Canadian doctors tackle the relationship between climate change, extreme heat and patient health

  • National Newswatch

This week, Canadian physicians are gathering for the annual meeting of the Canadian Medical Association (CMA). Often called Canada's 'Parliament of Medicine,' one of the meeting's strategic sessions is zeroing in on the health consequences of climate change. Slated to start with a keynote address from Dr. James Orbinski, past president of Doctors Without Borders, it comes at an auspicious time for many Canadians tackling the recent brutal and oppressive heat waves of summer.It's no secret that cities across the country have been in over-drive, issuing extreme heat warnings, turning libraries into cooling centres and alerting residents to the dangers of heatstroke and exhaustion. Though everyone is vulnerable, socially isolated seniors, racialized minorities, the homeless and those with chronic illnesses, including mental illness, are most at risk.Extreme heat produces ill-health in a number of ways. Nitrous oxides and volatile organic compounds, emitted largely in our cities from motor vehicles, are catalyzed in high temperatures into ozone. Known to increase inflammation in the lungs, researchers have shown that for those with asthma, higher levels of ground level ozone are linked to higher emergency department visits and more hospitalizations. For Canadians with chronic obstructive pulmonary disease (COPD), a higher risk of death can be added to that list.To help mitigate these ill-effects on health, doctors wisely recommend seeking shelter in a cool, air-conditioned environment. Ironically, the use of air conditioners for temporary relief can be counter productive in the long-run. Drawing power from an energy grid that still relies on carbon-based energy to meet peak demand pumps ever more greenhouse gas emissions into our atmosphere.Unfortunately, these climate-related health consequences represent only the tip of the (rapidly melting) iceberg. Thankfully, both the health care sector and policy makers are starting to take action.Last year, CMA members directed their organization to divest its financial holdings in fossil fuels.  This year, MD Management, a financial services company and subsidiary of the CMA, recently launched one of the few Fossil-Fuel Free mutual fundsin Canada.Just last month, Public Health in Toronto released 'Health Benefits of a Low Carbon Future' -- a report zeroing in on the local health benefits of reducing greenhouse gases and the steps needed to achieve them. Though the scope of climate change's problems are large, it's prescription for local action, focused through health, is worth a closer look.For example, the report lists transportation reform as a low hanging fruit. Motor vehicles are amongst the worst climate change offenders. Encouraging active transport and alternatives to driving play an important role in changing that.Building mixed-use neighborhoods where errands can easily be accomplished without a car is one step in that direction. Cities as diverse as Calgary, Dartmouth and Saanich are using the principles of 'Transit Oriented Development' to accomplish this. Comprehensive bike sharing services, like Montreal's BIXI and the recent aggressive expansion of Bike Share Toronto are also a step in the right direction.The old adage of 'reduce, reuse, recycle' also still rings true.In 2015, Vancouver took a major step forward via municipal legislation. Rather than dispose of organics in the trash, the city directs businesses and residents to separate organics, like food scraps, for collection and composting into nutrient-rich compost. This process creates climate positive biofuels to power engines, in addition to reducing greenhouse gas emissions created by decomposing, land-fill bound scraps. The Toronto Environmental Alliance is helping its own city catch up. After three years of campaigning, it secured city council's unanimous support for a 3R strategy that embraces a path to zero waste as a long-term goal.Reducing the impacts on the air, soil and water from waste transportation, processing and disposal is a big win for health.Climate change is a complex problem, one that touches on so many parts of our lives. It links greenhouse gases with extreme heat, worsens medical conditions like asthma and COPD, and demands we change our approach to transportation and power generation.Canadians innately understand how their health is linked with these issues. The question remains whether our current pace of change will be enough to match the urgency of the changing climate.Danyaal Raza is an advisor with, a family physician at St. Michael's Hospital and Assistant Professor at the University of Toronto. He also serves on the board of directors of the Toronto Environmental Alliance.