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 – supported 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.
Since 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:
- “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;
- 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;
- 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;
- 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.
The 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:
- 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;”)
- 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.”)
- 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.)
- 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.”)
- Be prepared for extreme weather events.
- Promote active transportation and local healthy agriculture and food systems to reduce emissions.
The 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 .
The 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 .
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:
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 .
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.”
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).