Climate change and health – part 1

Interview with Sara Ferwati

Governments are starting to draw the conclusions from the recent pandemic. We expect them to put in place resilience plans that will prepare citizens for future outbreaks.  

As the prestigious magazine The Lancet repeats with its Countdown to Health and Climate Change, these two topics are very closely linked. We believe this is a great opportunity for integrating pandemic resiliency plans with climate resiliency, or the ability to respond to challenges posed by climate change. To learn more about this topic, we spoke with Sara Ferwati who is an epidemiologist working in Nunavut. She has obtained an MSc in Public Health and an MSc in biochemistry from McGill University. She is also the Co-founder of Climatable, a Montreal based non-profit organization focused on involving Canadians in climate action.  

As a passionate advocate of public health and climate change, she has agreed to answer a few questions about the intersection of these two different issues.

This is the first of our two-blog interview series with Sara Ferwati. 

1. For many, the link between climate change and health is abstract. Could you explain the interactions between climate change and health in the Canadian context?

SF: “Climate change has many complex interactions with the social and environmental dimensions of public health. Moreover, while climate change will intensify existing health risks and introduce new ones, these risks will not impact us all equally. In particular, the impact of climate change on populations can vary based on age, economic resources, and location.

The effects of climate change on health can be categorized into three overarching categories:

Increased seasonal temperatures and extreme heat

Extreme heat is defined as “summertime temperatures that are much hotter and/or humid than average”. Extreme heat has been directly associated to deaths from cardiovascular and respiratory disease. For example, in 2018, Montreal experienced the hottest July recorded in 97 years. During this heat wave, health officials recorded almost 6,000 ambulance calls and 66 heat-related deaths. The demographics most vulnerable to this are older adults, the very young, and people with mental illness and chronic diseases.

Rising temperatures can also affect air quality by raising the level of pollutants and allergens, which can aggravate cardiovascular and respiratory diseases, specifically asthma; currently, it is recorded that more than 3 million people have asthma in Canada. Increased temperature can also damage infrastructure. Permafrost covers 40-50% of Canada’s landmass. Melting permafrost makes it difficult to build and maintain infrastructure such as roads, buildings, pipelines, and airports. This in turn affects housing, health service delivery, and essential goods distribution channels, all of which are critical determinants of health.

Finally, a rise in seasonal temperatures can affect food security for hunting communities, such as those in Nunavik and Nunavut. Many indigenous northern Canadian communities depend on hunting as a food source. Change in temperatures affects hunting by changing animal distribution. This is also worsened for northern communities who travel on sea ice. Changes in sea ice thickness due to the rise of seasonal temperatures contributes to temporal limitations on travel/harvesting. Hunting is not only essential for food security, but also constitutes an important element of cultural continuity, an important pillar of positive mental health.

Natural disasters and variable rainfall patterns

Natural disasters and variability in rainfall patterns impacts health by causing injuries, mental health stressors, food and water shortages, and limited healthcare access. On a global scale, the number of reported weather-related natural disasters has more than tripled since the 1960s.

In Canada, higher temperatures exacerbate wildfires, making them harder, or even impossible, to extinguish. Wildfires lead to displacement, injuries, and infrastructure damage. The 2016 Fort McMurray wildfire, for example, forced the largest wildfire evacuation in Alberta’s history, with up to 88,000 people displaced.

Floods and extreme precipitation are also increasing in frequency and intensity. Floods contaminate freshwater supplies, heighten the risk of water-borne diseases, and create breeding grounds for disease carrying insects such as mosquitoes. Aside from increasing the risk of injury and disease, climate-related natural disasters have also been associated with numerous mental health conditions. Natural disasters like those mentioned have mental health implications for those affected. Studies on the experiences of Fort McMurray, Alberta, after wildfires forced total evacuation in 2016, suggest that psychological impacts from the fires were widespread and likely to persist following evacuation.

Patterns of infection

Climate change increases the risk of insect and animal borne diseases. Impacts of climate change, such as increases in temperature, floods, and droughts, are changing the range and spread of these diseases. As a result, climate change is likely to increase the risk of introduction of new infectious diseases, the spread of diseases to higher latitudes, and the re-emergence of old infectious diseases. For example, it is well established in Canada that changes in precipitation patterns and increase in temperature will increase the spread of West Nile fever and Lyme disease. The number of reported cases of Lyme disease in Canada have already increased from around 150 in 2009 to almost 1,500 in 2017.”

Diagrams - health and climate change

2. Let’s zoom in on our healthcare system here in Canada – how could climate change affect the capacity to deliver healthcare?

SF: “Climate change will increase infrastructure damage and cause medical service interruptions. Currently, electronic medical records are an essential tool for health administration and disease surveillance. Natural disasters may cause power outages that lead to administrative delays by disrupting these digital systems. For example, Hurricane Juan caused physical damage to Victoria General Hospital in Halifax, where the roof was partially ripped off and water damage was done to 8 floors. This led the relocation of 200 patients and the closure of the operating theater for 4 weeks. Additionally, as we have seen with COVID-19, health care systems can get burdened during times of crisis, leading to delays of other medical services and procedures.

Many rural and indigenous communities already have limited medical infrastructure and number of medical personnel. Consequently, damage to community infrastructure, roads, airports etc. may worsen access to healthcare services and essential items required for healthcare delivery. The impact will vary across Canada, as we have very diverse geographies and populations. It is difficult to do justice to this question in a blog interview.”

3. What are some high impact measures Canadian governments can put in place to improve health resiliency, but also address climate resiliency?

SF: “I see two health responses, emergency and preventative health plans.

A preventative plan would decrease the health risks that will be aggravated by climate change. Emergency health plans would address the new health risks created by climate change. Preventative adaptation plans would include strengthening mental health service access and cultural access for indigenous and minority populations, assessing and addressing gaps in health equity, such as food, water and housing security.

Emergency adaptation plans would include: assessments of safe sites for establishing healthcare facilities, and essential services; assessing the safety of existing facilities; training health workers to respond to emergencies; increasing medical equipment inventory; and establishing emergency fund(s) for those whose income and homes will be directly or indirectly impacted by climate change.”

Interviewed by Amir Nosrat

Read the rest of our interview with Sara Ferwati on June 25th.


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