Building Climate-Resilient Healthcare Systems by Engaging Adolescents in Sustainability Efforts

Abstract

Background: Climate change increasingly threatens global health, with adolescents among the most vulnerable. Hospitals are major emitters of greenhouse gases, making carbon reduction in healthcare a pressing challenge. Nurses play central roles in implementing sustainability, while adolescents can contribute to long-term resilience. Methods: A scoping review of peer-reviewed articles (1990-2023) and World Bank datasets was conducted. Comparative analysis focused on Norway and South Korea, with the United States and Australia reviewed narratively. Inclusion criteria targeted studies on hospital-based carbon reduction and youth/nurse engagement; unrelated studies were excluded. Results: Three domains emerged: (1) governance approaches-Norway applied top-down integrated monitoring, while Korea showed fragmented progress, especially in private hospitals; (2) roles of adolescents and nurses-nurses led quality improvement in energy efficiency and waste reduction, while adolescents contributed through school-hospital partnerships and youth initiatives; and (3) barriers and enablers-key barriers included limited youth decision-making and lack of councils, while enablers included certification frameworks and WHO guidelines. Conclusions: Nurses and adolescents are complementary partners in sustainable healthcare. Establishing hospital green teams, integrating climate literacy into curricula, and fostering government-healthcare-education partnerships can reduce emissions and strengthen climate-resilient health systems.