On a recent summer afternoon, my cousin called from Brookdale Hospital, where she had taken her elderly neighbor for shortness of breath. It wasn’t the diagnosis that scared her, it was the heat. Inside the waiting room, the air felt thick, like someone had shut the door on a furnace. The air conditioning had broken down during Brooklyn’s latest heatwave, and the hospital had become a sauna. “How is this a hospital?” she asked. “How is this safe?”
It’s not.
Hospitals are supposed to be our last line of defense. But in a climate-stressed Brooklyn where heatwaves buckle infrastructure, floodwaters climb into basements, and smog clogs every child’s lungs — even our hospitals are falling. And the people paying the price? Low-income families in East New York, elders in Flatbush, immigrants in Sunset Park. These communities, already burdened by environmental injustice, are the ones left waiting for care in overheated rooms or turned away when cooling systems fail.
And yet, despite these predictable and preventable disasters, our health system keeps pretending climate change is someone else’s problem. It’s time to fix that. The fix begins not with sandbags or duct tape, but with a tool hospitals already live and die by: accreditation.
Every hospital in Brooklyn, and across the country, chases the stamp of approval from organizations like the Joint Commission or Centers for Medicare & Medicaid Services. These bodies determine whether a hospital is safe, qualified and fit to serve its community. They decide what counts as a successful emergency plan, a standard room, a quality metric. But right now, those standards ignore the most urgent health threat of our time: climate change.
Extreme heat, toxic air and flooding are not future problems. They’re happening now. In 2021, Hurricane Sandy knocked out power at NYU Langone and shuttered access to parts of the borough’s care network. Last year, smoke from Canadian wildfires blanketed Brooklyn in a haze that sent kids with asthma to the emergency department. And this summer, hospitals in Brownsville and Bed-Stuy scrambled to treat a spike in heatstroke and heart failure cases, all while their own cooling units failed.
These climate shocks are hitting working-class communities hardest. Why? Because decades of zoning and disinvestment have created heat islands in neighborhoods, stripped tree cover and concentrated pollution. Because those who rely on Medicaid and live in aging buildings with no air conditioning are the first to collapse when temperatures soar. And because the very hospitals that serve these communities are often under-resourced and left out of broader emergency planning.
If we don’t want our hospitals to become the next public health failure, we need to hold them accountable in the one language they understand: accreditation. That means making climate resilience standards for any hospital seeking federal funding or licensure.
Imagine this: before a hospital receives its stamp of approval, it must pass a resilience assessment. Not just building code compliance, but real-world scenarios: Can it stay open during a blackout? Can it cool its wards during 100°F heat? Can it deliver oxygen to patients when wildfire smoke fills the borough? Then add a community reflective emergency plan. Does the hospital have multilingual alerts and accessible signage for non-English-speaking patients? Does it coordinate with housing agencies, faith groups, and grassroots organizations like the Brooklyn Movement Center or El Puente to mobilize volunteers, share cooling resources, or conduct home visits for vulnerable patients? This work must be more than a checkbox. It has to be lived. That means integrating community voices into hospital planning boards and disaster drills, funding culturally competent outreach workers and building channels of trust before a crisis strikes.
This isn’t theoretical. After SARS and Ebola, infection control became non-negotiable. After COVID-19, health equity became a core reporting requirement. We must do the same for climate justice. Because voluntary climate pledges won’t save lives when the air conditioning goes down in the emergency department.
This is a call to action for CMS, the Joint Commission and New York State Department of Health: Update your accreditation standards. Bake in climate risk and community vulnerability. Reward hospitals that prepare and penalize those that don’t. Our communities don’t need more public service announcements. They need protection, now!
Alex Shen, BA, is a MD/MPH student at SUNY Downstate Health Sciences University.
