Canadian Medical Association

As temperatures plunge in Canada and snowy conditions move into many parts of the country, more than 400 forest fires continue to burn. They’re the holdovers of a devastating summer that broke records for its fiery destruction. As a result of climate change, there will probably be more record-breaking in the years ahead.

The health system is one of Canada’s biggest employers, and it is time to review its climate impact. Our health system is at great risk due to climate change. Nearly half of our health-care facilities were built more than 50 years ago, making them especially susceptible to climate change. Wildfires can affect hospital ventilation, increase admissions due to smoke-related health issues, and threaten hospital infrastructure. The supply chain for essential hospital resources can also be disrupted. Just a few months ago, the 100-bed Stanton Territorial Hospital in Yellowknife, N.W.T., had to evacuate because of wildfires. With resources already spread thin, patients and providers are ill equipped to face these environmental challenges.

It’s timely that the United Nations’ COP28 climate change event in Dubai on Nov. 30–Dec. 12 will feature its first-ever day dedicated to health, putting a spotlight on how climate change and health are inextricably linked.

Canada’s health-care system is not just a victim of climate change, affected by the strain of increased admissions and environmental threats. It is also one of the worst contributors, responsible for an estimated 4.6 per cent of national greenhouse gas emissions, more than aviation and shipping. Medical waste, anesthetics, and an enormous supply chain are just some of the ways the health system has contributed to climate change. If global health care were a country, it would be the fifth-highest carbon emitter in the world.

The health system is meant to improve health, not contribute to harm. It’s essential that governments and health-care leaders work to “green” the health system to help reduce our own carbon footprint. We cannot afford to wait any longer for bold action.

That’s why the Canadian Medical Association is calling for the federal government to create a climate and health secretariat. By linking Environment and Climate Change Canada, Health Canada, Infrastructure Canada, and other federal partners, and working with provincial, territorial, and Indigenous governments and partners, a secretariat could develop a pan-Canadian approach to address the health impacts of climate change and create a climate-resilient and low-carbon sustainable health system. This includes building a climate-resilient health workforce—meaning enough staff, capacity, and planning to address climate emergencies.

Other jurisdictions are well ahead of us in greening their health systems. In 2020, England’s National Health Service (NHS) became the world’s first health service to commit to reaching carbon net zero. In a single year following that commitment, the NHS reported reducing its emissions equivalent to powering 1.1 million homes annually.

While England has a single health service compared with Canada’s 13 provincial and territorial health ministries, the NHS does provide a good example of how climate change mitigation initiatives can be successful when properly funded, staffed, translated into law and regionally delivered. With a co-ordinated, national approach, governments and partners could work toward making Canada a leader in reducing its health-system-related carbon footprint.

We must act with urgency. Earlier this month, Jerry DeMarco, federal commissioner of the environment and sustainable development, reported that the federal government will miss its 2030 target to cut carbon emissions by at least 40 per cent below 2005 levels by 2030. He noted that Canada is the only G7 country not to achieve any emissions reductions since 1990.

“The need to reverse the trend on Canada’s greenhouse gas emissions has grown only more pressing,” DeMarco said. “This is not my first time sounding the alarm, and I will continue to do so until Canada turns the tide.”

Our health-care system can no longer afford to be part of the problem. To implement effective solutions to clean up its pollution, we urgently need the resources and a solid plan to reduce medical-related emissions.

Canada cannot solve climate change on its own. But we can do our part and live up to our national commitments. Greening our health-care system is one way we can do that. By working aggressively to mitigate climate change here at home while collaborating at the international level, we ensure we’re all working toward the same goal of a healthy, thriving planet for generations to come. We can set an example and lead the way, but we must do so with the same urgency with which we meet our now-annual extreme forest fire seasons.

Dr. Kathleen Ross is a family physician in Coquitlam and New Westminster, B.C., and the president of the Canadian Medical Association.

This commentary was originally published by The Hill Times

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