accessed 9 September 2022, data.giss.nasa.gov/gistemp/
3NASA Earth Observatory, “World of Change: Global Temperatures”, 2022, accessed 9 September 2022, earthobservatory.nasa.gov/world-of-change/global-temperatures
Measuring & Reducing Our Carbon Footprint
Since 2010, we have decreased our carbon emissions intensity—or CO₂ equivalents (CO₂e) generated per square foot of building space—by 35.4% and our total emissions by 25.7%.
In 2021, Cleveland Clinic emitted 130,604 metric tons of Scope 1 and 274,848 metric tons of scope 2 CO₂e for a total of 405,452 metric tons of CO₂e, an increase of 1.3% from 2020 and a 25.7% reduction from our 2010 baseline.4 We adjusted our baseline in 2021 to include natural gas and electricity consumption from all of our Florida facilities—including family health centers—and Mercy and Union hospitals. Additionally, we adjusted our electricity factor to a weighted average of Emissions & Generation Resource Integrated Database (eGRID) data tied to our locations by state. Our Scope 1 emissions, or CO₂e generated from on-site combustion and consumption, include emissions from natural gas, generator fuel, fleet vehicle fuels and anesthesia gases. Our Scope 2 emissions, or CO₂e generated from utility providers, include emissions from purchased electricity.
In 2021, we finalized our scope 3 carbon footprint working with a third-party consultant. Scope 3 measures indirect emissions, such as emissions from our supply chain, investments, capital purchased, employee commuting, waste disposal and other upstream and downstream impacts. We have used this footprint to target reductions in purchased goods and services, investments, capital goods and employee commuting as four areas that represent more than 80% of our scope 3 emissions.
According to the Northeast Ohio Areawide Coordinating Agency’s (NOACA) 2020 Air Quality Trends Report, vehicle emissions count for 31.6% of critical air pollutants in Northeast Ohio.5 In addition to respiratory illnesses, air pollution is tied to pre- and neonatal health risks, heart disease, stroke, cognitive issues and other health issues.6 To encourage our caregivers to select greener transportation options over commuting via single-occupancy vehicles, Cleveland Clinic offers the following green transportation programs, incentives and infrastructure:
- Carpool Program: Participating caregivers split the total monthly parking fee for their assigned area, and carpools with four members park for free.
- LEED Parking Discount: Caregivers who drive a vehicle with a Leadership in Energy and Environmental Design (LEED) score above 45 for their daily commute are eligible to apply for a 20% parking discount.
- Clean Vehicle Rebate: Full-time caregivers with at least one year of service can receive a rebate on the purchase of a SmartWay Elite qualifying vehicle (20% lowest-emitting passenger vehicles each model year). Rebates include $1,000 for the purchase of a new vehicle or $500 for a used vehicle.
- Gohio Commute: This NOACA platform allows caregivers to track the carbon impact of their daily commutes and offers information on greener transportation options in Northeast Ohio. Caregivers can also connect with one another via the platform to coordinate carpooling, vanpooling, public transit or biking trips.
- Public Transit: To promote public transit via bus, rail, Park-N-Ride and trolley, caregivers can purchase fares via payroll deduction pre-tax through the RTA Commuter Advantage Program.
Our green transportation efforts also extend to our vehicle fleet. We work to reduce the carbon footprint of our fleet by optimizing routes and replacing vehicles with more fuel efficient models at the end of their lifecycle. In 2021, we increased the average miles per gallon (MPG) of our fleet averages by 7% compared to 2020, and have increased the average MPG of our fleet by 42% from our 2009 baseline. To promote sustainable transportation options for all travelers and residents in the University Circle area of Cleveland, we continued to serve as a member of the Sustainable Transportation Action Committee in 2021. In recognition of our green transportation efforts, Cleveland Clinic received a bronze 2021 NEO Commuter Choice Award from NOACA for providing incentives to caregivers for the purchase of alternative-fuel vehicles and for carpooling.
Electric vehicle (EV) charging stations
In 2020, the Ohio EPA offered competitive grants to support the installation of Level 2 EV charging stations in 26 Ohio counties. The purpose of the grants is to help improve Ohioans' access to EV charging infrastructure, which aligns with Cleveland Clinic’s commitment to clean air and healthy communities. To this end, we applied for grants for all eligible hospitals and family health centers in Northeast Ohio. In March 2021, the Ohio EPA awarded $3.25 million in grants to support the installation of more than 500 publicly accessible Level 2 EV charging ports at more than 170 locations in 22 counties, which included up to 62 charging ports (124 EV charging spaces) at 22 Cleveland Clinic sites that best met the grant criteria.
During the summer of 2021, a cross-functional team of caregivers conducted site visits with our installer at each awarded site to determine the best location for stations at each facility. After finalizing site plans, we will begin installing stations in calendar year 2022.
5 Northeast Ohio Areawide Coordinating Agency, “2020 Air Quality Trends Report”, March 2021, accessed 9 September 2022, noaca.org/home/showpublisheddocument/26339/637528803731100000
6 American Lung Association, “2022 State of the Air Report”, 21 April 2022, accessed 9 September 2022, lung.org/research/sota/health-risks
Community Tree Planting
According to the National Park Service, trees improve air quality by directly removing pollutants from the air, altering pollution concentrations by decreasing surrounding air temperature and reducing energy consumption in buildings.7 In addition to reducing air pollution, trees provide ecosystem services such as absorbing and filtering water, providing wildlife habitat and food sources, buffering sound and preventing soil erosion. Urban forests are also associated with health benefits such stress reduction, attention restoration, active living, social cohesion, improved mood and more.8 Cleveland Clinic is a member of the Cleveland Tree Coalition, a collaborative group of public, private and community stakeholders supporting the City of Cleveland in restoring its tree canopy. The coalition has committed to creating a healthy, vibrant, sustainable and equitable urban forest, and to increasing Cleveland’s tree canopy from 19% to 30% by 2040.
From 2016-2021, Cleveland Clinic planted more than 4,000 trees and 1,100 shrubs at our properties and in our communities, and created 12 neighborhood parks. In 2021, we planted 682 trees and created a new community park in Fairfax on 108th Street and Cedar Avenue. We worked with Fairfax community members and volunteers from local organizations to plant nearly 70 trees and 150 perennials to create the park. In addition to serving as a community greenspace with walking trails, the park will be a gathering space for programming and community events on sustainability and well-being.
Tree Campus Healthcare Recognition
Tree Campus Healthcare is an Arbor Day Foundation program that recognizes health institutions across the United States for improving community wellness through tree plantings and maintenance, education programs and community engagement. Cleveland Clinic worked with the Arbor Day Foundation to create the program, which encourages collaboration between inpatient healthcare facilities and local community forestry programs to support and expand forests, especially in urban areas. Our main campus earned the Tree Campus Healthcare recognition for the third consecutive year in 2021, and Akron General Hospital earned recognition for the first time in 2021.
Caregiver Tree Giveaway
In September 2021, Cleveland Clinic Sustainability hosted its fifth consecutive Caregiver Tree Giveaway, and provided 555 free trees for caregivers to plant at their homes. Cleveland Clinic, in partnership with the Arbor Day Foundation, offers these trees through the Community Canopy program to improve air and water quality, manage stormwater runoff, sequester carbon and beautify neighborhoods. In addition to sending trees via mail, Cleveland Clinic Sustainability hosted a tree pickup day at Independence Family Health Center on October 19th. The infographic below from an impact report generated by the Arbor Day Foundation projects the 20 year cumulative benefits of these plantings:
7 National Park Service, “Air Pollution Removal by Urban Forests”, 7 January 2022, accessed 9 September 2022, nps.gov/articles/000/uerla-trees-air-pollution.htm
8 Wolf, Kathleen L.; Lam, Sharon T.; McKeen, Jennifer K.; Richardson, Gregory R.A.; van den Bosch, Matilda; Bardekjian, Adrina C.; “Urban Trees and Human Health: A Scoping Review”, International Journal of Environmental Research and Public Health, 18 June 2020; 17(12):4371, accessed 9 September 2022, doi: 10.3390/ijerph17124371
Climate and Health Collaborations
The scale and complexity of an issue such as climate change requires collective effort to achieve meaningful progress. We engage with community groups, industry organizations and government entities to:
- Raise awareness about the health impacts of climate change.
- Share and model best practices.
- Expand clinical education on climate and health.
- Formulate solutions and recommendations.
- Support behavioral, process and system-level changes.
- Promote collaboration on climate and health and resilience initiatives.
In 2021, we supported regional efforts in Northeast Ohio on clinical education and in Southeast Florida on community resilience. At the national level, we focused on evidence-based health impacts of climate change and policy recommendations for addressing them.
Addressing climate impacts on clinical practice in the Great Lakes region
Cleveland Clinic collaborated with University Hospitals (of Cleveland), MetroHealth and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University to offer a virtual half day symposium in March 2021 to educate and inspire regional healthcare professionals and students around climate action. Topics covered in the symposium included climate smart healthcare delivery, climate change and health disparities, integrating climate change and health content into health professional education and tools to address climate change effects on clinical practice in the Great Lakes Region.
Building healthcare and community resilience in Southeast Florida
In April 2021, Health Care Without Harm, Cleveland Clinic and Perkins&Will held a two-day, invite-only virtual summit focused on climate action planning in Southeast Florida. The goal of the summit was to catalyze collaboration to promote resilience in Southeast Florida in response to climate change and future pandemics. Attendees included individuals from healthcare, government, academia and community organizations. Through panel presentations, interactive sessions and facilitated discussions, participants worked together to better understand the current and expected future health impacts of climate change in the region, as well as opportunities to collectively support resilience in local communities.
Lancet Countdown U.S. Policy Brief Working Group
In 2020, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine became members of the Lancet Countdown U.S. Policy Brief Working Group. Each year, this group— comprised of health experts from over 70 institutions, organizations and centers—develops a brief in partnership with the American Public Health Association that details the key threats climate change poses for health in the United States, and provides accompanying policy recommendations for implementation. The brief serves as a companion to the Lancet Countdown: Tracking Progress on Health and Climate Change, an annual report created through an international research collaboration to provide evidence and guidance to governments on addressing the health impacts of climate change. In 2021, Cleveland Clinic and CCLCM participated as members of the Lancet Countdown U.S. Policy Brief Working Group for a second consecutive year.
Cleveland Clinic and CCLCM representatives held interactive discussion with colleagues to review and provide input on draft versions of the U.S. policy brief, and also contributed to the Focus on the Midwest regional brief, which highlights region-specific climate threats and the ways they deepen health inequities in 12 Midwestern states.
Regulated Air Emissions
Under Title V of the Clean Air Act, facilities that generate air pollutants above a designated threshold must obtain a Title V air permit, and comply with emissions limits and reporting requirements. Cleveland Clinic main campus meets the Title V emissions criteria and reports regulated emissions annually. Per the Title V requirements, we do not report normalized emissions. Our emissions increased in 2021 due to new unit installations, as well as additional testing and tuning of existing generators and boilers compared to previous years.
EPA Air Title V Emissions for Cleveland Clinic's main campus
|Air Pollutant||2018 Emissions
|Particulate Matter (PM)-10||0.837||.835||.808||1.2833|
|Volatile Organic Compounds||2.476||2.463||2.373||3.7613|
|Total of Chargeable Pollutants||28.931||26.082||25.431||38.3091|