Assessment of Environmental Sustainability and Corporate Social Responsibility Reporting by Large Health Care Organizations

IMPORTANCE: Sustainability practices by large corporations are increasingly important to reduce the environmental and social impacts of the business enterprise. The health care industry represents 18% of the US economy, employs more people than any other economic sector, and is responsible for 10% of US carbon emissions. The engagement of large health care delivery organizations in reporting sustainability efforts has not been previously assessed. OBJECTIVE: To evaluate sustainability reporting by large US health care delivery organizations compared with reporting trends in all other economic sectors. DESIGN, SETTING, AND PARTICIPANTS: Cohort study of 49 large health care organizations (HCOs) by inclusion on one of the following lists in 2015 or 2016: Fortune 500, S&P (Standard & Poor) 500, Forbes 100 Largest Charities, Becker’s Hospital Review of largest HCOs, and 24/7 Wall St’s largest state employers. Each HCO was analyzed for sustainability reporting by reviewing the main corporate website, Google search, and search of publicly available databases. The percentage of sustainability reporting by HCOs on each list was compared with the percentage of sustainability reporting by all corporations on each list as obtained from public reports and publicly available databases. Data analysis was conducted in January 2018. MAIN OUTCOMES AND MEASURES: The percentages of large health care corporations and other corporations publicly reporting sustainability information. RESULTS: Forty-nine large for-profit and nonprofit US HCOs were analyzed (10 appeared on >1 list but were analyzed only once) appearing on the Fortune 500 (8 [16%]), S&P 500 (3 [6%]), Forbes 100 Largest Charities (8 [16%]), largest state employers (14 [29%]), largest for-profit HCOs (11 [22%]), and largest nonprofit HCOs (17 [35%]) by facilities owned for sustainability reporting. Among them, 4 of 8 (50%) on the Fortune 500, 1 of 3 (33%) on the S&P 500, and 6 of all 49 health care corporations (12%) published a sustainability report compared with 389 of 500 (78%) on the Fortune 500 and 410 of 500 (82%) on the S&P 500 reporting by all economic sectors. CONCLUSIONS AND RELEVANCE: The health care delivery sector lags behind other US economic sectors in sustainability reporting. Publicly reporting sustainability activities would provide HCOs with an incentive to quantify and reduce their environmental impacts, lower costs, and protect human health.