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 .

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).

Ontario announces initiative re energy efficiency in hospitals, and updates Infrastructure Plan

hospital for sick kidsA press release on November 27 from Ontario’s Ministry of Health announced  an  investment of $64 million through  a Hospital Energy Efficiency Program, which will support 180 projects at 98 hospitals across the province, providing more efficient heating, ventilation, air conditioning and lighting. The funds will be directed from the proceeds of cap and trade auctions, and are in addition to the $9 billion for new hospital projects already announced in the 2017 Budget statement, as part of Infrastructure spending.

On November 28,  the government released Building Better Lives  , an  update for 2017 about the  Ontario Long Term Infrastructure Plan which was launched in 2014, and which integrates climate change priorities in infrastructure planning for public transit, transportation, schools and hospitals.    The government press release cites a study by the Centre for Spatial Economics to defend its program.   The Economic Benefits of Public Infrastructure Spending in Ontario (March 2017) estimates that  in the short-run, gross domestic product rises $0.91per dollar of spending, 4.7 jobs are generated per million dollars spent,  and $0.27 of each dollar spent by government is recovered in additional Ontario and federal and government revenues.

Building Better Lives also includes a Technical Appendix with details on the asset management strategies of key ministries and agencies, as well as information about their assets. The Appendix also provides an overview of the three-year review to be undertaken to identify best practices and to transform the asset management process for government ministries.  This status report and review is required under the Ontario Infrastructure for Jobs and Prosperity Act, 2015.

Carbon Neutral Government Operations pay off in Jobs in B.C.

Since 2010, public service organizations in British Columbia (hospitals, schools, universities) have been required to achieve carbon neutral operations, documented each year in annual Carbon Neutral Action Reports , which provide statistics, case studies of initiatives, and details of their purchases of carbon offsets. A new report, Leading by Example: The First Five Years of Carbon Neutral Government in British Columbia cumulates and analyses five years’ experience; one highlight is that 77% of public sector carbon emissions are facility- related, suggesting great potential for reduction through retrofitting and energy technologies.  A companion report, The Economic Analysis of British Columbia’s Carbon Offset Projects analyses the capital and operating expenditures of the 23 emission offset projects purchased by the public sector in 2013 and 2014.  It estimates that the $24 million expenditure in offsets contributed $28.9 million to provincial GDP, and created 221 jobs in 2013 and 2014. The report also builds on the findings of a Price Waterhouse Coopers analysis done in 2012, and concludes that carbon offset capital expenditures have resulted in 2,903 jobs, and operating expenditures resulted in an additional 1,535 jobs for the period 2008 to the end of 2014.