From instability to sustainability: the path to healthy people on a healthy planet

Looking at Great Slave Lake while on maternity leave from work as an emergency physician in 2012, I became curious about the local health impacts of climate change. I also wondered if the medical literature had any answers for concerns expressed to me by Dene elders about possible health impacts from the oil sands. I dove into PubMed, the medical database. I found little work looking at climate-related health impacts in the rapidly-warming Arctic—and not one peer-reviewed study into local health impacts of the oil sands. I was aghast. Eleven years later, as wildfires ravage Alberta, British Columbia, and the Northwest Territories, and Environment and Climate Change Canada opens an investigation into a suspected contravention of the Fisheries Act at Imperial Oil Ltd.’s Kearl Oil Sands Project, our response to climate-related health threats is just beginning, and we still don’t have comprehensive studies into the health effects of the oil sands. How did we end up with this blind spot at the intersection of the environment and health? And how do we improve our vision moving forwards? First, it helps to understand that most physicians don’t know what they don’t know about planetary health, the “health of human civilization and the state of the natural systems upon which it depends.” In 2009, The Lancet called climate change the “biggest health threat of the 21st century,” yet in 2020 only 15 per cent of global medical schools had curricula on climate change. This is a missed opportunity: many win-win policies allow us to save lives now through pollution reductions, improved physical activity, access to nature, and plant-rich diets, as well as into the future as these same measures stabilize our ecological foundations. Dr. Courtney Howard is an emergency physician in Yellowknives Dene Territory. Photograph courtesy of Courtney Howard We must make up for lost time as wildfires, heat domes, and floods are upon us. The Association of Faculties of Medicine of Canada deserves congratulations for its recent leadership in launching a Declaration on Planetary Health signed by most Canadian medical schools. Similarly, the federal government took a strong step when it committed to the World Health Organization’s resilient, low-carbon health system initiative: health care accounts for about 4.6 per cent of Canada’s greenhouse gas emissions, and is linked to the loss of 23,000 disability-adjusted life years annually due to pollution. We must brief the health workforce and establish secretariats federally and provincially to ensure recommendations from the National Adaptation Strategy are implemented, and that health-sector emissions are sectioned out in greenhouse gas emission inventories, with pathways plotted to net zero by 2050, and plans put into place to deliver reductions. Second, we must recognize that environmental health issues disproportionately impact Indigenous and racialized communities. Bill C-226, the National Strategy Respecting Environmental Racism and Environmental Justice Act, should be passed. As part of remedying data gaps, a government-funded, independent, comprehensive study should be initiated into the cumulative health impacts of the oil sands that pairs western science with traditional knowledge. This should be accompanied by improved monitoring, data transparency, and mechanisms to ensure polluters pay for cleanup. Until numbers are known and reclamation plans have progressed, further oilsands projects should not be approved. A cap on oil and gas development will help us meet climate goals. Finally, to live good lives in the face of ecologic, economic, and geopolitical instability, we must be explicit about measuring what matters to allocate resources efficiently. The World Health Organization calls for well-being societies that achieve equitable health now and for future generations without breaching ecological limits, a goal supported by Canadian health organizations. As the Canadian Institutes for Health Research take stock heading into the next cycle of activity, it is clear that Canada needs a new institute for Environments, Health and Well-being to stimulate the multidisciplinary research, policy, and advocacy required for data-driven leadership. Given that budgets are the way a society funds its ability to walk its talk, Finance Canada’s Quality of Life framework should be foregrounded within the budget process to ensure investments move us ever closer to a thriving, sustainable society. If we take the intersection of environment and health out of our blind spot we can recognize it for what it is: a powerful sweet spot where our efforts can yield outsized positive impacts on our lives now and into the future. Dr. Courtney Howard is an emergency physician in Yellowknives Dene Territory, a clinical associate professor at the University of Calgary, a community research fellow in planetary health at the Dahdaleh Institute for Global Health Research, and a master of public policy candidate at Oxford University. The Hill Times

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From instability to sustainability: the path to healthy people on a healthy planet

The intersection of environment and health is a powerful sweet spot where our efforts can yield outsized positive impacts on our lives now and into the future.

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