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Regardless of political views, everyone can agree that good health is preferable over illness and disease. In order to live a healthy life, most of us know that we should exercise, eat a nutritious diet, and try to avoid excess stress. However, it may come as a surprise that climate change has the potential to negatively affect human health in a variety of ways. Indeed, the Lancet Medical Journal has gone so far as to label climate change the biggest global health threat of the 21st century (1). Shake Up the Establishment has already provided a great introduction to the links between climate change and health which can be accessed here (2). The purpose of this article is to highlight a few recent publications and news events related to this topic, particularly in a Canadian context.
Building on their landmark 2018 report on health and climate change (1), the Lancet Countdown released an updated report in November 2019 focused on “ensuring that the health of a child born today is not defined by a changing climate” (3). Under a ‘business as usual’ framework of global carbon emissions, a newborn child will face the catastrophic implications of a world whose temperature has risen by more than 4°C (above the pre-industrial average). Keep in mind that this estimate refers to a child who is born today. Children of future generations could experience even greater risks, coupled with the reality that younger individuals are disproportionately vulnerable to many climate-related threats, including undernutrition, diarrhoeal disease, and air pollution.
According to this latest report from the Lancet Countdown, humanity is at a fork in the roads where our (in)action now (and in the near future) will put us on one of two pathways: Either we’ll prevent a global temperature increase of 2°C (and ideally remain well below this point), or we won’t. Striving for 1.5°C, with an ‘acceptable’ ceiling of 2°C degrees, is at the core of the Paris Climate Agreement (4). However, it’s important to remember that any incremental degree of warming contributes to a worsening of climate-related events, the impacts of which are not proportionately distributed. For instance, Indigenous peoples in the Canadian Arctic are already experiencing dramatic changes in their homelands due to accelerated warming conditions (5,6).
The 2019 Lancet report also provides a summary of updated evidence on 41 indicators across 5 categories, all of which are relevant to humanity’s ‘choice’ of pathway as we enter a new decade in the fight against climate change. Some key indicators from the Lancet Countdown were further distilled into a policy brief for Canadians (7) with assistance from Canadian Medical Association and the Canadian Public Health Association. First, it should not come as a surprise that Canadians have faced increased exposure to wildfires, resulting in serious concerns for our collective health, safety, and wellbeing. Second, transportation in Canada remains largely powered by fossil fuels (with some promising developments in electricity and biofuels), and there exists great opportunities for investments in sustainable and active transportation (public transportation and cycling infrastructure being prime examples). Third, healthcare services around the world emit large amounts of greenhouse gases, thereby inadvertently contributing to the health impacts of climate change. The policy brief points to a 2018 study which concluded that carbon emissions solely from the Canadian healthcare sector account for 4.6% of our national total!
While structural changes are needed to decrease the carbon footprint of the medical community, it’s promising that future generations of Canadian physicians are increasingly aware of the links between human health and the health of the planet. The Health and Environment Adaptive Response Taskforce (HEART), a subgroup of the Canadian Federation of Medical Students, recently evaluated the planetary health education provided by all 17 medical schools in Canada to identify areas for improvement (8). Including more content on climate change would ultimately help physicians better understand, and subsequently address, the impacts of environmental changes on the health of their patients and communities.
Another group currently active at the nexus of climate and health is the Canadian Association of Physicians for the Environment (CAPE). In January 2020, CAPE released a detailed report (9) entitled ‘Fractures in the Bridge: Unconventional (Fracked) Natural Gas, Climate Change and Human Health’. This report highlighted numerous concerns associated with the use of fracking to extract unconventional natural gas and oil reserves (i.e. where extraction cannot be accomplished via vertical well bores), including negative health outcomes, effects on nearby (often Indigenous) communities, and contributions to climate change. Among other recommendations, CAPE called for a Canada-wide moratorium on any new development of unconventional natural gas and oil reserves via fracking.
Many Canadians will be aware of the debate surrounding the proposed Teck Frontier Oil Sands Mine in Alberta, and this is another issue on which CAPE has been actively outspoken. In February 2020, CAPE, along with over 175 medical experts as co-signatories, submitted a letter to Prime Minister Justin Trudeau and Jonathan Wilkinson (Minister of Environment and Climate Change) regarding this project’s approval (10). These health experts called on the federal cabinet to “reject Teck to protect children’s health”, and they were not alone in their plea; dozens of Nobel prize winners published a letter in opposition to the Teck mine, claiming “projects that enable fossil-fuel growth at this moment in time are an affront to our state of climate emergency” (11). On February 23, Teck officially withdrew their regulatory application for the Frontier project (12). This was viewed as a success by the organization Indigenous Climate Action, whose ‘Reject Teck’ campaign voiced strong concerns over the implications of the Frontier mine for Indigenous communities and the environment (13).
A lot has happened over the past few years in the sphere of climate change and health, and the examples provided in this article represent only a handful of noteworthy publications and developments. Children’s health is a common theme of this work as we consider the potentially devastating impacts that increasing global temperatures will have on future generations. In line with this thinking, the World Health Organization, UNICEF, and the Lancet recently published a commission entitled ‘A future for the world’s children?’ which “presents the case for placing children, aged 0–18 years, at the centre of the SDGs [Sustainable Development Goals]” (14). Regardless of partisan affiliations, the health of children (and all of humanity) is something that should unite Canadians as a strong motivator for serious climate action. During the next cycle of elections, let’s remember what’s at stake and vote accordingly.
References
1. Watts N, Amann M, Arnell N, Ayeb-Karlson S, Belesova K, Berry H et al. The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. The Lancet. 2018, 382(10163): 2479-2514. DOI: 10.1016/S0140-6736(18)32594-7
2. Climate Change and Public Heatlh. Shake up the Establishment. 2020. Available from https://www.shakeuptheestab.org/health
3. Watts N, Amann M, Arnell N, Ayeb-Karlson S, Belesova K, Boykoff M et al. The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate. The Lancet. 2019, 394(10211): 1836-1878. DOI: 10.1016/S0140-6736(19)32596-6
4. The Paris Agreement. United Nations Framework Convention on Climate Change. Available from https://unfccc.int/process-and-meetings/the-paris-agreement/the-paris-agreement
5. Indigenous People's Atlas of Canada. Climate Change. Canadian Geographic. Available from https://indigenouspeoplesatlasofcanada.ca/article/climate-climate-change/
6. National Inuit climate change strategy. Inuit Tapiriit Kanatami. Available from https://www.itk.ca/national-inuit-climate-change-strategy/
7. Howard C, Buse C, Rose C, MacNeil A, & Parks M. The 2019 Lancet Countdown on Health and Climate Change: Policy brief for Canada. 2019, Available from https://storage.googleapis.com/lancet-countdown/2019/11/Lancet-Countdown_Policy-brief-for-Canada_FINAL.pdf
8. Hackett F, Got T, Kitching GT, MacQueen K, Cohen A. Training Canadian doctors for the health challenges of climate change. The Lancet Planetary Health. 2020, 4(1): E2-E3. DOI: 10.1016/ S2542-5196(19)30242-6
9. MacFarlane R & Perrota K. Fractures in the Bridge: Unconventional (Fracked) Natural Gas, Climate Change and Human Health. Canadian Association of Physicians for the Environment (CAPE). 2020, Available from https://cape.ca/wp-content/uploads/2020/01/CAPE-Fracking-Report-EN.pdf
10. Howard C, Parkes M, Tcholakov Y, Takaro T, Orbinski J, & Vipond J. Letter to Minister Wilkinson and PM on Teck Mine. Canadian Association of Physicians for the Environment (CAPE). 2020, Available from https://cape.ca/wp-content/uploads/2020/02/Teck-press-release-Feb-19-2020.pdf
11. Coetzee J, Munroe A, Yunus M, & Jelinek E. As Nobel prize winners, we demand Justin Trudeau stop the Teck Frontier mine. The Guardian. 2020, Available from https://www.theguardian.com/commentisfree/2020/feb/21/nobel-prize-winners-justin-trudeau-teck-frontier-mine
12. Lindsay, D. Letter to Minister Wilkinson. Teck Resources Limited. 2020, available from https://www.teck.com/news/news-releases/2020/teck-withdraws-regulatory-application-for-frontier-project
13. ICA Celebrates Reject Teck Win. Indigenous Climate Action. 2020, available from https://www.indigenousclimateaction.com/post/ica-celebrates-reject-teck-win
14. Clarke H, Coll-Seck AM, Banerjee A, Peterson S, Dalglish SL, Ameratunga S, et al. A future for the world's children? A WHO–UNICEF–Lancet Commission. The Lancet. 2020, 395(10224): 605-658. DOI: 10.1016/S0140-6736(19)32540-1