EcoCare Conference October 19, 2009 Peter Berry Ph.D. Climate Change and Health Office Health Canada Human Health in a Changing Climate

“Climate change is the biggest global health threat of the 21st century” Lancet and UCL, 2009

Over 300,000 deaths per year Over 300 million people severely affected each year Over 100 billion US dollars of economic losses each year Over 20 million climate displaced people, with 1 million more each year Key Climate Impacts Today (Global Humanitarian Forum, 2009)

Climate Change Impacts on Health McMichael and Bertollini, 2009

World Health Organization (2008) – Protecting Health in Europe from a Changing Climate USA - Global Climate Change Impacts in the United States (2009) European Environment Agency (2008) – Impacts of Europe’s Changing Climate Australia - Climate Change in Australia (2008) UN Food and Agriculture Organization – Climate Change: Implications for Food Safety Climate Change and Children: A Human Security Challenge (Unicef, 2008) Climate Change: Impact on Agriculture and Costs of Adaptation (Nelson et al, 2009) Climate Change: Global Risks, Challenges & Decisions (Richardson et al, 2009) Recent Reports - International

Human Health in a Changing Climate: A Canadian Assessment of Vulnerabilities and Adaptive Capacity (Health Canada, 2008) Emergency Management: Taking a Health Perspective (Health Canada, 2009) Climate Change and Health in British Columbia (2008) Climate Change and Extreme Weather: Designing Adaptation Policy (Henstra and McBean, 2009) From Impacts to Adaptation (NRCan, 2008) Recent Reports - Canadian

Table of Contents Introduction: Health in a Changing Climate Assessment Methods Impacts of Climate Change on Water, Food, Vector and Rodent-borne Diseases in Canada Air Quality, Climate and Health Canadian Vulnerabilities to Natural Hazards and Extreme Weather Health Impacts of Climate Change in Quebec Health Impacts of Climate Change in Canada’s North Vulnerabilities, Adaptation and Adaptive Capacity in Canada Climate Change and Health Vulnerability Assessment

Air Quality Under 4 degree increase in temperature ozone levels would increase in Canadian communities Most affected areas – Montreal, Toronto, Vancouver, Calgary, Edmonton, and Winnipeg Largest increase in Windsor – Quebec corridor 312 more deaths 4.6% increase in health burden to Canadian society related to air pollution over 3-month summer period ($1.3 Bil) PM 2.5 levels to decrease

Climate change will increase risks associated with some infectious diseases Possible spread of I. Scapularis in Canada under climate change

Drowning, injuries Shock, hyperthermia, cardiac arrest Wound infections; dermatitis; conjunctivitis; gastrointestinal illnesses; ear, nose, and throat infections; water-borne diseases Psychosocial disturbances Waterborne infections (enterogenic Escherichia coli, Shigella, hepatitis A, leptospirosis, giardiasis, campylobacteriosis), dermatitis, conjunctivitis Vector-borne diseases Electrocutions, injuries; lacerations; skin punctures Food shortage, disruption of emergency response Health Impacts from Floods

Frequency of Natural Disasters in Canada Canadian Disaster Database, 2006

Temperature-Mortality Relationships Gosselin et al., – 150 deaths 2050 – 550 deaths 2080 – 1400 deaths

Extreme Heat - Vulnerable Populations Seniors   Pre-existing disease   Social factors (living alone)   Use of certain drugs (e.g., antidepressants, alcohol, diuretics   Impaired cognition (e.g., dementia)   Housing (e.g., floor)   Lack of air conditioning   Physical activity – overexertion or inactivity 2006 – seniors 13% of population 2031 – seniors 25% of population

Ocean Acidification Climate System Surprises Melting of Polar Ice

Adaptation Matters – Heat alert and response systems Europe WHO study indicated that most of the 70,000 heat wave deaths in Europe in 2003 were preventable Recent study (2008) indicates that a similar heat wave in France in 2006 lead to approx. 4,000 less deaths due to implementation of alert system United States 1995 heat wave in US mid-west caused 514 deaths in Chicago Similar heat wave in 1999 resulted in only 119 deaths due to better response plans

Adaptation - The Critical Role of Public Health Cases of dengue fever in Texas and Mexico –

“In the face of what we know about the serious threats posed by climate change to health, the question today is not whether public health action is necessary, but what to do and how to do it. Health systems should respond by helping to strengthen disease control and health protection.” Dr. Marc Danzon WHO Regional Director for Europe 2008 The Adaptation Imperative

“International Day for Disaster Reduction 2009: Urgent action needed to protect hospitals from natural hazards” WHO, October 14, 2009 “WHO urges hospitals to join climate change battle” National Post, May 22, 2009

Adaptation Challenges What information not merely informs but changes behaviour? What is adaptation? What is needed to do to adapt? New activity? (e.g., heat alert system) Better activities? (e.g., public outreach – “maladaptation”) More activities? (e.g., expanded surveillance) How do you “mainstream” adaptation? acquire information about implications of future climate consider climate in routine risk assessments institutionalize climate considerations into assessment and planning How do you take a multi-sectoral/jurisdictional approach? federal, provincial/territorial, municipal level collaboration health considerations in multi-sectoral planning What are the costs of adapting? What are the costs of not adapting?

Knowledge of Health Risks Environics, 2008

Vulnerability of Canadians Environics, 2008

Protection from Climate Change Health Impacts Environics, 2008

Health Portfolio Activities on Climate Change Extreme Heat and Health Adaptation in Northern Communities Climate–related Infectious Diseases

Health Canada’s Extreme Heat Initiative Heat Alert and Response Systems Pilot systems in Canadian communities Best practices guidebook Health messaging to change behaviour Health Professional Interventions and Training Development of clinical guidelines Development of training materials

Pilot heat alert and response systems Windsor, ON Fredericton, NB Winnipeg, MN Assiniboine Region, MN

Heat health messaging Challenges: Scientific basis for messages Changing behaviour of vulnerable populations Reaching public health authorities Reaching caregivers

Clinical guidelines Doctors Nurses Home caregivers Paramedics Pharmacists Coaches Teachers

Canadians possess the knowledge, institutions and skills to reduce climate change health risks BUT – these resources must be harnessed to address the challenges ahead: public health officials should be engaged and supported public health programs should be ``mainstreamed`` best practices for adaptation must be identified collaborative partnerships must be built

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