Medical journals around the world call climate change the world’s leading health risk

The world’s leading medical journals stepped into the climate change debate again with warnings of the dangers of climate change – grounded in health concerns but including concerns for equity, food security, and environmental destruction.  On September 4,  more than 220 leading medical, nursing and public health journals around the world published the same editorial, titled “Call for emergency action to limit global temperature increases, restore biodiversity, and protect health”.

An excerpt:

“Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs health professionals have been bringing attention to for decades.  The science is unequivocal; a global increase of 1·5°C above the pre-industrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse.

Despite the world’s necessary preoccupation with COVID-19, we cannot wait for the pandemic to pass to rapidly reduce emissions. Reflecting the severity of the moment, this Comment appears in health journals across the world. We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory.”

The comment continues to state that “Targets are easy to set and hard to achieve”, and calls existing actions “insufficient”.  It calls on governments to  make “fundamental changes to how our societies and economies are organised and how we live. The current strategy of encouraging markets to swap dirty for cleaner technologies is not enough. Governments must intervene to support the redesign of transport systems, cities, production and distribution of food, markets for financial investments, health systems, and much more. Global coordination is needed to ensure that the rush for cleaner technologies does not come at the cost of more environmental destruction and human exploitation.” 

The editorial initiative was coordinated by the U.K. Health Alliance. The list of journals in which this statement appears is here, and includes The Lancet, the British Medical Journal,  the New England Journal of Medicine, Occupational and Environmental Medicine, The Journal of Climate Change and Health, and more than 200 other titles.  Canadian participants include the Canadian Journal of Respiratory Therapy and the Canadian Medical Association Journal.    The Canadian Association of Physicians for the Environment (CAPE) did not participate (not having its own journal), but on September 7 issued a echoed the same urgent concerns  in “A vote against fossil fuel subsidies is a vote for our health”.

Climate change and health: U.K. National Health Service launches new campaign for greener health care; more medical associations divest from fossil fuels

England’s National Health Service (NHS) is the country’s largest employer with 1.3 million staff, and its operations are responsible for approximately 4-5% of England’s carbon footprint. On January 25, the Chief executive officer of the NHS announced a new campaign to tackle the global climate change health emergency through a greener health care system.  A website for the new campaign, “For a Greener NHS”, focuses on a goal of a net zero national health service, with an Expert Panel to compile experiences and make recommendations in an interim report due in summer 2020, and a final report scheduled for Fall 2020.  In the meantime, the Greener NHS campaign will encourage such initiatives as switching from coal or oil-fired boilers to renewable heat sources for buildings; switching to less polluting anaesthetic gases and better asthma inhalers in treatment; and introducing technological solutions to reduce the number of patient visits and travel miles.

Another part of the initiative is a grassroots campaign for front-line workers, supported by the UK Health Alliance on Climate Change – which includes representative bodies covering over 650,000 NHS staff, including the union UNISON . The NHS press release quotes UNISON:  “Involving staff is crucial if the NHS is to help the UK meet its emissions targets in good time. They know more than anyone how the health service ticks and so are best placed to make practical green suggestions to get the NHS to where it needs to be.”  Examples of existing staff-oriented programs are described in case studies :  reducing the use of disposable plastic gloves;  an electric bike courier system for delivery of medical and laboratory samples; and a sustainable travel initiative  to encourage staff use of transit, shuttle buses, bicycles and walking for journeys to work.

British medical associations and organizations are also acting at the societal level. In January, the prestigious British Medical Journal (BMJ) published an editorial: “Investing in humanity: The BMJ’s divestment campaign” , which calls on individuals and organizations to act immediately, stating: “Divestment offers health professionals and medical organisations, for the duty is both individual and collective, an opportunity to influence politicians and industry towards behaviours that are better for the planet and people’s health.”  While urging divestment, the BMJ states: ” we will not accept advertising or research funded by companies that produce fossil fuels. We will also explore how else our business might be dependent on fossil fuel companies and take steps to end any such reliance. The BMA has no direct holdings in tobacco or fossil fuel companies.”  (Note that The Guardian newspaper in the U.K. also announced in February 2020 that  it will ban any fossil fuel advertising. ) According to a press release from the UK Health Alliance on Climate Change, six constituent groups of the Alliance have announced an intention, or are already divesting, from fossil fuels:  the British Medical Association, the Royal College of General Practitioners, the Faculty of Public Health, the Royal College of Emergency Medicine and the Royal College of Paediatrics and Child Health,  and in January 2020, the Royal College of Physicians .   The Canadian Medical Association has also divested from fossil fuels.

Redefining green jobs to include healthcare and educational workers in the Green New Deal

green new deal public housingA thoughtful new contribution to the “green jobs” debate comes in Re-defining Green Jobs for a Sustainable Economy ,  released by The Century Foundation, in cooperation with Data for Progress, on December 2.  Co-author Greg Carlock is currently Senior Fellow and Research Director for Climate at Data for Progress, and was one of the authors of the original visioning document A Green New Deal  , published in 2018 and leading to the current U.S. movement launched by Alexandria Ocasio-Cortez.  Data for Progress continues to monitor public opinion and publish important contributions to the Green New Deal debate – in November, exploring the issue of a Green New Deal for Public Housing.

Re-defining Green Jobs for a Sustainable Economy outlines an interesting  history of the  “green jobs” definition and measurement in the U.S., but the  main purpose of the report is to propose an expanded definition and framework of green jobs which would encompass the principles of equity and sustainability. Ultimately, the report recommends how an expanded definition can be integrated into U.S. public policy.

Perhaps most importantly,  Re-defining Green Jobs for a Sustainable Economy focuses in detail on demonstrating  why health care and educational workers should be considered as part of the green workforce,  stating that including them in the green workforce definition  “would go a long way toward gender and racial equity, and toward ensuring all workers green, family-sustaining jobs.”

An expanded definition of a green job, from the report:

“A green job should refer to any position that is part of the sustainability workforce: a job that contributes to preserving or enhancing the well-being, culture, and governance of both current and future generations, as well as regenerating the natural resources and ecosystems upon which they rely. And in order for green jobs themselves to be sustainable, they need to be good, living-wage jobs…. These green job occupations stand in contrast to work—even decent-paying work—in industries that result in the depletion or degradation of ecological systems and the social, cultural, and political institutions that support them.”

 

 

Climate change and health in Canada

The Prairie Climate Centre at the University of Winnipeg maintains the Climate Atlas of Canada, and on November 20  launched a new section of their website devoted to climate change and health in Canada.   So far, the webpages provide a general overview of the issues of air quality, diseases, extreme heat, and mental health  – supporteclimate-video.pngd by more detailed  articles – for example,  Climate Change, Air Quality, and Public Health ;  Wildfire Smoke and Health ; and a new 4-minutes video about wildfires, with impactful images which highlight the links between wildfires and mental health,  especially relating to first responders and medical providers.  The Prairie Climate Centre also published the Heat Waves and Health  report, released in August 2019, and now part of the new section.

2019 Lancet Countdown emphasizes climate impacts on children’s health

lancet childrenSince 2016, the prestigious medical journal The Lancet has published an annual report,  Countdown  on Health and Climate Change  .  The 2018 Countdown report focused on  work-related health impacts of climate change, especially heat effects, as summarized in the WCR here . The 2019 edition  just released in early November focuses on the impacts of climate change on the health of children, with this key message: it is possible to limit the global average temperature rise to well below 2ºC, a situation which “would transform the health of a child born today for the better, throughout their lives. Placing health at the centre of the coming transition will yield enormous dividends for the public and the economy, with cleaner air, safer cities, and healthier diets.”

In addition to the global report, the Lancet also publishes country-specific Policy Briefing reports.  The Policy Briefing for Canada  (in French here ) is written in cooperation with the Canadian Medical Association and the Canadian Public Health Association.  The four highlighted results for Canada are:

  1.  “Exposure to wildfires is increasing in Canada, with more than half of the 448,444 Canadians evacuated due to wildfires between 1980 and 2017 displaced in the last decade; lancet wildfires
  2. The percentage of fossil fuels powering transport in Canada remains high, though electricity and biofuels are gaining ground. Fine particulate air pollution generated by transportation killed 1063 Canadians in 2015, resulting in a loss of economic welfare for Canadians valued at approximately $8 billion dollars;
  3. Canada has the third-highest per capita greenhouse gas emissions from healthcare in the world, with healthcare accounting for approximately 4% of the country’s total emissions;
  4. The health of Canadians is at risk due to multiple and varied risks of climate change…… An ongoing, coordinated, consistent and pan-Canadian effort to track, report, and create healthy change is required.”

For each of the four problems, broad policy recommendations are made.

Some of the other countries for which Policy Briefs are available: Australia ;  European Union ; the United Kingdom ; and the United States . Each one reflects the unique challenges of the country concerned.  The full menu of all Country Briefs is here.

How nurses can contribute to climate and health justice

Nurses’ Unions, Climate Change and Health: A Global Agenda for Action   was Nurses unions -GNU-Final-Coverwritten by Sean Sweeney, Irene Shen and John Treat of Trade Unions for Energy Democracy (TUED). ( A summary appears in the September 2019 Bulletin 90 of the TUED ).  The report provides a brief overview of climate change issues, and an extensive chapter about the human health impacts of climate change. It concludes by outlining six key areas where nurses and their unions “can make use of their expertise and political strength in the fight against the climate and health emergency, and for climate and health justice.” The agenda for action  includes: Resist new fossil fuel projects; Make Emergency Response and Recovery Services “Climate Ready”; Work with Allies at the Global Level on Preparedness; Fight Poverty and Racism. Defend Worker Rights and Protections; Articulate and Advocate for a Pro-Public Shift in Policy; and Extend Public Control Over Energy Generation and Use through Energy Democracy. Although the report was written for nurses’ unions, the authors express the  hope is that it can be useful for the labor movement more generally, “to wage the struggle for climate protection and climate justice with a clearer understanding of the challenges that must be faced in order to achieve it.”

The report was written for  Global Nurses United , a federation of the nurse and health care worker unions which has grown to represent  27 nations since its founding in 2016.  The Canadian Federation of Nurses Unions and Fédération interprofessionnelle de la santé du Québec are members from Canada;  National Nurses United is the member from the United States. The purpose of GNU is to fight against austerity, privatization, and attacks on public health, as well as  to work for nurses’ and workers’ rights and improved patient care for all.

Nurses climatechange-cover-368x480The Canadian Federation of Nurses released its own publication in June 2019,   Climate Change and Health: It’s Time for Nurses to Act , “as a starting point for for advocacy and leadership”.  It shares some content with the Global report, but focuses on Canadian examples, and outlines its own six recommendations for action. A summary appears here .

Workers who respond to wildfires – some news you might have missed

The Columbia Journalism Review published an article on November 1: “What journalists miss when covering the California fires” . It states “we discuss celebrities and show pyro-pornography to capture attention. …. journalists could also use the borrowed interest to discuss bigger environmental consequences impacting people inside (and sometimes outside) of California.”

firefight in smokeHere are some articles which  focus on the impacts for working people in California and Canada, especially first responders and health care workers.  A previous WCR article,  “What happens to workers when wildfires and natural disasters hit?”  appeared in December 2017, after the Fort McMurray wildfires in Alberta.

California:

At PG&E, a workforce on edge — and under attack — as fire season arrives” in the San Francisco Chronicle (June 8) describes how front line workers are suffering harassment because the public blames their employer, Pacific Gas and Electric Company, for the 2018 Camp fire, as well as for the disruptions of their planned power outages to avoid sparking more fires.

A blog post  Power Shutoffs: Playing with Fire summarizes the issue of California power shutoffs and includes anecdotal reports from a  focus group study of home health care and nursing home workers, which  found that lack of communication was a common problem as they try to care for or evacuate their vulnerable patients.  The focus group was convened by the Emerald Cities Collaborative and SEUI2015.

Home healthcare in the Dark : Why Climate, Wildfires and Other Emerging Risks Call for Resilient Energy Storage Solutions to Protect Medically Vulnerable Households from Power Outages. This report published by Clean Energy Group and Meridian Institute in June 2019  identifies the problems associated with unreliable power when the electric grid goes down either through disaster or through  planned power outages to prevent wildfires. The report  makes a series of recommendations directed at policy makers, including:  “truly resilient power should be generated onsite, should not be dependent on supply chains that may be disrupted during catastrophic events”.

Getty fire: Housekeepers and gardeners go to work despite the flames” in the LA Times which also highlights the chaos brought by lack of communication, and the need for low-wage workers to work, despite danger.

International Association of Firefighters press release “California Members Work around the Clock to Contain Wildfires” provides an overview of  wildfire fighting by their members and points out that firefighters’ homes may also be in the path of destruction. (a fact that is true for other essential workers such as  health care workers).

“As fires rage, California refines an important skill: Evacuating” in the Washington Post (Oct. 29).  Describes the challenges of first responders responsible for vulnerable patients in hospitals.

New threats put wildfire fighters health on the line”  in the New York Times points out : “While burning wood poses some threat to lungs, man-made products and the gases and particles they produce when burned are far more dangerous…Unlike urban firefighters dealing with structural blazes, these wildfire responders do not wear heavy gear that filters air or provides clean air because the gear is unwieldy and too limited to allow the kind of multi-hour, high-exertion efforts demanded on the front lines of these large outdoor infernos.”

And from 2017, “Suicide rate among wildland firefighters is “astronomical”” in Wildfire Today  , based on a more substantial article in The Atlantic: “A Quiet Rise in Wildland-Firefighter Suicides”

 

Canada:

Climate change is making wildfires in Canada bigger, hotter and more dangerous”  in Maclean’s (July 18 2019) is a quick overview of the Canadian experience.

We were blindsided: Rappel firefighters criticizes UCP for axing program  in the Edmonton Journal  (Nov. 7) and an article in the newspaper Fort McMurray Today react to the Alberta government cuts which will eliminate the 40-year-old rappelling program, which employs more than 60 firefighters who rappel from helicopters into forest fires. Staffing for close to 30 wildfire lookout towers and one air tanker unit will also be cut. The articles describe the dangerous job of fighting fires.

A  British Columbia government press release at the end of October 2019 announces two research projects underway to study  firefighter health and wellness (including its physical, mental and emotional dimensions).  One at the University of Northern B.C. is a scoping study to contribute to a long-term research strategy for worker health by the B.C. Wildfire Service. The second, supported by the government of Alberta,  is examining the nature and concentration of polycyclic aromatic hydrocarbons in the air that firefighters breathe and accumulate on their skin. This study will also “explore the practicality and effectiveness of firefighters using respiratory protective equipment; and investigate whether wildland firefighters have more chronic lung disease than other people of the same age, gender and geographic location.” A progress report on the initial phase of this project is expected in March 2020.

“Fire-weary Western Canadians are picking up stakes and moving on” in the National Observer (June 24  2019)considers the impact of smoke as well as fire over the past two years in the West, discussing how “residents … young and old, often on fixed or limited incomes, are making tough choices about where they want to live and to work. The decisions are being informed by many factors, but often the most pressing concern is the increasing frequency of forest fires.”  (This updates some of the themes of a 2017 Globe and Mail article “Fort MacMurray wildfires leaves livelihoods in limbo” ).

Unions have made consistent and significant donations to wildfire-affected communities.  Some examples: “Steelworkers Humanity Fund Contributes $69,000 to Fort McMurray Recovery” (2016); “Steelworkers Contribute $100,000 to B.C. Fire Relief” (August 2017),  and Steelworkers Humanity Fund Contributes $58,950 to Support Disaster Recovery Here and Abroad (June 2019) –  which specifies a $10,000  donation to the  High Level Native Friendship Centre food bank in Northern Alberta after  forest fires caused  the evacuation of the town.  Also,  “Unifor wildfire relief donations top $220k” in 2017, and  a 2018 press release announced $150,000 to the B.C. Fire Relief Fund of the Canadian Red Cross in 2018 through Unifor’s Canadian Community Fund  as well as its Social Justice Fund .

Canadian nurses’ unions issue a call for action on the climate health emergency

Nurses climatechange-cover-368x480The Canadian Federation of Nurses Unions (CFNU) is the umbrella organization representing approximately 200,000 nursing and front-line health professionals in unions across Canada. At their Biennial Convention in Fredricton in June, representatives passed Resolution #3, calling on the CFNU and its Member Organizations: …  to recognize within their position statements that climate change is “a global crisis and health emergency”; …to support sustainable health care practices to reduce greenhouse gas emissions in health care settings; …to “engage with community stakeholders, such as the Canadian Labour Congress, in initiatives and campaigns that raise the public’s awareness about the serious health implications of climate change”; and to call on the federal and provincial governments to undertake the necessary policies to meet Canada’s obligations under the United Nations Framework Convention on Climate Change (the Paris Agreement)….”

Also at the convention, the CFNU released a  discussion paper: Climate Change and Health: It’s Time for Nurses to Act . It is described as “a starting point for for advocacy and leadership”. It summarizes the well-established health impacts related to climate change in the Canadian environment – for example, heat stress, increased allergies and asthma, cardiorespiratory distress from air pollution due to wildfires, Lyme disease. It includes a special focus on mental health and anxiety impacts.  It also highlights three practical examples from  2018 : wildfire smoke exposure in B.C., flooding in Atlantic Canada, and heat waves in Ontario and Quebec.

The report concludes with these six recommendations for nurses:

  1. Work with your employers, unions and associations to reduce emissions and to “green” your workplace.  (sub-recommendations include “Promote the divestment of pension plans from high-emission sectors and the investment in clean technologies and low-emission sectors;”)
  2. Know about climate change science, and help educate patients and the general public about it.  (sub-recommendations include “Campaign for the ecological determinants of health to be included in nursing education to prepare future generations of nurses, who will see the greatest effects of climate change. Nursing education should support a basic level of climate change literacy.”)
  3. Call for meaningful federal and provincial actions to reduce and eliminate climate change-causing emissions to ensure Canada leads the world in implementing its obligations under the UN Framework Convention on Climate Change (The Paris Accord). (Sub-recommendation: Promote transitioning away from fossil fuels towards renewable energy. ….. By investing in renewal energy rather than in fossil fuels we are committing to a healthier future.)
  4. Be aware and plan for the emerging needs of patients resulting from climate change and help them take action to support a healthy planet. (Sub-recommendation: “ Be aware and prepare your workplaces for future influxes of climate refugees coming to Canada. This population may have experienced trauma or extreme environmental conditions and taken risks to enter this country.”)
  5. Be prepared for extreme weather events.
  6. Promote active transportation and local healthy agriculture and food systems to reduce emissions.

Climate-Change-Toolkit-for-Health-Professionals-2019-234x300The Discussion paper was launched as part of a panel which included Dr. Courtney Howard, president of the Canadian Association of Physicians for the Environment.  CAPE issued their latest Call to Action  in February 2019 , in collaboration with the Canadian Medical Association , the Canadian Nurses Association, the Urban Public Health Network , and the Canadian Public Health Association.  On April 30, CAPE released a Climate Change Toolkit for Health Professionals, which is available for download in either English or French , and offers eight stand-alone modules with seven factsheets. Topics include Climate Change Health Impacts Globally and Across Canada; Taking Climate Change Action at Health Facilities ; Preparing for Climate Change in our Communities;  and Engaging in Climate Change as Health Professionals, which highlights, for example,  CAPE’s role in the campaign to phase-out coal in Alberta. As part of their active advocacy campaign, CAPE  makes frequent media statements and was part of the health delegation which met with the federal Minister of Health on June 7 .

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.”

Lancet Report details health impacts of climate change with new estimates re heat impacts on labour

The latest landmark Report of the Lancet Countdown  was released at the end of November 2018, updating the global research on the health impacts of climate change.    The title of the press release reveals the focus : Extreme heat damaging our health and livelihoods and threatening to overwhelm hospitals around the world  . Using new methodology, the report estimates work hours lost to extreme heat: “153 billion hours of work were lost in 2017 due to extreme heat as a result of climate change. China alone lost 21 billion hours, the equivalent of a year’s work for 1.4% of their working population. India lost 75 billion hours, equivalent to 7% of their total working population.” lancet 2018 map heat and labour

Although the 2018 report emphasizes the increasing threats related to heat, it  measures 41 indicators related to disease, air pollution, extreme weather, and addresses economic and social impacts – including food security and climate migration.  Regarding energy, it states “ In 2017, renewable energy provided 10.3 million jobs – a 5.7% increase from 2016. But fossil fuel extraction industries increased to 11 million – an 8% increase from 2016.” The report estimates  deaths from air pollution by source attribution, with coal estimated to account for 16%  of deaths globally.  It also includes a new indicator mapping extremes of precipitation, identifying South America and southeast Asia among the regions most exposed to flood and drought and, on food security, the report points to 30 countries experiencing downward trends in crop yields, reversing a decade-long trend.

In addition to the main global report, national Briefings for Policymakers are provided for the Brazil, China, the EU, India, the Netherlands, Spain, U.K. and the U.S., as well as Canada. An excellent summary of the main report and the Canadian sub-report appears from the Canadian Association of Physicians for the Environment.

The Briefing for Canadian Policymakers  is written in collaboration with the Canadian Medical Association and the Canadian Public Health Association. It provides a Canada-specific view of  health impacts, and makes recommendations: for example, “Phase out coal-powered electricity in Canada by 2030 or sooner, with a minimum of two thirds of the power replaced by non-emitting sources ;…  increase ambition in reducing greenhouse gas emissions and air pollution in Canada and twin this with an emphasis on Just Transition Policies to support an equitable transition for people who work in the fossil fuel industry as the energy economy transforms;…. Apply carbon pricing instruments as soon and as broadly as possible, enhancing ambition gradually in a predictable manner, and integrate study of resulting air pollution-related health and healthcare impacts into ongoing policy decisions.” The report provides Canadian context for  the under-appreciated topic of  “Climate Change, Mental Health and Ecological Grief”, with examples from the Arctic and sub-Arctice: Rigolet, Nunatsiavut, and a study of  the SOS Summer-of-Smoke , when the area around  Yellowknife experienced  prolonged smoke and fire exposure in 2014.

Finally, the global Countdown report warns  that “A lack of progress in reducing emissions and building adaptive capacity threatens both human lives and the viability of the national health systems they depend on, with the potential to disrupt core public health infrastructure and overwhelm health services.”  It points to the growth of health-related advocacy groups , the divestment from fossil fuels, (including by the Canadian Medical Association), and the need for climate change-related training for health professionals.    The Canadian report also addresses this need for training for health professionals, stating:  “A well-trained workforce is required to respond to these challenges. The Canadian Public Health Association’s Ecological Determinants Group on Education has been working to integrate an ecosocial approach into public health education, including facilitating the participation of the Canadian Federation of Medical Students in an International Federation of Medical Students’ Associations initiative which seeks to see climate change and health gain a foothold in curricula by 2020 with fuller integration by 2025.”

The Lancet Countdown: Tracking Progress on Health and Climate Change is a global, interdisciplinary report funded by the Wellcome Trust, and researched through the collaboration of  27 academic institutions and inter-governmental organizations. The full report is here  (registration required).

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.