“First, do no harm” is the most famous passage of the Hippocratic Oath, the oldest ethical code for physicians in the Western world. In a different light, it could also be a guiding principle in the face of climate catastrophe. 

Effective healthcare and climate change work share an emphasis on preventing a problem as more valuable than treating its consequences. Climate change is already imprinting itself on the health of Canadians, and medical organizations, including social impact organizations focused on health, are keenly aware. While doctors and nurses in Canada’s public health system focus on treating patients affected by rising temperatures, extreme weather, and a less hospitable education, health related social impact organizations such as the Canadian Lung Association and the Melanoma Network of Canada are playing an important role by educating Canadians. 

“Meeting our emission commitments is not a theoretical ‘nice to have’. There is a growing awareness that climate change is leading to emerging health threats,” reads a 2019 paper by the Public Health Agency of Canada. Some of the effects of climate change on human health are obvious. Heat waves can batter the body and exacerbate existing conditions. Others, such as the decline of the ozone layer, can put Canadians at risk of developing aggressive skin cancer years after a bad burn. Less obvious effects include the rise of new diseases and more extreme winter weather.

As Canada’s social impact sector prepares for the climate crisis, healthcare-focused organizations are already at the forefront. Public education and advocacy is an important part of any health organizations’ mission at the best of times, but their ability to translate the abstract effects of climate change into the very concrete health impacts seen by Canadians will be incredibly important. The organizations interviewed by Future of Good say they don’t see a separation between healthcare and climate action — and are already considering the effects of our changing world. 

Record heat waves in Montreal

Montrealers joke that their city has just two seasons: winter and construction. But during the summer months, it also experiences some brutally dangerous heat waves, a consequence of Montreal’s geography and intense humidity. At least 66 Montreallers died in 2018’s heat wave according to CBC News. Two-thirds of these people were over the age of 65 and at least 75 percent had pre-existing chronic conditions. To make matters worse, Montreal’s centuries’ old architecture exacerbates the effect of heat waves on residents living in the city’s three-storey townhouses and low-rise apartments.

“In a lot of the main parts of the city, there’s no central air,” says Vanessa Herrick, executive director of Seniors Action Quebec — an English-language organization focused on helping seniors organizations. This includes seniors’ homes. “I haven’t seen a lot of them with central air, so I would say that it’s an issue for a lot of seniors.” Herrick says these heat waves and Montreal’s infamous ice storms are not new, but climate change is making them more frequent and destructive. “The heat waves in the last 5 to 10 years are definitely more intense and they go longer,” she says. 

A report from the Prairie Climate Centre found that in just 30 years, the number of heat waves — or days where the temperature reaches 30 C over a period of three days — seen in Winnipeg could triple to six every summer. Vancouver, a city that has never experienced a heat wave, could be facing two such events every year by 2050. Isolated Montreal seniors living in homes without air conditioning could be in serious trouble during a heat wave, and Herrick says the link to climate change is undeniable. “I think that climate change has an undeniable impact on all of us and seniors are often the most vulnerable in our communities because they’re physically frail or they have more chronic issues,” she says. 

Montreal seniors living in homes without air conditioning could be in serious trouble during a heat wave, and Herrick says the link to climate change is undeniable.

Quebec’s government has acknowledged the impact of heat waves on Montreal’s population. Herrick says there have been public efforts to buy air conditioning units for seniors before they sell out in the summer. Quebec Seniors’ Minister Marguerite Blais has spoken about the health impacts of heat waves on seniors as a top priority for the province’s Coalition Avenir Quebec government. 

“Realistically, they can’t buy air conditioning units for every senior. It’s not going to happen,” Herrick says. Seniors organizations can, however, raise public awareness of the impact of heat waves on the elderly. They can teach seniors (and their neighbours) about the importance of dressing appropriately for a blistering hot Montreal summer, drinking enough water, and not going outside at high noon. Herrick says seniors organizations can also encourage the neighbours of elderly people to check in on them, especially if they live alone or are medically vulnerable. 

Seniors Action Quebec doesn’t work with seniors directly. Instead, it offers training and support to community organizations who work with English-speaking seniors around the province. They haven’t run any seminars around climate change and health impacts on seniors, but Herrick says they may look into it. “If we have the general public keeping an eye out to take care of our older adults, then we don’t necessarily have to wait for the government to put in legislation or buy air conditioning,” she  says. “Fundamentally, an educated and caring general public is the most powerful tool we have.” 

Wildfires in Western Canada

Western Canada’s wildfire season used to last a couple of days in late summer. In recent years, it has engulfed whole provinces in smoke so thick it turns the sky orange and filled the air hundreds of kilometres from a burn with the tang of charred pine. The infamous wildfire season of 2016 left the Alberta city of Fort McMurray in ruins, while, on one notable summer day in 2019, wildfire smoke blocked out the sun in Edmonton. The smoke is unavoidable. 

Wildfires have always been a part of life in Western Canada. For certain species of plants and animals, wildfires are essential to their reproductive cycle. Climate change is nonetheless exacerbating wildfires with dangerous consequences. Menn Biagtan, vice president of health initiatives and programs at the B.C. Lung Association, says unless there are significant improvements, forecasts are all pointing to worsening wildfires over the next 30 to 50 years. “The way we’re going, the forecast will be more severe wildfires and a much longer wildfire season,” she says. 

Much of the news coverage around wildfires is understandably focused on the people who lose their homes, businesses, or lives to the flames. But Biagtan says wildfires are also very detrimental to people with pre-existing lung conditions such as asthma or chronic obstructive pulmonary disease (COPD) who may live a great distance away from a burn. These people might immediately see flare-ups of their condition — wheezing, tightness of the chest, shortness of breath — and may even need to be hospitalized. The Canadian Lung Association also advocates for better emissions standards and improved funding for healthcare organizations to respond to the health effects of climate change. 

“Action is needed to minimize the impacts on health of the climate crisis and solutions can only be sought through strong federal leadership and decisive policies which put the health of Canadians and future generations first,” reads an advocacy backgrounder from the association. 

The B.C. Lung Association is doing what Biagtan calls “knowledge translations”, reviewing research findings and translating them into plain language anyone looking for information on lung health can understand. This includes clear, consistent advice posted to the websites of the B.C. Lung Association and provincial health authorities on what to do during a wildfire: turning on air conditioning units, closing doors and windows to keep out smoke, and potentially looking for a ‘clear-air shelter.’ “These are some of the things that we have been telling people day in and out during wildfire season — or even before the wildfire season starts,” Biagtan says. That said, Biagtan says there isn’t any conclusive data on how harmful it is in the long-term. “It is very difficult to measure because the exposure only lasts for about two to three months,” she says. 

However, it is clear that the effects of climate change are not only exacerbating wildfires, but also worsening their effects on populations forced to endure their flames and smoke. The B.C. Lung Association works not only with the B.C. Centres for Disease Control on research and policy development, but also the Ministry of the Environment and Metro Vancouver. “We see the interconnectedness,” Biagtan says. “Because if we want to be very effective in educating the public and to encourage the public to take action, then we need to understand all of these aspects — and translate them into consistent, accurate, science based messaging.” 

Rising melanoma rates across Canada

As temperatures rise around the world, people are increasingly spending the summer months outdoors. This can be deadly. Decades of industrial pollution has eroded the Earth’s ozone layer since at least the 1970s, contributing to a sharp rise in skin cancer. A 2009 paper from the U.K.’s Journal of the Royal Society of Medicine found that “ozone depletion and climate change are separate entities which are intricately linked.” Annette Cyr, chair of the Melanoma Network of Canada and a cancer survivor herself, says skin cancer is one of the few types of cancer that have actually seen an increase over the past few decades.

Tanning beds and North America’s obsession with sun exposure on beaches are partly to blame. But so is climate change. “Certainly, the environment is having the most significant impact on the rise of skin cancer rates,” Cyr says. “That has, without question, been scientifically documented.” While the Network doesn’t have the resources to focus heavily on environmental changes, she says, they are able to provide public awareness to try and reduce UV exposure. 

One of the ways they do this is through a consultation program with summer camps across Ontario that evaluates their policies around shade and wearing sunscreen. Several hundred camps typically take part, Cyr says, although the COVID-19 pandemic has changed it this year. “Youth and children get a lot of exposure to UV radiation through the sun in their outdoor activities in the summer,” she says. “What we’re trying to encourage is an awareness of playing safe and trying to promote sun safety and awareness.”

The Network has also collaborated with public health authorities, particularly in Ontario, to try and get municipalities to think more seriously about shade when designing new public spaces. This has become a serious issue in hotter cities such as Los Angeles, where a combination of urban sprawl and scorching sun make it particularly difficult to avoid UV rays. Some urban planners in L.A. have proposed sun awnings — large shade coverings — but Cyr believes the most effective way to provide shade is even simpler: plant trees. “It’s going to help not only with air quality, but certainly with increased shade protection,” she says. “We’ve done small efforts, but certainly the messaging is clear…this is a concern for human health as well.” 

But above all, public education around the rise in skin cancers across Canada, and how to avoid or minimize UV radiation exposure, is one of the most important parts of the Network’s mission. “Awareness is the number one thing,” Cyr says. 

Health and climate are inextricably linked

Studies about the effects of climate change on human health have circulated within Canada’s broader medical community for years. While health-focused social impact organizations are not necessarily in a position to rewrite health policy or run major hospitals, they can use their experience dealing with the health effects of climate change to advocate for reducing emissions. 

Furthermore, they can try and reach out to the public with their findings on the very real effects of climate change on human health. Perhaps Canadians who don’t see the need for urgent action on rising temperatures will be alarmed at the impact of worsening heat waves on seniors in their communities — and take action. 

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