2020 Lancet Countdown report on Health and Climate Change finds Canadians most at risk from extreme heat and air pollution

The Lancet Countdown Report on Health and Climate Change has been a landmark report since its first edition in 2015 (earlier reports are here ) .Compiled by an international team from more than 35 institutions including the World Health Organization and the World Bank, it documents the health impacts of climate change, and discusses the health and economic implications of climate policies. The global  2020 Countdown Report was released on December 2. Along with troubling statistics comes one core message:

“The COVID-19 pandemic and climate change represent converging crises. Wildfires and tropical storms in 2020 have tragically shown us that we don’t have the luxury of tackling one crisis alone. At the same time, climate change and infectious disease share common drivers. Responding to climate change today will bring about cleaner skies, healthier diets, and safer places to live–as well as reduce the risk factors of future infectious diseases.”

The Countdown project produces country-specific reports , with the Canada Briefing written by Drs. Claudel Pétrin-Desrosiers and Finola Hackett, and endorsed by the Canadian Medical Association.  The Canadian briefing presents updated information on two major issues: extreme heat and air pollution. Some highlights:

  • a record 2,700 heat-related deaths occurred among people over the age of 65 in Canada in 2018;
  • there were 7,200 premature deaths related to fine particulate air pollution from human-caused sources in Canada in 2018;
  • the work hours lost due to exposure to extreme heat was 81% higher in 2015-2019 than in 1990-1994 in Canada, with an average of 7.1 million extra work hours lost per year.

Although previous Canadian reports have called for carbon pricing, the 2020 report offers six recommendations which prioritize retrofitting and energy efficiency policies, along with funding for low-emissions transportation and active transportation.  The report also calls for: “…a recovery from COVID-19 that is aligned with a just transition to a carbon-neutral society, considering health and equity impacts of all proposed policies to address the climate and COVID-19 dual crises, directly including and prioritizing the disproportionately affected, including Indigenous peoples, older persons, women, racialized people, and those with low income.”

Courtney Howard, past president  of the Canadian Association of Physicians for the Environment writes “COVID-19 recovery is an opportunity to tackle worsening climate crisis: New report”  (The Conversation, Dec. 3).  The Canadian Medical Association announcement of the report is here ; and the CMA also released a recent survey  of its members, showing that 95% of respondents recognized the impacts of climate change, and 89% felt that  health professionals have a responsibility to bring the health effects of climate change to the attention of policy-makers . The World Health Organization sponsored the survey as part of a global initiative –  the Canadian results will be included  in a global WHO report scheduled for release in January 2021.

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.

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 .

United Nations reports warn of health impacts of climate change, thawing Arctic

geo6 final 2019The Fourth United Nations Environment Assembly (UNEA) convened from March 11 – 15 in Nairobi, Kenya, under the sombre cloud of the crash of Ethiopian Airlines which killed many, including Canadians, on their way to attend the meetings.

The flagship report, produced by 250 global scientists and experts, is the Sixth Global Environmental Outlook, which the UN press release calls “the most comprehensive and rigorous assessment on the state of the environment completed by the UN in the last five years .. warning that damage to the planet is so dire that people’s health will be increasingly threatened unless urgent action is taken.”  It warns that, without such urgent action,  cities and regions in Asia, the Middle East and Africa could see millions of premature deaths by 2050, with pollutants in freshwater systems leading to deaths through increased  anti-microbial resistance, as well as impacts on  male and female fertility and impaired neurodevelopment of children, from endocrine disruptors.  A 28-page  Summary for Policymakers   is available in multiple languages besides English, including French .  GEO6-NA_cover_large

The official documents from the UNEA meetings are compiled here , including the closing press release summary, “World pledges to protect polluted, degraded planet as it adopts blueprint for more sustainable future” .

Other reports relevant to Canada:

1.The Assessment and Data Report for North America is one of the regional reports, all of which are compiled here .

2.  Global Resources Outlook 2019: Natural Resources for the Future We Want    examines the economic benefits and environmental costs of resource use, and finds that all resource sectors combined (including agriculture, mining, forestry ) account for 53% of the world’s carbon emissions. Extraction and primary processing of metals and other minerals  is responsible for 20% of health impacts from air pollution and 26% of global carbon emissions. The report warns that without change,  resource demand would more than double to 190bn tonnes a year, greenhouse gases would rise by 40% and demand for land would increase by 20%.   A summary of the report appeared in The Guardian.

3.   With a forecast even more dire than the 2018  IPCC report, Global linkages: A graphic look at the changing Arctic  warns that even if global emissions were to halt overnight, winter temperatures in the Arctic would still increase 4 to 5°C by 2100 because  of  greenhouse gases already emitted and ocean heat storage. The UNEA report warns of the dangers of thawing permafrost, predicting that by  2050, four million people, and around 70% of today’s Arctic infrastructure, will be threatened.  However, a critique by  the Carbon Brief    disputes this particular conclusion within the UNEA report, and states that  if humanity can mobilize to hit a -2 degrees C target, “future Arctic winter warming will be around 0.5 to 5.0°C by the 2080s compared to 1986-2005 levels, much lower than the 5.0 to 9.0°C values stated in the report.” … “This means that much of the future warming in the Arctic will depend on our emissions over the 21st century, rather than being ‘locked in’, as the report claims.” The Carbon Brief analysis is summarized in The  Energy Mix .