Climate Change and Health and Well-Being: A Policy Primer

Executive Summary

Climate Change and Health & Well-being in Canada

Scientists, governments and international bodies have recognized that greenhouse gas accumulations in the atmosphere will change the global climate, and will affect the environment and human health and well-being. The range of potential health effects from this phenomenon is quite broad. Some communities will be more vulnerable than others, for geographic reasons, due to health status or because of limited resources.

Although many successful mitigation measures to reduce the impact of greenhouse gas emissions are already underway under the First National Business Plan, it is also recognized that mitigation efforts will not totally eliminate the risk of climate change. Even if the provisions of the Kyoto Protocol are fully met by all participating countries, the date at which CO² will double in the atmosphere will simply be pushed back, but this will still occur. Canada will have to cope with, and adapt to, the many climate-related environmental changes which have already begun, particularly in the North, and which will affect the future health and well-being of Canadians.

Health Canada has identified eight significant climate change induced health effects which are expected to increase in the future in this country. They include health and well-being issues related to increased smog episodes, heat waves, water and food borne contamination, vector-borne diseases, stratospheric ozone depletion and extreme weather events. These effects are expected to be particularly severe for vulnerable populations such as children, the elderly, the poor, disabled people, immigrant populations and Aboriginal Canadians. A host of broad socioeconomic issues related to climate change are also of considerable concern including changed determinants of environmental health and well-being, health and social co-benefits of climate change mitigation actions along with the attendant risks (next page).

Canada's Health Impacts From Climate Change And Variability

Health Concerns	Examples of Health Vulnerabilities
Temperature-related morbidity and mortality	Cold and heat related illnesses Respiratory and cardiovascular illnesses Increased occupational health risks
Health effects of extreme weather events	Damaged public health infrastructure Injuries and illnesses Social and mental health stress due to disasters Occupational health hazards Preparedness and population displacement
Air pollution-related health effects	Changed exposure to outdoor and indoor air pollutants and allergens Asthma and other respiratory diseases Heart attacks strokes and other cardiovascular diseases Cancer
Water- and food-borne contamination	Enteric diseases (diarrhea, vomiting,etc.)
Vector-borne infectious diseases	Changed patterns of diseases caused by bacteria, viruses and other pathogens carried by mosquitos, ticks and other vectors
Stratospheric ozone depletion and increased exposure to ultra-violet radiation	Skin damage and skin cancer Cataracts Disturbed immune function
Population vulnerabilities in rural and urban communities	Seniors Children Chronically ill Low income and homeless Subsistence populations Disabled Recent immigrants
Health and Socio- Economic Impacts on Community Health and Well-being	Changed determinants of health and well-being Global burden of disease Vulnerability of community economies Health co-benefits and risks of GHG reduction technologies

As part of this effort, Health Canada held its First Annual Climate Change and Health & Well-being National Policy and Planning Conference (September 5-7, 2001) involving policy analysts and practitioners from federal health programs, provincial and territorial Ministries of Health, community health programs, and health and environmental nongovernmental organizations. The goal of the conference was to coordinate the development of collaborative policy networks, provide information about the development of Canada';s health impact assessment guidelines and begin addressing priority health issues which will help Canada successfully adapt to climate change.

The Climate Change and Health Office at Health Canada will facilitate policy development and planning by providing the following services:

• Inventory of climate change and health funding sources
• Inventory of climate change and health policy analysts and practitioners
• Inventory of potential adaptation measures and current activities
• Facilitate climate change and health policy research activities
• Coordinate climate change health policy issue seminars and workshops

Managing the Risks to Human Health and Well-being from Climate Change

Adaptation to the health effects of climate change and variability involves the management of an inter-related set of risks. Of particular importance for decision makers is the identification of how vulnerable specific communities and regions of Canada are to the possible effects of climate change. This is a function of existing sensitivities (e.g., vulnerable populations) and the adaptive capacity (e.g., resources, technology, knowledge, institutions, etc.) of the communities.

The risk management process provides a framework for selecting adaptation strategies which are best suited for a community';s infrastructure, operations, economy or populations. In collaboration with Health Canada, an expert panel from the University of Ottawa has developed a formal risk management framework, the Health Canada Policy Framework for the Management of G lobal Climate Change Issues. The framework will undergo further development to suit the needs of communities in Canada.

Assessing the Impacts of Climate Change on Human Health

Sound adaptation policies should be based on sound knowledge of the impacts of climate change, the vulnerability and sensitivity of Canadians to it and existing options for adaptation that are effective in reducing the risks.

For that reason, in March 2001, Health Canada hosted, in partnership with the Canadian Climate Impacts and Adaptation Research Network (C-CIARN) of Natural Resources Canada, the First Annual National Health and Climate Change Science and Policy Research Consensus Conference. The conference involved a wide spectrum of national and international researchers and policy analysts. By identifying current gaps in knowledge the conference produced a climate change and health research agenda to guide future scientific efforts.

Populations in all countries will be affected by climate change. International and bi-national cooperation will be needed in efforts to adapt to the impacts of climate change on health and well-being. For that reason, Health Canada, helped the WHO European Centre for Environment and Health, the United Nations Environment Programme and the Pan-American Health Organisation to develop guidelines for assessing climate change human health impacts guidelines that will identify the sensitivity and vulnerability of populations for a range of health issues to guide policy makers in efforts to protect human health. The first draft of the guidelines is expected to be available in late 2002, at which time a WHO/UNEP/WMO review process with a broad coverage of expertise and countries will be initiated. Health Canada is also working with the United States Environmental Protection Agency on these issues.

Ultimately, these guidelines will be used by public health decision makers in Canada, in their collaborative efforts to protect Canadians from such risks.

Integrating Climate Change Considerations into Public Health Policies

The wide range and potential magnitude of the effects of climate change on human health & well-being means that both public and private decision makers should begin now integrating such considerations into public health promotion and protection activities through targeted adaptation initiatives. Canadians have always found ways of coping with climate change and variability and extremes. Our experience over the course of history indicates that adaptive measures and policies sensibly and consistently applied over the long-term can produce excellent results and enhance health and well-being.

Although the climate is changing at an unprecedented rate and scientific uncertainty about the various processes exists, we can make progress in a manner that is affordable and that is protective of human health & well being. We need to clarify what the risks are and who will be affected to inform adaptation planning and policy development in public health and related sectors. Policy options based on the "precautionary principle" or "no-regrets" actions are available to public health decision makers which respond to concerns about the costs of action, possibility of maladaption and scientific uncertainty. These might include increased monitoring and surveillance of vector-borne infectious diseases, the use of climate forecasting in water infrastructure planning, or improved housing and sanitation practices to protect vulnerable populations (Annex 3 - List of Climate Change and Health & Well-being Adaptation Measures). Some communities in Canada have already begun integrating climate change considerations into their public health activities and decision makers would benefit from the sharing of knowledge and experiences in this regard. For example, the City of Toronto has developed two extreme weather alert plans: Extreme Cold Weather Alerts and Heat-Health Alerts (Annex 4: Climate Change and Health & Well-being Adaptation Case Studies).

In addition, a number of national and bi-national government authorities have begun including climate change into their discussions. For example, bi-nationally, the Conference of the New England Governors and Eastern Canadian Premiers and the International Joint Commission have had focused discussions on climate change. Nationally, the National Air Issues Coordinating Committee - Climate Change has been engaged on this issue since 1997.

First Annual Climate Change and Health & Well-being National Policy and Planning Conference

To provide adequate opportunity for discussion and analysis, the Policy and Planning Conference (September 5-7, 2001) will not address the entire 8 health and well-being concerns. Rather, discussions in the breakout groups will focus on climate change effects related to air quality, water and food-borne contaminants, vector-borne infectious diseases and vulnerable populations. The other concerns including temperature-related morbidity and mortality, the health effects of extreme weather events, stratospheric ozone depletion and increased exposure to ultra-violet radiation, and the socio- economic impacts on community health and well-being will be the focus of future conferences and workshops.

The wide range of health issues associated with climate change require the collaborative involvement of actors at the federal, provincial, territorial levels and especially with municipalities where many public health programs are delivered. For this reason, an important part of the Policy and Planning Conference will be the use of breakout sessions on the second day to identify current policy gaps and how Health Canada might provide support to address these issues. One option to be considered will be the use of policy networks to facilitate effective approaches to policy development.

The breakout sessions will involve participation by a range of public and private decision makers from one of 6 regions (North, British Columbia, Prairies, Ontario, Quebec, Atlantic). The groups were identified by ecozone or by climate region based upon the expectation that they will share similar climate change and health & well-being problems in the future (e.g. Atlantic Canada). The breakout session groups will be tasked with launching the development of collaborative policy networks, or alternative cooperation mechanisms, to begin addressing the health effects of climate change related to air and water quality, infectious diseases and vulnerable populations. Each group will define the scope of the policy gaps which need to be addressed and the required activities to move forward with action.

Moving Forward

The results of the National Policy and Planning Conference and the Research Conference will inform Climate Change and Health Office efforts to collaboratively assess and manage the health & well-being issues in Canada through two key oversight committees. These committees will address policy and research issues respectively and include the Climate Change and Health & Well-being Executive Policy Committee and Climate Change and Health & Well-being Technical Program Committee. Both committees will be comprised of federal and provincial/territorial representatives of Ministries of Health, other federal climate change partners, the Climate Change Secretariat, and representatives from a sample of health, environmental and non-governmental organizations such as stakeholders. They will also include a representative from the health research funding community. Policy networks which do arise during the course of the Policy Conference will provide an advisory function to the Executive Policy Committee and will constitute the primary implementation mechanism at the community level.