Climate Change and Health in Canada — Dr. Howard Njoo

20 min | Published September 21, 2023

Sky-high temperatures, wildfires clouding cities with smoke, damaging floods and many people suffering from mental health issues related to anxiety about global warming. In this episode of the CHIP, we are joined by Canada’s deputy chief public health officer, Dr. Howard Njoo, to discuss the effects of climate change on health, some of the larger changes that are needed and what average people in Canada can do to help themselves and the environment.

This episode is available in French only.

Transcript

Alya Niang

This year has been filled with dreadful news about the environment and destructive wildfires here in Canada and around the world, which have spread smoke and burned down millions of hectares of forests.

Audio excerpt

The megafire season started very early and has been devastating. Some 4 million hectares have already gone up in smoke. In Canada, that’s 15 times higher than the average for the last 10 years.

Alya Niang

Record heat has been felt around the world. Some people have lost their lives, while others have been burned by simply touching the pavement. We’ve also seen catastrophic flooding.

Audio excerpt

Some roads have been washed away and others are still underwater.

Alya Niang

According to the experts, these are indisputable signs of global warming. Decades of burning oil and gas for industry and to transport heat have caused our ocean temperatures to rise, making weather conditions less predictable. This has also taken a toll on human health, causing injury, disease and death, as well as endangering our water and food supply. In today’s episode, we’ll be talking to Dr. Howard Njoo, deputy chief public health officer of Canada, who will explain why climate change is one of his top health-related concerns.

Dr. Howard Njoo

As we saw this summer, Canadians are already feeling the negative effects of climate change on their health. Canada is warming twice as fast as the global average.

Alya Niang

He will explain why his team has developed a plan to mobilize public health action on climate change and why Canadians need to prepare themselves.

Dr. Howard Njoo

People should be encouraged to hear that there are solutions and measures that we can all take to ensure our common future.

Alya Niang

Hello, and welcome to the Canadian Health Information Podcast. I’m your host, Alya Niang. Please bear in mind that the opinions and comments of our guests do not necessarily reflect those of CIHI, but this is a free and open discussion. In this episode, we will be talking about climate change and how one of Canada’s top doctors wants to protect the country’s health.

Welcome to the podcast, Dr. Njoo. Thank you for being here today. Dr. Njoo, most Canadians know you and Dr. Tam as the voices and faces of Canada’s response to COVID-19. And today, you’re talking about climate change, which is also part of your work, even if many people aren’t aware of that. Why is public health participating in discussions about climate change?

Dr. Howard Njoo

Hello, and thanks for your question. Climate change isn’t a new issue for public health. We’ve been involved in it for some time. As deputy chief public health officer of Canada, my role is to work with our partners in the various levels of government and sectors to help protect Canadians from threats to their health and promote healthier communities using the best data available. The World Health Organization (WHO) has qualified climate change as the single biggest threat facing humanity, affecting the air we breathe, the water we drink and the livability of the planet. As we saw this summer, Canadians are already feeling the negative effects of climate change on their health. Canada is warming twice as fast as the global average, and Northern Canada is warming 3 to 4 times as fast. As average temperatures rise, the repercussions for our health become more severe.

That’s why, in her annual report last year, Dr. Theresa Tam, as chief public health officer, focused on mobilizing public health action on climate change. In concrete terms, public health can provide practical and scientific advice on the best ways for people to protect themselves, monitor the population’s health and trends in human and animal diseases to guide prevention efforts, support emergency preparations and related initiatives, and bring partners together to promote healthier and more resilient communities that are better adapted to extreme events. The report encourages us to shift our collective mindset to consider climate change not only as an environmental issue, but as one of the greatest threats to public health we have confronted, which urgently needs our attention.

Alya Niang

Who in Canada is most at risk due to climate change? Are Indigenous Peoples in Canada and their communities particularly at risk?

Dr. Howard Njoo

Yes, and thank you for the question. While no one is immune to the repercussions of climate change on health, some communities are disproportionately affected. As was the case with COVID-19, some groups are at higher risk for exposure, adapt less well and are more vulnerable to serious health problems. For example, seniors who live alone are more vulnerable during extreme heat waves. Nearly 620 people died during the heat dome in British Columbia in 2021. In addition, people with disabilities and those with reduced mobility face additional challenges in emergency evacuations. Another example is low-income people, who have fewer means to flee if their area is overcome with smoke from wildfires.

Until now, climate change wasn’t always looked at from an equity perspective. For example, efforts to adapt to climate change have focused more on income-related inequalities than on the experiences of First Nations, Inuit and Métis Peoples, racialized populations, migrants, LGBTQ2+ people and people with disabilities.

Alya Niang

Dr. Njoo, as you mentioned, Dr. Tam’s 2022 annual report to Parliament focused on the repercussions of climate change on health. What particular health problems do you expect to see more frequently due to factors such as extreme heat, wildfires and floods?

Dr. Howard Njoo

Yes, climate change and the more frequent and intense extreme weather conditions resulting from it — such as heat waves, hurricanes, floods and wildfires — have had multiple, cascading impacts on our physical and mental health. These include serious, direct repercussions for health, such as injury, disease and death. Other repercussions impacting Canada include aggravations to chronic health problems due to heat exposure, an increased prevalence of respiratory allergies and asthma due to the poor air quality caused by wildfire smoke and an accelerated spread of infectious diseases that are climate-sensitive, which are carried by ticks, mosquitoes and vectors.

Habitat changes resulting from climate change also increase the risks of water-borne diseases, such as the proliferation of algae, and food-borne diseases, such as toxins from mollusks. There are also a host of other indirect repercussions for health, including disrupted access to health, social and community services, damage to essential infrastructure, lost property and forced evacuations, where there are constraints to leave your home. At the community level, climate change can disrupt social cohesion and well-being due to the deterioration of cultural practices, a sense of identity and belonging, and intergenerational knowledge sharing.

Alya Niang

Thank you. Wildfires have caused major damage in Canada this year. Millions of acres burned down and smoke spread throughout the country and the United States. And there has been at least one death, a 9-year-old boy in British Columbia named Carter Vigh who had asthma, which the coroner linked to smoke exposure. Dr. Njoo, is his death a sign of imminent danger?

Dr. Howard Njoo

The individual cases of death or health complications linked to exposure to wildfire smoke are tragic and worrying. My heart goes out to his family and the many Canadians who are dealing with health problems and difficulties due to evacuations, wildfires and smoke. This year’s wildfire season has been unprecedented in scope, affecting every region of the country at one time or another. Wildfire smoke contains particles and a complex mix of chemicals that can be toxic for human health, particularly for those suffering from asthma or other pre-existing chronic health problems, young children, seniors and people who work outdoors. There’s a growing amount of evidence showing that exposure to smoke from seasonal wildfires can have long-term repercussions for our physical and mental health.

Alya Niang

Thank you. Do we have a better idea as to whether more Canadians are beginning to suffer from the impacts of global warming on their health? And what can we do better to measure and monitor the effects of climate change on health?

Dr. Howard Njoo

That’s a great question, as evidence is an essential tool in enabling public health to measure and monitor the overall repercussions of global warming for our health. While we have solid data on the environment, such as weather conditions and air quality, there are still gaps in disaggregated data on health that would give us a comprehensive picture of the long-term repercussions and the people who are most affected. These are areas in which we can continue to work with the Canadian Institute for Health Information.

Alya Niang

What lessons learned from the COVID-19 pandemic can be applied to the climate crisis?

Dr. Howard Njoo

Yes, of course, we can apply a number of lessons from our experience with COVID-19, such as the need to take quick, strong action when urgent measures are necessary, while working to prevent and mitigate future threats. Due to the wide range of immediate and future health risks related to climate change, this will be crucial. We need to acknowledge that our health is closely tied to that of other animals and our shared environment.

For example, the “one health” approach is important, as is fostering relationships with Indigenous Peoples and learning from them while supporting the leadership, knowledge and practices of First Nations, Inuit and Métis Peoples. We should adopt an equitable approach that gives priority to those at higher risk and experience disproportionate health repercussions. And lastly, we need to work in partnership with all levels of government, sectors, communities and borders to fight complex health risks. COVID-19 clearly demonstrated the power and collaboration of a whole-of-society approach.

Alya Niang

Dr. Njoo, what is the link between global warming and the spread of new infectious diseases?

Dr. Howard Njoo

Rising temperatures and climate change can have repercussions for ecosystems, changing the distribution and behaviour of disease vectors, such as mosquitoes and a number of other types of wildlife. This could lead to the growth of habitats that are conducive to spreading disease. For example, the incidence of Lyme disease increased 17-fold between 2009 and 2019. Tick-borne diseases are increasingly common in certain regions of Canada, in part due to climate change and land use. Lyme disease is one of the infectious diseases quickly emerging in Canada and the most frequently reported vector-borne disease in North America.

Climate change has repercussions for tick populations due to longer, warmer summers and milder winters, which promote their survival, growth and reproduction rates. Longer summers also mean an extended season in which ticks are active and people are outdoors, which increases the possibility of physical interactions. More generally speaking, climate change, biodiversity and the loss of habitats also increase the risk of zoonotic diseases, which are transmitted between humans and animals. This increases the risk of future pandemics. And lastly, this underscores the importance of a “one health” approach, which examines the relationships between human, animal and environmental health, and is based on interdisciplinary collaboration in order to understand and mitigate the spread of infectious diseases.

Alya Niang

Studies have shown that climate change is also having an impact on mental health, leading to increased anxiety and depression. People feel like the phenomenon is beyond their control. How are you helping people come to terms with this new threat?

Dr. Howard Njoo

I think it’s important to improve access to mental health support and increase the number of resources to help build communities that are resilient in the face of climate change. More and more people — particularly young people, who carry the heaviest burden of climate change — are experiencing climate anxiety due to uncertainty over the future of the planet. It’s an existential threat, so it’s normal to feel all sorts of emotions. While the support of mental health professionals may be necessary, we can channel some of our emotions toward positive collective action. For example, for young people, this could mean pursuing a career related to sustainable development or public health.

Secondly, take measures that are beneficial for mental health and the environment, such as walking or riding a bike instead of driving. And lastly, advocate for change by working with organizations and participating in eco-friendly community initiatives, such as urban gardening and volunteering. By promoting a sense of community and belonging, we can give people hope and optimism with regard to the planet’s future.

Alya Niang

Right. Dr. Njoo, how have you adjusted your lifestyle due to climate change? The situation appears fairly bleak. Do you have hope for the future?

Dr. Howard Njoo

Yes, of course. I have hope that by acting now, we can make a difference by preventing and reducing the effects of climate change on our health. The underlying theme of the reports by the chief public health officer is to embrace hope. Hope means believing in a healthier world and in the power we have to work together to achieve that. We’re increasingly aware of the effects of climate change on our health, and the role of public health will be to raise awareness about what we can do to mitigate those effects.

I’m encouraged by the interest young people are showing and the proactive approach they’re adopting. We can also be inspired by and learn from First Nations, Inuit and Métis Peoples, who have long recognized the interconnectedness of human, animal and environmental health. This knowledge has been essential for the identity, resilience and survival of Indigenous Peoples, and it’s crucial for a healthy and sustainable future for us all. The COVID-19 pandemic showed us that by working together with administrations, communities and sectors, we can accomplish remarkable things in public health.

People should be encouraged to hear that there are solutions and measures that we can all take to ensure our common future. On an individual and community level, people can make sustainable and eco-friendly choices, like cycling or walking instead of driving.

Alya Niang

Right. And how have you adjusted your lifestyle due to climate change?

Dr. Howard Njoo

Personally, I stay very aware, and whenever possible I make sure to ride my bike or walk to go places instead of taking my car.

Alya Niang

Great. Thank you. Dr. Njoo, thank you very much for participating in this podcast. I hope people will read the report, and I also hope to find out more about what public health plans to do to help Canada and the world stave off this imminent threat. Thank you very much.

Dr. Howard Njoo

My pleasure. Thank you.

Alya Niang

The report Dr. Njoo referred to is called Mobilizing Public Health Action on Climate Change in Canada, and we will be posting a link on our website at cihi.ca. In addition to staying informed and sharing ideas, even small steps to reduce your environmental footprint count. Thank you for listening to this important episode. Climate change will affect us all.

Our executive producer is Jonathan Kuehlein, and special thanks to Heather Balmain and Avis Favaro, the host of the CIHI podcast in English. To learn more about the health data collected by CIHI, please visit our website. And be sure to subscribe to the Canadian Health Information Podcast and listen to it on the platform of your choice. I’m Alya Niang. Talk to you next time.

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