Climate change and health: a new call to action for doctors

Two new articles appeared in the January issue of the New England Journal of Medicine, recognizing the health impacts of climate change and the gap in environmental justice. Most frequently cited, sometimes with alarmist headlines, is  “The Imperative for Climate Action to Protect Health” (Jan. 17)  (registration required). The authors state that the World Health Organization may have underestimated the health effects of climate cop24_health_climate_change_reportchange when it predicted in a 2018 report that climate change will kill 250,000 people per year between 2030 and 2050.  The NEJM authors Haines and Ebi state: “We think the impact is more difficult to quantify because there is also population displacement and a range of additional factors like food production and crop yields, and the increase in heat that will limit labour productivity from farmers in tropical regions that wasn’t taken into account, among other factors. ”  They point to the need for investment and policies to promote adaptation to reduce health risks.

The other article in January’s New England Journal of Medicine is an overview of the issue and a more direct call to action for doctors.  ” Climate Change: A health emergency ”   by Drs. Caren G. Solomon and Regina C. LaRocque states:    “Disruption of our climate system, once a theoretical concern, is now occurring in plain view — with a growing human toll brought by powerful storms, flooding, droughts, wildfires, and rising numbers of insect borne diseases. Psychological stress, political instability, forced migration, and conflict are other unsettling consequences. In addition, particulate air pollutants released by burning fossil fuels are shortening human life in many regions of the world. These effects of climate disruption are fundamentally health issues, and they pose existential risks to all of us. People who are sick or poor will suffer the most….As physicians, we have a special responsibility to safeguard health and alleviate suffering. Working to rapidly curtail greenhouse gas emissions is now essential to our healing mission….  The authors’ call to action includes: “working with medical students on climate action, supporting the undergraduate divestment movement, joining forces with like-minded health professionals, and speaking with our legislators. “

In Canada, the Canadian Association for Physicians and the Environment (CAPE)   is leading the way on such education and advocacy – a compilation of their press releases  reveals the broad range of their actions. Most recently, on January 15, CAPE announced  that the Ontario Court of Appeal has granted intervenor status to the Intergenerational Climate Coalition, of which  CAPE is a member, to defend the constitutionality of the federal pricing of climate emissions, challenged by the Ontario provincial government in a case to be heard in April 2019.  Other members of the Intergenerational Climate Coalition are Generation Squeeze,  Saskatchewan Public Health Association, the Public Health Association of BC, the Canadian Coalition for the Rights of Children , and the Youth Climate Lab.  The same group announced in December 2018  that it has intervenor status in the Saskatchewan government’s challenge to the federal carbon tax plan.

UPDATE: 

A February 5 press release states: “Together, representatives from the Canadian Association of Physicians for the Environment (CAPE) , the Canadian Medical Association (CMA)  , the Canadian Nurses Association (CNA), the Canadian Public Health Association (CPHA) and the Urban Public Health Network (UPHN) are calling for action: asking federal parties to recognize that climate change is the greatest public health challenge of the 21st century, and to make climate solutions a priority in the 2019 federal election.”

Dr. Gigi Osler, President of the Canadian Medical Association (CMA) is quoted  : “Climate change is no longer some abstract idea that may harm future generations or people on the other side of the globe; it’s a reality that’s already harming the physical and mental health of Canadians. We cannot afford to treat climate change as a wedge issue. We must treat it as the public health crisis that it is.”

New U.S. medical consortium forms to bring the message mainstream: climate change is harming our health

Eleven medical societies in the United States, representing over 400,000 medical practitioners, have joined together to form The Medical Society Consortium on Climate & Health .  Their launch document  on March 15  was  Medical Alert! Climate Change is harming our health , directed at the general public to sound the alarm that climate change health impacts are here and now.

The report gives only a nod to the threats in the workplace, given its goal to reach a general audience. It warns that “anyone can be harmed by extreme heat, but some people face greater risk. For example, outdoor workers, student athletes, city dwellers, and people who lack air conditioning (or who lose it during an extended power outage) face greater risk because they are more exposed to extreme heat. People with chronic conditions such as cardiovascular and respiratory diseases, and those who work or play outside, are especially vulnerable to extreme heat.. ..”  The report also touches on the other major health-related impacts, such as spread of infectious diseases borne by ticks and mosquitos, air pollution,  effects of forest fires, polluted air and food, mental health burden, etc.

The Consortium  states that “most physicians are aware of the adverse health effects of climate change and feel a responsibility to inform the public, patients and policymakers about them. A majority of survey respondents report they are already seeing health harms from climate change among their own patients – most commonly in the form of increased cardiorespiratory disease (related to air quality and heat), more severe and longer lasting allergy symptoms, and injuries attributed to extreme weather.”

The goal of the consortium is to educate,  and to advocate for reduced fossil fuel consumption and increased clean energy.  Their website offers a library of publications    related to the growing literature on climate change and health. The website  also compiles resources from their member societies, such as the American College of Physicians and the American Academy of Pediatrics,  about how to green medical workplaces.   In this, they join a number of existing associations such as Practice Greenhealth   and Healthcare without Harm, an international organization with Canadian membership.

In Canada, the Canadian Association of Physicians for the Environment , which was established in 1994,   shares a similar mission for policy advocacy, and maintains an active blog  and Facebook presence.  The Canadian Medical Association has a number of policy and position documents on environmental impacts on health; their most recent policy statement on Climate change and Health  was issued in 2010, yet still seems remarkably relevant.

 

Clean Electricity in Alberta Means Less Reliance on Coal

While the government of Alberta continues to develop its Alternative and Renewable Energy Policy Framework, a new report from the Pembina Institute and Clean Energy Canada argues that “With effective policy, the province could cut the percentage of grid electricity that is supplied from coal energy from over 60 per cent today to less than four per cent by 2033.” (p.1) According to the report, in 2013, coal power generation supplied 63.7 per cent of electricity in Alberta’s grid (compared to 39.1 per cent of the in the United States). And whereas total coal power generation in the United States decreased by 21.3 per cent between 2007 and 2013, it decreased by only 13 per cent in Alberta. (p.4). See Power to Change: How Alberta can Green its Grid and Embrace Clean Energy at http://www.pembina.org/docs/power-to-change-pembina-cec-2014.pdf with a backgrounder at http://www.pembina.org/docs/power-to-change-pembina-cec-backgrounder.pdf . Earlier in 2014, the Canadian Association of Physicians for the Environment commissioned a survey which revealed that 80% of Albertans agreed that wind energy should be used to reduce reliance on coal-fired power in the province. See the CAPE Newsletter (Summer 2014) at http://cape.ca/wp-content/uploads/2014/05/capenewsummer2014.pdf . And on May 23, a public opinion commissioned by the Alberta Energy Efficiency Alliance, in conjunction with the Pembina Institute, reported that 76 per cent of Albertans support the stronger greenhouse gas performance regulations for industrial facilities. See the Ipsos Reid poll at http://www.ipsos-na.com/news-polls/pressrelease.aspx?id=6509 .