Community Health

By Mary Grauerholz

Kaiser Permanente takes a holistic approach to healing its patients and the environment.


For places of healing, hospitals have emitted notoriously toxic substances—to say nothing of the noxious waste the structures discharge. Until the turn of this century, not much thought was given to the contradiction this posed.

Kaiser Permanente, the prominent healthcare provider based in Oakland, California, has been turning this notion on its head. Kaiser Permanente executives maintain that hospitals should be healing environments and that healing is done best in clean, “green” environments. The same environmental stewardship, the organization maintains, can transform communities for better health for residents overall. In 2013, Kaiser Permanente invested $1.9 billion in the environment, people, knowledge, and communities through sponsorships and partnerships with community health clinics and other nonprofits with similar social missions. Also in 2013, the organization made a commitment to seek a minimum of Leadership in Energy and Environmental Design (LEED) Gold certification for new construction of its hospitals, large medical offices, and other major projects. The effort is expected to affect as many as 100 buildings and millions of square feet over the next 10 years.

Kathy Gerwig, Kaiser Permanente’s environmental stewardship officer. Photo: © Eric Millette

Kaiser Permanente has spent much of the last 50 years cultivating enlightened environmentalism far beyond LEED construction, as part of its mission to create healthy communities. This includes early involvement in the healthcare industry’s efforts to address the issue of medical waste; hospitals generate some 7,000 tons of waste per day, or more than 2.3 million tons a year. In 1963, before environmentalism was a household word, Kaiser Permanente invited Rachel Carson, author of the groundbreaking environmental treatise, Silent Spring, to speak to its staff physicians and scientists. It was Carson’s last public appearance before her death.

The same principles gathered new steam in 2001, when a Kaiser Permanente executive visited a neonatal intensive care unit in San Francisco and questioned the use of medical equipment that contained DEHP, a phthalate used to soften some plastics. Kathy Gerwig, Kaiser Permanente’s environmental stewardship officer, details that experience in her new book, Greening Health Care, How Hospitals Can Heal the Planet, along with the ensuing efforts she and others in the healthcare industry have made to embrace environmental stewardship as part of their commitment to improve the health of communities.


As part of their community outreach Kaiser Permanente holds farmer’s markets at many of its facilities. Photo: Kaiser Permanente

Kaiser Permanente thinks of its mission in terms of “total health,” and advocates for a healthcare system that treats the minds, bodies, and spirits of patients. “We invest significant resources in programs that improve the health of our communities because we know ensuring good health extends beyond our doors,” Gerwig says. “It begins with healthy environments, fresh fruits and vegetables in neighborhood stores, successful schools, clean air, accessible parks, and safe playgrounds. These are the vital signs of healthy communities, and Kaiser Permanente is committed to working with our many community partners to create them.”

The organization recently funded $90,000 to the Oakland-based Alliance for Climate Education (ACE) to support its ongoing initiatives to build climate-change solutions with youth in schools. ACE works with high school students, equipping them to be the next generation to lead lasting climate solutions for a healthy planet and thriving communities.

So far, ACE has educated 1.77 million high school students nationwide and mentored youth to lead energy and waste reduction projects, spread awareness about climate solutions, and explore green majors in college. ACE prioritizes reaching youth in urban public schools, providing underserved populations with quality climate science and hands-on experiential learning opportunities. Approximately 73 percent of the high schools with which ACE works are public schools; and 48 percent of those are designated as Title I or at-risk schools in low-income districts.

Healthful food is another part of Kaiser Permanente’s mission. The organization hosts more than 50 farmers, markets and farm stands at its hospitals, medical offices, and other buildings across the country, including a weekly market outside its corporate headquarters in Oakland, California. Kaiser Permanente also promotes sustainable food and agriculture by increasing sourcing of local and sustainably produced food in its hospitals, cafeterias, and vending machines. About 190 tons of the fruits and vegetables (nearly 50 percent of all fresh produce that Kaiser Permanente purchases each year) served on patient menus across the organization are sustainably produced. To meet this definition, the produce must be either grown within 250 miles of the Kaiser Permanente facility or certified as sustainably produced by a third-party eco-label.

Today, with the growing effects of climate change, Kaiser Permanente’s commitment to cleaner, greener medical settings is stronger than ever. The organization pledged in 2012 to reduce its greenhouse gas emissions by 30 percent by 2020, from a 2008 baseline.

Donald Orndoff, Kaiser Permanente senior vice president of National Facilities Services, announced the details of its Leadership in Energy and Environmental Design (LEED) building goals. “By adopting the LEED standard for all new major construction, we are demonstrating our commitment to green building strategies and to the total health of our communities,” Orndoff says. “The LEED certification program provides an internationally recognized approach to building and operating well-designed buildings.”

“A LEED plaque is an internationally recognized symbol of good design,” Orndoff says. “We are always proud to put a LEED plaque on our buildings as a demonstration of our commitment to the environment, as an extension of our mission for total health. We hope that as more of our medical centers carry the plaque, we will build momentum for healthier buildings of all kinds, and encourage others to measure the value of a building not only by economics, but by its effect on people and the environment.”

While the first Kaiser Permanente hospital to earn LEED Gold status is in Hillsboro, Oregon, the organization has since opened the LEED-certified San Ramon Medical Offices near its home base in Oakland, California.


Photo: Kaiser Permanente

The 67,000-square-foot project, located in San Ramon, earned LEED Gold certification for sustainable, environmentally sound construction. Some of the project’s aspects exceeded the stringent LEED Gold standards; for example, 93 percent of the onsite-generated construction waste was diverted from landfill. LEED certification requires only 50 percent be diverted. Kaiser Permanente converted a foreclosed big box store in Portland, Oregon into a LEED Gold medical office building; and its Antelope Valley Medical Offices, which opened in October in Southern California, was designed to meet LEED Platinum (certification still pending).

Kaiser Permanente, which operates 38 hospitals and more than 600 outpatient medical offices across the country, was one of the first healthcare institutions to eliminate polyvinyl chloride (PVC) from carpets and flooring. In 2004, in fact, the organization worked with manufacturers to bring PVC-free building products to the market when none existed. Last June, Kaiser Permanente leaders announced they wouldn’t purchase furniture with flame-retardant chemicals.

“For Kaiser Permanente, sustainability is about health,” Gerwig says. “By addressing air pollution and climate change, reducing the use of harmful chemicals, and promoting sustainable food choices, Kaiser Permanente is taking concrete steps toward reducing pollution and conditions that can harm health.”