# Sustainability on the Menu: Assessing the Role of Hospital Cafeteria Composting in Advancing Planetary Health Initiatives

## TL;DR

This study explores how hospital cafeteria composting can reduce food waste and carbon emissions, while highlighting the need for education and infrastructure to support such sustainability efforts.

## Contribution

The study introduces a novel hospital-based composting program and evaluates its feasibility, impact, and stakeholder perceptions in a healthcare setting.

## Key findings

- A six-month composting initiative diverted 490.6 kg of food waste and reduced CO2-equivalent emissions by 0.35 metric tons.
- Cost neutrality for composting could be achieved at a daily diversion rate of 116 kg.
- Surveys showed strong support for composting but limited awareness of its environmental impact.

## Abstract

Public health relevance—How does this work relate to a public health issue?
The healthcare sector contributes an estimated 4.6% of global carbon emissions, and planetary health is a movement within the sector to address its emissions footprint.Supply chain-associated emissions contribute the largest proportion of healthcare’s footprint, with composting serving as a simple and scalable way for healthcare entities to address food waste.

The healthcare sector contributes an estimated 4.6% of global carbon emissions, and planetary health is a movement within the sector to address its emissions footprint.

Supply chain-associated emissions contribute the largest proportion of healthcare’s footprint, with composting serving as a simple and scalable way for healthcare entities to address food waste.

Public health significance—Why is this work of significance to public health?
This pilot-scale composting initiative diverted nearly 500 kg of food waste and prevented 0.35 metric tons of CO2-equivalent emissions over six months at an academic medical center cafeteria.By partnering with a community composting partner, cost parity with traditional waste disposal was calculated at a composting volume of 116 kg per day.

This pilot-scale composting initiative diverted nearly 500 kg of food waste and prevented 0.35 metric tons of CO2-equivalent emissions over six months at an academic medical center cafeteria.

By partnering with a community composting partner, cost parity with traditional waste disposal was calculated at a composting volume of 116 kg per day.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Healthcare sustainability initiatives require integrated approaches combining infrastructure improvements, staff education, administrative support, and strategic partnerships with community organizations to overcome barriers of cost, contamination, and operational coordination.Composting programs can serve as both a waste reduction strategy and an educational avenue for engaging healthcare workers, patients, and administrators in planetary health concepts.

Healthcare sustainability initiatives require integrated approaches combining infrastructure improvements, staff education, administrative support, and strategic partnerships with community organizations to overcome barriers of cost, contamination, and operational coordination.

Composting programs can serve as both a waste reduction strategy and an educational avenue for engaging healthcare workers, patients, and administrators in planetary health concepts.

U.S. hospitals generate considerable food waste, contributing to environmental degradation strategies. This study evaluated the feasibility, impact, and perception of a novel composting program implemented at Rhode Island Hospital over six months beginning in December 2024. Compostable waste bins were installed in the cafeteria with educational signage. Surveys assessing composting knowledge, attitudes, and roles in waste management were distributed to staff, patients, and administrators. Collected food waste was transported to Bootstrap Compost, which provided daily weight data used to estimate greenhouse gas emissions reductions, compare composting with landfill disposal costs, and project annual outcomes. Over the study period, 490.6 kg of food waste were diverted from landfills, corresponding to a reduction of 0.35 metric tons of CO2-equivalent emissions. While composting was more expensive than landfill disposal ($6.45/kg vs. $0.24/kg), cost neutrality could be achieved with diversion rates at or above 116 kg per day. Surveys revealed strong support for composting but limited awareness of its relevance to healthcare’s environmental footprint. Respondents suggested improvements in education, signage, and infrastructure. This program demonstrated how hospital-based composting initiatives align with healthcare institutions’ environmental stewardship goals while highlighting financial and logistical challenges relevant for pilot–scale efforts.