Healthcare organizations and Kermit the Frog are singing the same tune nowadays—“It’s Not Easy Being Green.” According to a new study published by JAMA Network Open, only a few of the 49 largest healthcare organizations reported sustainability efforts, and most didn’t appear to be concerned about issues such as pollution, waste generation and disposal, and water use.

“The take home message is that large healthcare organizations in the United States, which have become a major sector in American industry, are not doing a good job of putting sustainability forward,” said Dr. Phil Landrigan, coauthor of the study and former dean for global health at the Icahn School of Medicine at Mount Sinai in New York City.

Landrigan and his coauthor, Dr. Emily Senay, studied healthcare companies included on lists such as the Fortune 500, the S&P 500 and Forbes 100 Largest Charities. To determine whether the organizations were striving to become more environmentally green, the researchers looked at official sustainability reports, scrutinized organization websites and searched with Google for environment-linked words.

Landrigan pointed out that the healthcare industry represents 18% of the U.S. economy and is responsible for 10% of all carbon emissions.

“Despite that great magnitude, [healthcare is] not doing nearly as good a job as many Fortune 500 companies have in putting sustainability programs in place,” Landrigan said, adding that he believes healthcare has a particular onus to care for the environment. “Since healthcare organizations are in the overall business of promoting good health, they should be leading by example. We now know that when the environment is not healthy, it affects people adversely. Air pollution causes asthma, for example. Toxic chemicals can cause cancer.”

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