Climate Change and Health in Canada — Dr. Theresa Tam

Avis Favaro

2023 has been a year of frightening news on the environment.

Male speaker 1

Oh, look. That’s fire.

Avis Favaro

From destructive wildfires around the world and here in Canada that filled the air with smoke and scorched many millions of hectares of forest land…

Male speaker 2

We’re in uncharted territory. We’ve never seen fire like this in our modern record.

Avis Favaro

Heat records were set around the world where people died, and others were burned simply touching the pavement. And there have been devastating floods in Alberta, Nova Scotia and Quebec.

Journalist

The floodwaters have cut off roads and bridges, isolating around 1,000 residents.

Avis Favaro

Experts say it’s the unmistakable mark of global warming. Decades of burning oil and gas for heat, travel and industry have heated up our oceans, making weather patterns more unpredictable. And there is a price to human health, in injuries, death, disease and the risk to our food and water supply.

On today’s show, we talk with Canada’s chief public health officer, Dr. Theresa Tam, about why climate change is one of her top health concerns.

Dr. Theresa Tam

The emergency is at our doorsteps. You can’t actually ignore it, so we do have to seize this moment to get all of us better prepared.

Avis Favaro

She’ll talk about how her office has developed a plan to mobilize public health action on climate change and why Canadians need to prepare.

Dr. Theresa Tam

I think what we are trying to do is not just tell people that your health could deteriorate, but what you can do about it in terms of protecting yourself and preventing these episodes from happening.

Avis Favaro

I’m Avis Favaro and welcome to the Canadian Health Information Podcast. We call it the CHIP for short.

One note: the opinions expressed here don’t necessarily reflect those of CIHI, but it is a free and open discussion. And this episode is about climate change and how Canada’s top doctor wants to safeguard the country’s health.

Dr. Tam, welcome to the podcast. Thank you for being here.

Dr. Theresa Tam

It’s great to be on the podcast, Avis.

Avis Favaro

So you have had quite the job in the last few years dealing with COVID. How are you managing with that still-important issue?

Dr. Theresa Tam

Yeah. So I’m doing fine. We’re just gearing up for the fall/winter respiratory virus season. So it’s a continuous area of work.

Avis Favaro

How do you manage it? Like, do you take vitamins? Exercise? What is it that you do to keep up this big job of watching the health of Canadians?

Dr. Theresa Tam

Well, I do try to exercise, of course, and eat healthily. I have good support systems, great family, friends; I rely on those social connections, I think. And a walk outside is great for mental health and physical health. So that’s been really key, I think, to sustaining that marathon.

Avis Favaro

A marathon, no doubt for sure.

But Canadians should know you’re not just the face of the country’s COVID response in public health. You’re also helping the country deal with climate change when it comes to human health. And this has been a landmark year.

And I want to start off with a clip from the UN Secretary-General, António Guterres, with this powerful statement. Here’s the clip:

António Guterres

For scientists, it is unequivocal: humans are to blame. The era of global warming has ended; the era of global boiling has arrived.

Avis Favaro

What did you think when you heard him say that?

Dr. Theresa Tam

Well, I think it’s calling urgency to something that we keep saying is happening and we need to be aware is happening, is preparing, and now it’s come to a critical point. People experience the actual emergency.

And we are seeing the fires. And he’s talking about this sort of boiling point. And the WHO also said climate change is the single biggest threat to human health, affecting everything that we breathe, water that we drink. And the livability of the planet is critical to human health. And Indigenous People have said that all along, that the planet is our health system, in some ways. And so we haven’t grasped onto that.

But of course, now the emergency is at our doorsteps. You can’t actually ignore it. So we do have to seize this moment to get all of us better prepared.

Avis Favaro

Tell me what your role is in looking at public health in relation to climate change.

Dr. Theresa Tam

People across this country are much more alerted to climate change, severe weather events, wildfire smoke this year. And it wouldn’t be surprising, I think, to everyone to realize that there’s quite a lot of different health impacts of climate change. It’s far-ranging.

And, of course, as a chief public health officer, my role is to bring attention to these really important health challenges that’s impacting our population. But also rallying around my colleagues in the public health system to support them in taking further action, whether it’s local, provincial and indeed at the national level and international, and look at how we take concrete actions to play our role.

But the other thing that I encourage all public health leaders to do is to be at the table with environmental colleagues and others, because health hasn’t really been at the centre of the climate discussion. And right now, we know that we have to adapt while mitigating the impacts of emissions and greenhouse gas. That’s one thing. But we know we must adapt because these events are actually right on our doorsteps.

Avis Favaro

Oh, you bring up the point I was going to make. Do you get the sense that people — like are people now recognizing there’s a health impact in Canada? Are you hearing that now from politicians? They will invite public health to the table?

Dr. Theresa Tam

Well, I think there’s increasing realization. And one reason I say that is that we now actually have a national adaptation strategy that has health and well-being as a key pillar. So finally, we’ve arrived at where health and well-being is in an overarching strategic document, and so we need to play our role within the context of that pillar.

Avis Favaro

So making health a priority. What are the health effects of global warming?

Dr. Theresa Tam

Well, it’s actually quite wide ranging. So the things that people may notice initially are actually the loss of life and injuries from many of these severe weather events, for example. And then they may notice exacerbation in underlying medical conditions like asthma. If you had wildfire smoke, for example, so wildfires contain these fine particles, which, when inhaled, can cause harms and exacerbate underlying medical conditions, if you have heart disease or if you have respiratory chronic illnesses, to name a few.

Avis Favaro

And on that point, we actually had a heartbreaking example that the B.C. coroner made public, and that is of 9-year-old Carter Vigh. He died after wildfire smoke in B.C. worsened his asthma. Here are some comments from his parents, Amber and James:

James Vigh

I never expected that from asthma. I just didn’t see this one coming.

Amber Vigh

They just figure there was just something in the air, I guess, something to do with the wildfire. The smoke exasperated it so much more.

Avis Favaro

What did you think when you heard that case coming forward?

Dr. Theresa Tam

Well, it’s really sad and tragic event. I’m a pediatrician, so I think I’m aware of just how dangerous asthma can be for kids, and it’s quite a common chronic condition. And we’ve been trying to message, of course, during the wildfire season, with Health Canada as well, that it is known that wildfires and the smoke can drift quite a long way, and try to tell people what they can do to protect themselves. But I know the family tried very hard. And, unfortunately, some of these really difficult medical emergencies do occur.

I think what we are trying to do is not just tell people that your health could deteriorate, but what you can do about it in terms of protecting yourself and preventing these episodes from happening.

Avis Favaro

Okay. We’ll maybe get to that a little bit later on. But what are the other issues that you’ve brought up in this plan that you have?

Dr. Theresa Tam

Yes. So we were just talking about the far-ranging health impacts, and we touched upon some of them like extreme weather events, heat stress, that heat dome, for example, that also heavily impacted on seniors, in particular, living alone, people who are isolated; air pollution and its impact; changing habitats of mosquitoes and ticks. That’s another area that the Public Health Agency has been working at quite a bit. Food security and food safety and water safety.

And then, I think there’s a much greater appreciation of mental health writ large, but also mental health in relation to climate change. And under the context of all of those key health impacts is where public health can assist.

So what my objective is with this report is to actually outline some of the concrete areas that public health — many of it is already taking place that people don’t actually know about, but bring it to the forefront so that people can support the public health system in doing its role.

The public health system, just like the rest of the health system, has been burned out by many challenges, including COVID. And without a little bit of support and resources and also trained professionals, it’s difficult to tackle the health impacts of climate change.

One of the really key points that — or key roles — that public health plays is actually on what we call the more upstream, the health promotion and prevention side, as much as it is about dealing with the actual emergencies or outcomes when they occur.

Most importantly, I want to sort of highlight — and this is a lesson learned from COVID — is that you’ve got to engage the community. Community participation, and both in the preparedness stage as well as during the response, is a key ingredient of any response to public health crises.
So those are some of the key messages.

And then by leveraging some of the other public health roles like data gathering, this aggregating data to show the inequitable outcomes, is a public health role, I believe. And we can take that information and evidence to those multi-sectoral tables to help the broader community plan and respond to these important events.

Avis Favaro

Is it possible to collect data on the effects of climate change? And are you able to do that now?

Dr. Theresa Tam

Yes. So, in some areas, yes. In other areas, we need to do a bit more. Just as an example, the Public Health Agency has been looking at and preparing for and responding to Lyme disease and other tick-borne illnesses, West Nile virus. We have quite a lot of scientific capabilities in mapping climate conditions on top of data on the vectors, on top of the actual health impacts.

Avis Favaro

Let me interrupt. So what you’re talking about here is that — one of the key points you made earlier is that in climate change, we will also see diseases that were elsewhere and not in North America like, for example, malaria and Lyme disease and other vector-borne diseases that are spreading. So is that a sign?

Dr. Theresa Tam

It is absolutely a sign. So we can demonstrate, through those scientific studies and data, that the spread, geographic spread, of ticks and mosquitoes are related to this change in our ecosystem and climate. And we’ve seen that in Canada already. And we’ve seen it all over the world: dengue and other; malaria. Florida is tracking things right now. Because some of the vectors are already here, the conditions may be such that they will spread and I think in Canada, keep going north, basically.

And there’s longer summers, and that means a prolonged season for ticks, for example. And not only are the ticks happy and so they survive for a longer season, the humans are also being outdoors more when the seasons shift as well, so.

Avis Favaro

Well, that’s a Canadian thing. We go, oh, global warming, that’s good; it means we have shorter winters and the weather is better. But it’s not a joke.

Dr. Theresa Tam

It’s not. But again, we always have to tell people what they can do to reduce the risk. We want people to go outside, but you can reduce the risk of things like these vector-borne diseases by mosquito repellents, the right clothing. Horrible image, you know, pulling your socks up over your pants, but not the best fashion statement. But things that you can do, put a hat on, all of those things, and tick checks, and how to remove a tick, these should become an everyday skill within every household, every family.

The other thing I’ve been really interested in, and that’s a bit linked to pandemics, is the emergence of new pathogens, what we call zoonotic diseases, diseases coming from animals, transmitted to humans. That’s going to increase.

Avis Favaro

Like COVID.

Dr. Theresa Tam

Yeah. At some point, that’s the prevailing hypothesis. A lot — the majority of these new emerging pathogens in humans came from an animal host at some stage. And so we need to take this holistic human–animal–environmental approach, what we call “one health” approach or planetary health.

So public health practitioners and leaders have been interested, as well as Indigenous leaders, in this planetary health approach, where we’re not just thinking about the humans, but our connections to the animals and to our environment is something that we haven’t really grasped, I don’t think.

Avis Favaro

So how much of your focus now is shifting to climate change and public health?

Dr. Theresa Tam

Well, I think it should be an ongoing focus. I mean, we can’t just focus on one thing or another — there’s many public health challenges. But there’s some common aspects, I think, that helps us to be more resilient to all hazards, and we need to sort of figure some of that out as well. And I think that’s where public health can help.

So when we talk about upstream and helping communities and collaborating with them to be more resilient, we mean to be generally more resilient to whichever hazard comes along, from both physical and mental health perspective. But also, what we would call building, not just the physical infrastructure like dams or  —

Avis Favaro

— streets and airport runways that don’t buckle in the heat. Yes.

Dr. Theresa Tam

Yeah. But also, what I would call the social infrastructure, which is the connectivity between communities. Being able to look after, look in on a neighbour because the person who’s going to help you the most during an emergency or a crisis is likely to be people around you.

So there are other community-building and general health promotion aspects that can actually cut across these multiple challenges so that we’re not having just to look at each one in its silo, but those common capabilities and capacities.

Avis Favaro

So how do you deal with these people who say that there is no climate change, that it’s a hoax?

Dr. Theresa Tam

Well, I think that, from a factual perspective, I think it is clear that there’s changes in temperatures and severe weather events, so that you can’t actually ignore. However you come at it in terms of, is this due to human activity or not, there’s lots of debate.

But the bottom line is, things are changing. The glaciers are melting. The north of Canada is going up in temperature way faster than the rest of Canada and other parts of the world. That’s just a fact. You can’t ignore that wildfires and floods and things that are happening now, so that’s — and that human health is being impacted. Those are the facts, and we’ve got to do something about it.

And rallying some can, I would say, reduce the divisiveness and say, here are our common objectives: We want people to be in better health, and we don’t want them to suffer injuries, physical or mental. We can find common ground in that, even if these other debates are happening.

I think the key word “adaptation” is so important in this whole concept because we can adapt when we have to. And so, how do we help people adapt to what’s inevitably going to impact their lives?

Avis Favaro

Yeah. So what do you do when a lot of people who may be listening to this say, “I’m scared. I don’t want to lose my job. I don’t want things to change. Figure it out another way.”

Dr. Theresa Tam

It’s important to take note of these emergencies, and you can’t ignore them. And I think that it takes the collective to address these important changes.

I think it is difficult. Nobody wants to lose their jobs. But having a solution and a plan as to how you shift. It’s very difficult to suddenly shift things; we know that. But knowing where we can get to, if we had a plan — and it can’t be short term — and bringing people along the way, I think it’s really important. We’ve got to acknowledge the mental, physical, economic impacts should people’s jobs change, and then look at other measures to support them, or training, or shifts that the business and private sector has to also support. It’s not just up to the governments alone.

But I think we’ve got to address fear through providing people with actions that they can take. I think that’s another message in my report is that we can’t just lose hope. By taking steps, however small or big you think it is, by taking those steps we can make a difference.

Avis Favaro

What you’re saying is that, if people — if public health comes to the table in these discussions, you may get better outcomes in terms of people being willing to accept this is happening and we have to make mitigation. We have to take strategies to slow it down.

Dr. Theresa Tam

Yes. And I think public health, especially people on the ground, whether you’re environmental health inspectors or food inspectors, there are people on the ground, and I think we can give practical solutions. Every little thing counts. There’s so much that you can do within your own settings.

Can I just add one thing that I haven’t touched upon, which is one thing that is pervasive in all of my work, is health equity. And my message about health equity is that we will all get impacted by climate change, but there are some communities and some groups that will be impacted more than others and that we should be tailoring our responses accordingly.

And seniors, of course, we’ve seen the very young, but also Indigenous, First Nations, Inuit, Métis People, who are impacted even more by activities that are taking place elsewhere. And we need to shore up those supports in order for them to be more resilient and more prepared.

So you can’t just ask people to change behaviours and take lots of actions if we don’t have the supports that are needed for people to do so. So that’s why, in public health, we’re also there to be the voice of that equity approach because in the end, that is the most effective approach.

Avis Favaro

So we’ll link to the report on that. Are there things that you’re doing that are in the report, so that people can take those as examples? I’ll just throw in, we put in a heat pump so that we were off the regular furnace system, just to do a part. It makes you feel better. Not cheap, but you do that. But what kind of things are you doing?

Dr. Theresa Tam

So I do think that some of the actions that we can all take is some little things such as walking and cycling, and that’s also good for your health, physical and mental health, as well as it reduces emissions if you use less cars.

One thing that just came across my desk I couldn’t believe was, we’re very — public health is into increasing people’s physical activities. So we have these 24-hour movement guidelines and we collect data. And one of the data points I read was, less than half of students — we’re going back to school, remember — who live less than 5 minutes from school walk or cycle to school.

So these small things. I’m not asking everyone to go to a gym. People can’t sign up to gyms, or... But schools can play a part. Everyone can take some of those steps. So I do that, of course.

And making your home more energy efficient, like you are doing. But people who can’t afford to install a heat pump actually will benefit economically if you dial down your heat by a little bit, like the temperature by 1 degree, put on a sweater or something, you can actually make a difference to your energy bill, as well as an impact on the environment.

The same within the summer — we want people to stay cool, don’t want to get heat-related illnesses. But for many people, and I have to say, some workplaces, it feels cold inside!

Avis Favaro

True.

Dr. Theresa Tam

Want to put on a jacket. So just by dialling down 1 degree, you could save energy, reduce your costs, as well as do something for the planet.
I think that we all have to protect nature; planting trees, people have gardens. I like plants. People can plant things and support that. Because the greenery is great for your mental health, but it also is huge in terms of our planet’s health and the plants being a healer, I would say. So bring nature back in your room, and gardening, and you can even grow your own stuff.

Avis Favaro

Do you grow your own vegetables?

Dr. Theresa Tam

Well, I live in a condo, so —

Avis Favaro

That’s hard.

Dr. Theresa Tam

— that restricts things, but yeah. And I certainly encourage other people to do so, and then we can share food that people have grown.
And reducing food waste, that’s one of my key things. I don’t like to have waste. And every little bit counts on that front, and not just for your pocketbook, but also to reduce environmental impacts, et cetera.

I am a vegan. I’m not asking everybody to do that, but eat more plants. Good for your health; also good for reducing emissions.
So, for wildfires, we’ve messaged how people can get more prepared. You know, N95 mask can be used for wildfires as much as it can be used by layering on protection for respiratory viruses. Have these things all well set up at home.

Apparently, more people are having these go-bags where you can be ready if the emergency actually comes along, and having water, food supplies to last you out, I think most people may recommend 2 weeks, if you lose power. These are very real things that are going to happen to us in the winter cold and heat conditions. So there’s lots of things I think that you can do.

But talking to people. So for youth who are very concerned, joining a group where you can actually talk things through and figure out what you can do, make your voice heard and do something in your community often helps.

Avis Favaro

I hear you trying to give people who may feel hopeless a sense of control.

Dr. Theresa Tam

Yes. I think actions is what brings hope. And at a time when I think there’s a lot of mental anguish and concerns about all sorts of things in different parts of our lives, we mustn’t lose hope. But you can’t just talk about that. I think, for me, action brings hope, and I’m trying to put that across in this report as well.

Avis Favaro

Well, Dr. Tam, thank you so much for being part of this podcast. I hope that people will look at the report, and I hope to hear more about what public health is going to be doing to help Canada and the world deal with this looming threat.

Dr. Theresa Tam

Yeah. Yeah. That’ll be great. And thank you for your interest.

Avis Favaro

Wonderful. Thank you again, Dr. Tam. Appreciate it.

Dr. Theresa Tam

Bye.

Avis Favaro

The report that Dr. Tam references is called Public Health Action on Climate Change in Canada, and we’ll post a link to that on our website at cihi.ca. That’s C-I-H-I dot C-A. And it has data and ideas. Even the little things that cut your environmental footprint count.

Thank you so much for listening. This is an important episode because climate change will touch us all.

Our executive producer was Jonathan Kuehlein; production assistant, Heather Balmain. And a shout-out to Alya Niang, who’s the host of our French CIHI podcast.
And if you want to learn more about all the health data collected by CIHI, please take a look at our website and subscribe to the CHIP wherever you get your podcasts.

I’m Avis Favaro. Talk to you next time.