Health Calls Season 6, Episode 17 explores how health systems across the United States can improve outcomes by connecting health care, nature, and community partnerships. Host Brian Reardon and Executive Producer Josh Matejka welcome Dr. Sheetal Rao, Assistant Professor at the University of Illinois Chicago, to examine the growing evidence linking green space access to better physical, mental, and community health.
Health Calls Season 6, Episode 17 explores how health systems across the United States can improve outcomes by connecting health care, nature, and community partnerships. Host Brian Reardon and Executive Producer Josh Matejka welcome Dr. Sheetal Rao, Assistant Professor at the University of Illinois Chicago, to examine the growing evidence linking green space access to better physical, mental, and community health.
Dr. Rao shares how the COVID‑19 pandemic revealed stark inequities in access to nature, introducing concepts like tree equity and “nature deficit” in underserved communities. The conversation highlights how hospitals, acting as anchor institutions, can partner with local organizations to expand tree canopy, support biodiversity, and reduce environmental risks like heat, flooding, and air pollution. With U.S. health care contributing significantly to climate impacts, Dr. Rao underscores how nature‑based solutions, from native plantings to urban forestry, can strengthen resilience, improve health outcomes, and advance more equitable, sustainable care nationwide.
Brian Reardon (00:05):
Welcome to Health Calls, the podcast of the Catholic Health Association of the United States. I'm your host, Brian Reardon, and with me is Josh Matejka. Hey, Josh.
Josh Matejka (00:13):
Hey, Brian. Good to be back.
Brian Reardon (00:15):
Yeah. So on this episode, we're going to talk about health, nature, and how community partnership can build a better future. And in just a moment, we're going to bring in Dr. Sheetal Rao. She is an assistant professor of clinical medicine at the University of Illinois Chicago. She's been a guest on some of our webinars. There's been a CHW article that we'll mention. But before we bring in Dr. Rao, Josh, again, throughout this season we've been talking about United for Change various collaborations. As I mentioned, Dr. Rao spoke at a recent webinar this spring entitled Heat Floods: Breathing and Bugs, Health Impacts of the Ecological Crisis and How Healthcare Can Respond. You've had a chance to talk to her since the webinar. Tell us a little bit about the context of how this conversation came about.
Josh Matejka (01:04):
Yeah. I think what I'm really looking forward to about this conversation and why I think it's important for our listeners is that, and this isn't saying anything negative about any environmental efforts going on anywhere, but when we have these conversations, it can tend to be centered around a very specific framework of like, oh, well, people come with different ideas and how do we implement them at a system level and how do we all pitch in so that we can make a better future together? But they tend to be about specific, how do we take better care of our trash or recycling or how do we do this or how do we make this a little bit more sustainable? And when I talked to Dr. Rao, I kind of came into our pre-conversation with that idea and I'm glad I did because Dr. Rao really broke it open for me.
(01:56)
She's like, "You know what I'm really doing and what I'm really working on with my colleagues is studying the bigger effects of how do healthcare and nature intersect and what impact does green space have on people? " From the United for Change perspective, I think Dr. Rao will be really helpful for our listeners too, because she's going to talk not so much about partnering with your colleagues within your systems, but how can we look outward? How can we look at people who are already doing this work? How can we look at people who maybe have more data or better data than we do to drive these decisions? So I'm really excited. This is the kind of stuff when we talk about the environment and climate that I really get into. So I'm really grateful to her and I'm really excited for this conversation.
Brian Reardon (02:43):
Yeah. It just so happens we are taping this episode during Laudato Si week and Laudato Si of course is the encyclical from Pope Francis on the environment. So very appropriate that we're having this conversation now. And Josh, as you know, we've covered a lot of different issues over the years related to integral ecology. Again, how can we become more sustainable as a health system? I think one of the statistics that keeps popping out at me is that healthcare is a huge contributor to climate change. We make up about healthcare 8.5% of all US admissions. So we have a big impact on healthcare and the more we can do to lessen our carbon footprint, for example, the more healing we can bring to the communities and patients we serve. So with that context, let me go ahead and reintroduce Dr. Sheetal Rao. She again is an assistant professor of clinical medicine at the University of Illinois, Chicago.
(03:36)
Great to have you with us, Dr. Rao. So starting off, if you could maybe just tell us a little bit about that intersection of nature and medicine and the work that you do at UIC.
Dr. Sheetal Rao (03:48):
Well, I guess I can start with kind of why I do this work, which is there are ... Let's start with a little story, which was right around the pandemic in 2020. I, like many of my colleagues, was a burned out physician. I think part of it was felt kind of our group had sold to private equity and I felt like what I was doing in medicine or what the practice of medicine in general wasn't aligned with why I got into medicine and felt like a cog in a wheel. My stress relief at that time was running in the Forest Preserve that was near my home, only five minutes away. So I would go there pretty frequently. And when there was so much flux and so much uncertainty, I knew that the trees were always there. The path was always the same. The sounds, the birds, the water sounds were always the same.
(04:41)
And so that was my retreat. And in about the spring of 2020, I think a lot of other people had the same idea because the mayor in Chicago, Mayor Lightfoot, at the time, had to shut down some of the forest preserves, walking paths, the lakefront path, because so many people were congregating there. There was a fear of there being spread of COVID. And this was of course before the vaccine and the only place to be amongst others safely was outside. And it really kind of became obvious to me how lucky I was and that anyone who lived near nature was because so many people couldn't access nature easily and they couldn't find that same respite. And so around the same time, a friend of mine, my best friend from college, actually Christine Diploma, approached me to start a nonprofit and the nonprofit's called Nordson Green Earth Foundation and her uncle had sort of made his last wish to her to carry on his tree planting work that he had done in the Philippines.
(05:46)
And he had planted 200 acres of native forests to kind of help clean up some of the mess that industry had left behind in deforestation and things like that in his hometown. And he said," I know you can't come to the Philippines. I know you can't travel during COVID. You can do whatever you want in your own way, in your own town, but I hope that you'll be able to carry this forward because he didn't have any living descendants. "And he passed away soon after that, but Christine and I started talking about nature and trees and this access point became really obvious to us kind of like, what can we do about that? And we learned all these new terms like tree equity and nature deficit and realized that there were actually documented deficiencies in nature in many neighborhoods. And this was due to historical inequities like redlining and various zoning decisions that had happened decades ago, but that those decisions and those policies were actually translating into worse health in those communities now.
(06:48)
So for instance, because certain communities had less trees or have less trees now, those communities were several degrees warmer now. Those communities had a lot more noise. They had a lot more flooding because they had this sort of concrete infrastructure. And so that was when kind of that connection between health and nature, which I mean is kind of a known connection but really became plainly obvious to me and just kind of in a real time.
Brian Reardon (07:19):
Yeah. And I think we talk a lot about social determinants of health. Food deserts have come up, lack of housing, but I think what you're describing is maybe tree deserts or the lack of tree canopies and that impact it can have on neighborhoods. So can you tell us a little bit more about looking into that? I imagine it's not only the environmental impact of warmer temperatures, because again, the sun basically has nowhere to go but the concrete, but what does it do to residents in those neighborhoods where there aren't sufficient tree canopies as far as their overall health or health outcomes?
Dr. Sheetal Rao (07:55):
So we know that a lot of times more tree canopy is associated with higher home values, lower crime, better air quality and lower temperatures, less flooding. So the trees provide a lot of benefits. For instance, their roots under the ground are really good at holding water. They of course support a lot of biodiversity, the birds that make nests in their leaves, insects and all kinds of other pollinators that trees support. They're a food source. They also improve our mental health by a lot. We know that there's actually more violence in areas that don't have trees and there's confounding factors, of course, but it sort of goes along with having trees makes people feel more calm. It's actually, I think kind of an ancient, I don't know what the word is, something that's within us that when we see greenery, we know there's food for many years that being around nature has been associated with a security that being devoid of that nature actually raises our cortisol level, actually gives us more stress.
(09:11)
And so the communities that have less trees a lot of times because of policy decisions that are from a long time ago, the residents that live there now actually can see changes in their health because of that.
Brian Reardon (09:24):
Yeah. And I know you've been doing some research in this, you're looking into this. I know it's fairly preliminary, but can you talk a litle bit more about who you're partnering with and what do you hope the research is going to lead? There's, I guess, some initial insights that you might be able to share.
Dr. Sheetal Rao (09:41):
Yeah. So UIC, the School of Public Health, the Department Environmental and Occupational Health has a new NIH Center for Extreme Conditions. It's called the NIH Center for Extreme Conditions and Health Excellence and we call it CHE. So that center, there's a bunch of different subgroups and the one that I'm a co-leader of, we are looking into healthcare sustainability and green space. And so we're doing what's called a scoping review article, which basically means we comb through thousands of articles and we use a computer program to do that, but that are based around healthcare systems that have either invested in green spaces or have, whether that's in the community or on their own campus and kind of examining what those studies or those different interventions look like. And we hope to compile all that data at the end of this and see what benefits these different healthcare systems saw by working to increase green space, whether again on their own campus or out in the community or support those green spaces in some way.
(10:53)
And the reason why we decided to look into this is, as you mentioned early on, healthcare does have an outsized impact on climate change. And one of the ways that we can help to not only mitigate that, but also invest in our communities is by increasing nature for all the health benefits that I had just mentioned.
Brian Reardon (11:16):
Yeah. And hospitals in many, if not most communities are considered anchor institutions. And so the role of a local hospital, it doesn't have to be in a Chicago or a large metropolitan area, but even in smaller communities, they kind of have outside influence in some of this space. So what would you recommend to, again, healthcare leaders that are listening to this of how they might be able to lean more into supporting green spaces, supporting the planning of trees. In fact, CleanMed just had a conference here in St. Louis this past week and one of the field trips they did was a system here in St. Louis SSM actually went out and did a tree planning initiative. And so that's a story that as folks go to our website and see this podcast, there'll be a link to that story as well. So this isn't totally uncommon for hospitals to do that, but I think it's something that there's probably a lot of untapped opportunity
Dr. Sheetal Rao (12:11):
Absolutely. And one idea just off the top of my head is having the green space on healthcare campuses be native green space. Native plants, for instance, use less water. Well, they're well suited to the area that they're from. So they use less water, they use less pesticides and things like that. They don't need as much of our help to grow because they're made to survive in that area. They also draw in native pollinators, native insects. And when you have native insects, you then have native birds and the different things that eat those pollinators. And so the biodiversity benefit of native plants is huge. There's actually an initiative called, I think it's called Homegrown National Parks led by someone named Doug Talame. And the idea there is that if more people in the US planted native plants in their yards, we could have an area that's much larger than all of our national parks combined that would be increasing biodiversity and boosting native vegetation, which could have huge impacts.
(13:15)
And these are things that people can do individually or collectively in their community, but think of the impact it could have if a healthcare center did that or if a bunch of different healthcare centers did that. Trees could cool a lot of urban healthcare centers. They could have a cooling effect in those kind of heat island situations that are just warmer than surrounding areas and then even flooding and some of the other great benefits that nature brings to us. And that could be led by healthcare systems, tree planting, native planting. And I know that there's an initiative called Tree Campus Healthcare that I believe has worked with healthcare without harm. I'm sorry, I missed the clean med conference. I was at a different conference, but I heard great things about it.
Brian Reardon (13:55):
And no, I think of hospital campuses and for good or bad, and I maybe look at it as a negative, they have a lot of parking spaces, right? They've got surface lots. So would on step maybe be as those are being designed or upgraded to include, like you said, figure out a way to get some native plant plots within that sort of surface area and what kind of difference that could make.
Dr. Sheetal Rao (14:20):
Yeah, exactly. And ultimately, if you had people who knew how to take care of them, you could save money because you don't have to water as much, you don't have to really mow as much and you don't have to ... Just the maintenance is a lot less because this is kind of, again, what's supposed to be here. So it does take maintenance, but it could potentially just have a really great environmental impact and a financial benefit as well.
Brian Reardon (14:44):
And look a lot nicer than just a bunch of concrete landscape. One of the things I thought interesting from the webinar, you talked, and again, that webinar was entitled Heat, Floods, Breathing and Bugs, Health Impacts of the Ecological Crisis and How Healthcare Can Respond. And again, there's an article that we covered on that if people just want to read about it in Catholic Health World, it'll also be linked in the show notes. But bugs is something I have not really thought about. We hear a lot about obviously the heating planet and what that does in causing more floods. We know about air pollution, what that does to people with asthma, for example, but vectors or bugs is something I hadn't really given much thought until your webinar and reading the article. Can you talk a little bit more about how this all ties together and how things like mosquitoes and what that does to health.
(15:34)
So the vector piece I'm really interested in hearing a litle bit more about.
Dr. Sheetal Rao (15:38):
Yeah. Well, the idea around that was that with changes in our climate that we're seeing, we have warming that's happening in a lot of places and the growing seasons, the breeding seasons for a lot of these harmful vectors like ticks that cause Lyme disease or mosquitoes that cause West Nile are being impacted. So one example is for instance, Lyme disease, the cycle during which those bugs like breed and grow is affected by temperature. And so the more warming you have, that time period is actually longer. And so they get more time to grow and they get more time to breed, which is not a good thing. And then we also have these land use changes that are happening where people are cutting down some of their native habitat to build whatever houses and buildings. And so there's more contact of humans with those creatures as well.
(16:28)
And so we are seeing an uptick in Lyme disease, West Nile disease, and a lot of these other vector-borne illnesses, you mentioned mosquitoes. The likelihood of seeing something like malaria in the US is low now. It actually used to be endemic in the US many hundreds of years ago, but we actually got rid of malaria. But with these changes in temperature, we are seeing some malaria more in the southern, just south of the US and just that the range of that is expanding. We have to get prepared to be able to see some of these diseases in places that we didn't expect them to be.
Brian Reardon (17:01):
And as we look to lower the temperature, our own communities where we're located health systems, what would you say to those listening of how can they look for partners locally to work on some of these projects where, again, we're increasing the number of trees being planted, we're looking at including natural vegetation on campuses. Any tips on how to be maybe a litle bit more creative or think outside of the box and forming those partnerships?
Dr. Sheetal Rao (17:27):
Yeah, absolutely. I think in most major cities and even smaller towns, there's already people doing the work. And so looking for those organizations, those grassroots organizations that are already planting or increasing nature in the area around the hospital, it's great to reach out and see where partnerships can be found. They're usually looking for support or funding or a place to plant. So that's a great natural partnership that could form there.
Brian Reardon (17:57):
Great. Well, let me bring Josh back into the conversation. Josh, we've been talking about what I would describe as just another influence on determinants of health and that is again, increasing our nature footprint and the role of hospitals and health systems in sort of encouraging that or supporting that. Any questions or thoughts you have for Dr. Rao as we wrap up this conversation?
Josh Matejka (18:22):
Yeah, Brian, and thank you, Dr. Rao, your thoughts. One thing that I'm often doing as I'm kind of sitting here and taking everything in is I'm thinking about this conversation from the perspective of a listener and a lot of our listeners tend to be either administrators or executives or people within mission related roles in Catholic healthcare. And as much as I personally am like, I love talking about biodiversity and natural pollinators and natural plants in my yard, which is something that me and my family try to do. From the perspective of someone working in Catholic healthcare, they're like, "Well, yeah, but my job is to make sure that we're taking care of people every day and that the budget's getting balanced or that our message is getting out to our community." And so there are all these competing priorities. So from your perspective, and you're starting to do research into this and you already have done some is why should the folks who are in Catholic healthcare that may not be specifically operations, why should they care about biodiversity or natural pollinators as it relates to their home campuses?
Dr. Sheetal Rao (19:34):
Well, the biodiversity crisis along with the climate crisis are both huge impacts on humanity on public health. I can give you a few examples of why that is and that is kind of ultimately this does touch healthcare. So one example would be there's something, this was published in nature a few years ago. So there's this pollinator insect called the nocturnal hawk moth. And this insect, this study found that at certain levels of pollution, primarily nitrous radicals and ozone pollution, which is very readily found in most cities because it comes out of tailpipes and things like that and factories at certain levels of pollution, the hawk moths are not able to detect flowers. And so they found that in most cities, the pollution from ozone is bad enough that these certain pollinators cannot detect the flowers that they're supposed to pollinate. And so if that's happening, and this is just one species that they actually studied, this is huge implications for our food systems because without pollinators, we can't grow food and we already have food insecurity and that's a big problem that is part of a lot of hospitals concern because of their patients.
(20:52)
This is something on a global scale that could be a really big problem. Another example is actually in the New York Times and that was in several counties throughout the country, these bats got infested, infected with an invasive fungus, white nose it was called. And bats are really good at killing insects and pests. And so when farmers are farming and they have pests, bats are really good at eating those, but the bats were dying off. So the farmers started using more pesticides on their crops and that actually translated to increased infant mortality in those counties. So they were able to find there was a researcher out of University of Chicago that made that connection. And so we're kind of here trying to improve health outcomes, improve chronic disease. And then on the other hand, we're doing things that are making people sick. We're kind of chasing our tails.
(21:50)
I think it's important, and this is a lecture that I give to the med students on biodiversity and health at University of Illinois. And it's one of my favorite lectures to give because kind of like those aha moments that people make, like the connections that they don't even think about, like all the different far reaching impacts that one decision can have on human health and mortality is just so interesting, but also important for leaders in healthcare to understand.
Brian Reardon (22:15):
Yeah. And I think it's a good reminder of how interconnected everything is. So I think the examples you just gave really brought that home to me is we don't think about the consequences of what may seem like a small change. And I think that the changes that you mentioned that we can do in healthcare don't seem like a big deal of planting trees, being careful about what we plan on our campuses, but they all add up, right? At the end of the day, those changes can have an impact. And the other thing we didn't really touch on, but I think it's also important to remember that caring and healing is not just the medical interventions, it's our lived environment. And so when you have more trees in your neighborhood, there's an emotional and even spiritual aspect to having a place to sit and shade. So I think all of these topics you covered really are connected to what we do in Catholic healthcare.
(23:05)
So love this perspective. Really appreciate you sharing your thoughts, not only in this conversation, but also in the recent webinar and just the work you're doing should be applauded. So again, thank you for being with us.
(23:20)
And again, that was Dr. Sheetal Rao. She's Assistant Professor of Clinical Medicine at the University of Illinois, Chicago. It was great having her on the show. Again, I'm your host, Brian Reardon. This has been another episode of Health Calls, the podcast of the Catholic Health Association of the United States. Josh Matejka is our executive producer. Our scheduling producer is Sarah Marchant. Health Calls is engineered and produced at Once Studios in St. Louis, Missouri. You can listen to Health Calls on all of your favorite podcast streaming services and you can find the episodes, both video and audio on the CHA website, and that is chausa.org. Go to the top there under news and publications and you can get to the podcast link. And as mentioned, we'll have some links to articles that pertain to this conversation that you can also find on that page. And if you do download or sign up to health calls on your streaming services, please give us some feedback.
(24:13)
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