Compared to big corporations in other sectors of the economy, most healthcare organizations – even large ones – appear to be falling short when it comes to finding ways to protect the environment, a new study suggests.

Few of the 49 largest healthcare organizations had reported efforts toward sustainability, according to the study published in JAMA Network Open. Unlike large corporations in other sectors, many of those involved with healthcare 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,” study coauthor Dr. Phil Landrigan told Reuters Health in a phone interview.

“The healthcare industry represents 18 percent of the US economy and it is responsible for 10 percent of all carbon emissions. Despite that great magnitude, it’s not doing nearly as good a job as many Fortune 500 companies have in putting sustainability programs in place,” added Landrigan, who was dean for global health at the Icahn School of Medicine at Mount Sinai in New York City when he worked on the study.