Health policy and climate change in British Columbia: Who's responsible for building adaptive capacity?

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1 Health policy and climate change in British Columbia: Who's responsible for building adaptive capacity? Tim Takaro, MD, MPH, MS. *Faculty of Health Sciences Simon Fraser University, Canada Stacy Barter, MEd. BC Healthy Communities Stephanie Gatto, MPH, Lindsay Galway, MPH * Sally McBride, MPH, Public Health Association of BC

2 Outline Climate and health context in BC BC Healthcare Surveys: data collection methods Findings level of interest, capacity, gaps Climate change health policy group Membership Mission Activity in first two years Lessons learned

3 Anticipated health impacts of climate change in B.C. Increase in extreme weather events, flooding, landslides Reduced freshwater storage with glacier and snow-melt Increase in ozone and particulate pollution (range fires) Shifting waterborne and vector infectious disease patterns Sea-level rise effects Heat stress effects Increase in pollen Increase climate refugees Strain on emergency services & communications Mental health impacts Mas Matsushita & Dan McCarthy

4 Reduction in glacial surface area in BC and Alberta from 1985 to % - 7.0% % AB 25.5 ± 3.4 % BC 10.8 ± 3.0 % % % % % % % % Source: Tobias Bolch, Brian Menounos, Roger Wheate (2010), Rem. Sens. Environ.

5 New chilling BC glacier data Clarke, et al. Nature Geosci. 6Apr15

6 New chilling BC glacier data Clarke, et al. Nature Geosci. 6Apr15

7 Who s responsible for health impacts of climate change in BC? Ministry of Health finances five health authorities who are responsible for care in their geographic region and PHSA for province. First Nations HA since Oct 2013

8 Who s responsible for health impacts of climate change in BC? Multiple jurisdictions across province are potentially impacted by climate change. The links to between climate change and health are both direct and indirect AND therefore the impacts in different secotr vary in how impacts can and should be addressed.

9 Research Questions Who is thinking and working on health impacts of climate change on health in the province? What is our level of preparedness (adaptation or preparedness) for predicted changes

10 Two surveys of health authorities and service providers on preparedness for CC Survey 1 - BC Healthy Communities 436 surveys sent with 20% response rate representing all of the provincial health authorities and 9 different departmental areas. Survey 2, - Canadian Ctr Policy Alternatives Focus on climate induced migration: 40 frontline immigration and health providers were surveyed in addition to 10 key-informant interviews focussing on health.

11 Methods Survey questionnaires and key informant interviews collected in both 1 & 2. Key domains in survey 1 Program activity and planning within health authority department Perceptions about health effects of climate change in their region Level of knowledge & awareness of climate change & related health effects Perception of organizational capacity to respond to effects

12 Key Domains in Survey 2 BC s adaptive capacity for climate-based migration, service providers & decision makers Policies and programs needed to build adaptive capacity for influx of climate migrants Socio-cultural capacity for climate-based migration Capacity of service providers to ascertain whether environmental degradation as a key reason for migration?

13 Survey 1 - Key Findings 64% expect their region will experience CC health impacts (next 20 years) 93% think it important to consider health effects of CC Rated own knowledge as high 66% agreed or strongly agreed they are knowledgeable about potential health impacts of CC Less certain about other colleagues & managers 43% did not know or did not agree other senior managers or staff are knowledgeable 21% believe colleagues are aware of health impacts

14 Survey 1 Organizational Capacity 80% did not know if their HA has a climate adaptation strategy or action plan in place 22% expressed lack of understanding of how to assess health risks, or where to find information (31%) Nearly half do NOT believe their department has experience to assess health impacts, 20% do not know if it does. 81% indicated that preventing or preparing for public health impacts is NOT among the current top ten priorities for their health authority

15 Survey 2 Key Findings No one is initiating or leading a conversation on prospective climate migration Canada s Immigration and Refugee Protection Act NOT designed to accommodate climate change impacts on migration Current immigration policies don t adequately respond to the most vulnerable populations These policies draw a false distinction between the good and the bad migrant

16 Survey 2 Future Needs Affordable housing and enhanced settlement services will be required for less affluent refugees of the future Migrant service providers already stretched thin Partner with other nations and NGOs to invest in climate change adaptation strategies in vulnerable, less developed regions Provide refugee status specifically to climate migrants Address Canada s responsibility for CC by meaningful GHG reductions

17 A Fundamental Common Observation Across Both Surveys Public health and population health could be a voice for transforming the public discourse regarding the issues related to climate change. Engaging populations to talk and to plan are a part of the work. However, the silos of authority and the hierarchies in the structure make getting to actual action difficult. Survey 1 participant

18 We Don t Have to be Constrained by Silos to Act I think Health Authorities should also focus not just on minimizing health effects from climate change, but also be more aggressive and outspoken advocates for identifying causes of climate change (fossil fuel dependence, consumerism, etc.) and promoting personal, governmental, and societal means of eliminating or reducing the influences of such factors that contribute to climate change. Let's be proactive, not just reactive. Survey participant The Canadian Coalition for Green Health Care

19 Bridge the Gap - Climate Change and Health Policy Group Established 2 years 60 members BC focus with inter- national affiliations Diverse membership BC Gov t Climate Action Secretariat, MoH, HEU MoE, BCCDC, BCGEU, BC Healthy Comm. NGOs, Clinicians, 6 HAs, BC s 4 Res. Univ. PHABC

20 Climate Change and Health Policy Group Mission TARGET: BC s Climate Action Secretariate, individual health authorities and their constituencies The mission of the CCHPG is to provide a vehicle for organizing the health sector to document and reduce the impacts of climate change on health in the province while supporting efforts to reduce the sector s carbon footprint.

21 Climate Change and Health Policy Group Activities Our interests span action & capacity building in both mitigation and adaptation for public health Policy brief on climate related health impacts specific for BC Building on institutional connections with Canadian Coalition for Green Healthcare, Healthcare without harm Developing narratives for policy makers that illustrate the connections between CC & health

22 International Climate Health Alliance Building Our members are affiliated with healthcare workers around the world with similar imperatives Global Climate & Health Alliance US Climate & Health Alliance

23 Paris COP-21 Current Events Global march for climate Nov BC Climate Action Plan Coal Ports and Kinder Morgan expansion plans

24 Partners in CCHPG

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26 PERCEIVED RISKS & HEALTH IMPACTS: Ecosystem health ( 85%) Food/water production & supply ( 82%) Risk for vulnerable populations ( 82%) Demands on health care services ( 75%) Interference with livelihoods (71%) Social and mental stress (68-72%)

27 PROGRAMMATIC ACTIVITY & PLANNING Many ARE undertaking activities to adapt to and mitigate health impacts of CC They do NOT approach this through the lens of climate change Challenges around institutional culture, lack of cross-portfolio communication

28 ORGANIZATIONAL CAPACITY Primary reason they are not more engaged in addressing or preparing for health impacts of CC Little time, budget or authority to make this a priority.

29 BARRIERS: ORGANIZATIONAL CAPACITY Not perceived as immediate threat or risk Workload issues Lack of strategic vision or policies Not seen as relevant to public health mandate Lack of clear leadership, decision-making authority Lack of awareness/understanding Political barriers