Beyond Carbon Toward Liberation: An Urban Bioethical Case for a Socially and Environmentally Just University Health System

Abstract

Awareness of critical public health issues stemming from historical and contemporary environmental injustice has been growing, yet institutions are still working to identify how to respond. How do we transform University Health System infrastructure, in the built environment and affiliated community assets and human capital, to center equity and the lived experience of climate injustice in urban communities? Through the application of urban bioethical principles and examination of a public state-related university and its health system in a major U.S. city, I argue that the higher education institutional climate action planning process for medical schools and their attendant university health systems, in concert with public sector actors, can be a vehicle and accelerator for achieving health equity in urban communities and suggest what exactly that could or should look like. This thesis will look at the role of university health systems in addressing climate change and mitigating its impacts. More specifically, it looks to provide context for the influence of “meds and eds” in urban communities: how their status as anchor institutions and sites of economic development implicates their responsibility to anticipate the differentiated material experience of climate change. As sites of care delivery, medical education and training, and major employers these institutions have a duty to ameliorate the associated inequitable health outcomes of climate change. I provide a model for action by all urban university health system stakeholders with recommendations to sustain equitable resilience in the face of environmental crisis.