Department of Health and Human Services Secretary, Xavier Becerra and Joanne Kenen, Journalist-in-Residence, Johns Hopkins University

The first Earth Day, held in 1970, was a collaborative effort between government and citizens under the common banner of “a future worth living.” More than 50 years later, with a climate that is rapidly changing, we continue to seek shared solutions to the existential challenges facing life on earth. Given this context, Earth Day was the perfect occasion for the Hopkins Business of Health Initiative (HBHI) to host a first-of-its-kind conversation with HHS Secretary Xavier Becerra about addressing healthcare’s climate footprint in the context of environmental justice.

Xavier Becerra is the 25th Secretary of the Department of Health and Human Services and the first Latino to hold the office in the history of the United States. When Becerra was a child, he witnessed the outsized impact of environmental exposure on the health of his father, a farm worker who supported his family with jobs that demanded outdoor manual labor. In his capacity as a top-ranking federal official, Becerra has now made the climate one of his signature issues in office. In 2021, he helped to establish the landmark Office of Climate Change and Health Equity (OCCHE), whose mission is to protect the health of people throughout the US in the face of climate change, especially those experiencing a higher share of exposures and impacts.

“The office of climate change and health equity is essentially saying to America: wake up. This is all of our concern. People are dying every day, and we can try to change that.” -HHS Secretary Becerra

Department of Health and Human Services Secretary, Xavier Becerra and Dan Polsky, PhD Bloomberg Distinguished Professor and Director of Hopkins Business of Health Initiative, Johns Hopkins University

In a fireside chat at the Bloomberg Center in Washington D.C. with HBHI’s journalist-in-residence Joanne Kenen, Becerra shared the insights he’s gained through his work with health systems large and small, urban and rural, domestic and foreign.

The moderator asked Becerra how he creates impact without using the mandate power of the federal government. “You have to continue to cultivate the will to get there,” he said. “We'll get there just as we always do, because economics requires folks to get there–at some point the price will become too unbearable, to not be clean. But I don't think any of us wants to wait till we get to that point.”

On the issue of the politics of climate change, Becerra was surprisingly sanguine. “If you speak of this issue in global terms, it's not really red/blue political. It's have/have not, more than anything else,” he said. “And what you find is that most places around the world are struggling just to keep their places sanitary, let alone reduce their carbon footprints.”

He talked about this global dynamic as it exists in the US healthcare system, as rural health systems and hospitals serving disadvantaged patients have fewer resources to dedicate to innovation than larger, well-funded institutions.

“If you talk to a rural health facility, they would love nothing more than to save money on their waste budget. It’s that they’re having such a hard time just meeting their patient needs that they don't have the bandwidth to think about that. So that requires places like Boston, Los Angeles, New York City, San Francisco, to step up and say, this is how we do it. Let's share this know-how and to some degree let's share some of that wealth to get everyone to come up so all boats will get lifted.”

Cybele Bjorklund, VP Federal Strategy and Executive Director of the Bloomberg Center at Johns Hopkins University; Department of Health and Human Services Secretary, Xavier Becerra; Melinda Buntin, PhD, Bloomberg Distinguished Professor and Director of the Center for Health Systems and Policy Modeling at Johns Hopkins University

In terms of what the federal government can do to increase sustainability in the health care sector, Becerra suggested that financial incentives could spur faster adoption of new ways of working but that increasing costs will inevitably force major change.

“They should connect the dots that it's in their interest to do this because at some point, if they continue to be close to 10% of the problem, they're going to start paying 10% of the price.”

Innovation in American healthcare is often driven by economic motivations, and the issue of sustainability is no different. With technical and financial support coming from the highest levels of government, real change could be coming soon to the health care sector for the health of the planet.