Climate change and health in british columbia: projected impacts and a proposed agenda for adaptation research and policy

Climate Change and Environmentally Sustainable Kidney Care in Canada: A Knowledge, Attitudes, and Practices Survey of Kidney Care Providers

Background

Climate change impacts health and threatens the stability of care delivery systems, while healthcare is mobilizing to reduce its significant environmental impact.

Objective

This study aimed to assess knowledge, attitudes, and practices (KAP) about climate change among Canadian kidney care providers.

Design setting participants measurements and methods

An electronic KAP survey, created by the Canadian Society of Nephrology-Sustainable Nephrology Action Planning committee, was distributed to kidney care providers across Canada, from March to April 2023.

Results

A total of 516 people responded to the survey. Most respondents (79%) identified as women; 83% were aged 30 to 59 years. Nurses and nephrologists made up 44% and 23% of respondents, respectively. About half of the participants felt informed about climate change to an average degree. Most respondents (71%; 349/495 and 62%; 300/489) were either extremely or very concerned about climate change and waste generated in their kidney care program, respectively. The vast majority of respondents (89%; 441/495) reported taking steps to lower their personal carbon footprint. People who felt more informed about climate change presented higher degrees of concern. Similarly, both those who felt more informed and those who reported higher degrees of concern about climate change were more likely to take steps to reduce their carbon footprint. Over 80% of respondents (314/386) were at least moderately interested in learning sessions about environmentally sustainable initiatives in care.

Limitations

This survey is at risk of social acceptability, representative, and subjective bias. Overrepresentation from Quebec and British Columbia, as well as the majority of respondents identifying as women and working in academic centers, may affect generalizability of the findings.

Conclusions

Most kidney care providers who responded to this survey are informed and concerned about climate change, and their knowledge is directly associated with attitude and practices. This indicates that educational initiatives to increase awareness and knowledge on climate change will likely lead to practice changes.

Associations of five food- and water-borne diseases with ecological zone, land use and aquifer type in a changing climate

BACKGROUND

Food- and water-borne pathogens exhibit spatial heterogeneity, but attribution to specific environmental processes is lacking while anthropogenic climate change alters these processes. The goal of this study was to investigate ecology, land-use and health associations of these pathogens and to make future disease projections.

METHODS

The rates of five acute gastrointestinal illnesses (AGIs) (campylobacteriosis, Verotoxin- producing Escherichia coli, salmonellosis, giardiasis and cryptosporidiosis) from 2000 to 2013 in British Columbia, Canada, were calculated across three environmental variables: ecological zone, land use, and aquifer type. A correlation analysis investigated relationships between 19 climatic factors and AGI. Mean annual temperature at the ecological zone scale was used in a univariate regression model to calculate annual relative AGI risk per 1 °C increase. Future cases attributable to climate change were estimated into the 2080s.

FINDINGS

Each of the bacterial AGI rates was correlated with several annual temperature-related factors while the protozoan AGIs were not. In the regression model, combined relative risk for the three bacterial AGIs was 1.1 [95% CI: 1.02-1.21] for every 1 °C in mean annual temperature. Campylobacteriosis, salmonellosis and giardiasis rates were significantly higher (p < 0.05) in the urban land use class than in the rural one. In rural areas, bacteria and protozoan AGIs had significantly higher rates in the unconsolidated aquifers. Verotoxin-producing Escherichia coli rates were significantly higher in watersheds with more agricultural land, while rates of campylobacteriosis, salmonellosis and giardiasis were significantly lower in agricultural watersheds. Ecological zones with higher bacterial AGI rates were generally projected to expand in range by the 2080s.

INTERPRETATION

These findings suggest that risk of AGI can vary across ecosystem, land use and aquifer type, and that warming temperatures may be associated with an increased risk of food-borne AGI. In addition, spatial patterns of these diseases are projected to shift under climate change.

Voices from the landscape: Storytelling as emergent counter-narratives and collective action from northern BC watersheds

The 'Ecohealth and Watersheds in Northern BC'' project, situated in a resource rich, settler colonial context, generated three digital stories at the request of the project's Steering Committee members that sought to connect health, environment, and community. Three Steering Committee members championed these stories from their distinct watersheds, resulting in emergent counter-narratives that respond directly to their social-ecological contexts. Nested in literature on blue and green spaces, we present and examine the process of storytelling as emergent counter-narrative and how these narratives challenge us to think of blue and green spaces in interconnected and nuanced ways.

Health Impacts of Climate Change-Induced Subzero Temperature Fires

General fire risk and the special risk related to cold climate cellulosic drying processes are outlined. Four recent subzero temperatures fires are studied with respect to health impacts: a wooden village fire, a single wood structure fire, a wildland urban interface (WUI) fire and a huge wildland fire. The health impacts range from stress related to loss of jobs, psychological effects of lost possessions, exposure to smoke and heat as well as immediate, or delayed, loss of lives. These four fires resulted in 32 fatalities, 385 persons hospitalized for shorter or longer periods, 104 structures lost and 1015 km² of wildland burned north of, and just south of, the Arctic Circle. It is shown that the combination of subzero temperature dry weather, strong winds, changing agricultural activities and declining snowpack may lead to previously anticipated threats to people and the environment. There are reasons to believe that these fires are a result of the ongoing climate changes. Risk impacts are discussed. Rural districts and/or vulnerable populations seem to be most affected. Training methods to identify and better monitor critical fire risk parameters are suggested to mitigate the health impacts of a possibly increasing number of such fires.

A review of national-level adaptation planning with regards to the risks posed by climate change on infectious diseases in 14 OECD nations

Climate change is likely to have significant implications for human health, particularly through alterations of the incidence, prevalence, and distribution of infectious diseases. In the context of these risks, governments in high income nations have begun developing strategies to reduce potential climate change impacts and increase health system resilience (i.e., adaptation). In this paper, we review and evaluate national-level adaptation planning in relation to infectious disease risks in 14 OECD countries with respect to "best practices" for adaptation identified in peer-reviewed literature. We find a number of limitations to current planning, including negligible consideration of the needs of vulnerable population groups, limited emphasis on local risks, and inadequate attention to implementation logistics, such as available funding and timelines for evaluation. The nature of planning documents varies widely between nations, four of which currently lack adaptation plans. In those countries where planning documents were available, adaptations were mainstreamed into existing public health programs, and prioritized a sectoral, rather than multidisciplinary, approach. The findings are consistent with other scholarship examining adaptation planning indicating an ad hoc and fragmented process, and support the need for enhanced attention to adaptation to infectious disease risks in public health policy at a national level.

Climate change and mosquito-borne diseases in China: a review

China has experienced noticeable changes in climate over the past 100 years and the potential impact climate change has on transmission of mosquito-borne infectious diseases poses a risk to Chinese populations. The aims of this paper are to summarize what is known about the impact of climate change on the incidence and prevalence of malaria, dengue fever and Japanese encephalitis in China and to provide important information and direction for adaptation policy making. Fifty-five papers met the inclusion criteria for this study. Examination of these studies indicates that variability in temperature, precipitation, wind, and extreme weather events is linked to transmission of mosquito-borne diseases in some regions of China. However, study findings are inconsistent across geographical locations and this requires strengthening current evidence for timely development of adaptive options. After synthesis of available information we make several key adaptation recommendations including: improving current surveillance and monitoring systems; concentrating adaptation strategies and policies on vulnerable communities; strengthening adaptive capacity of public health systems; developing multidisciplinary approaches sustained by an new mechanism of inter-sectional coordination; and increasing awareness and mobilization of the general public.

Canadian federal support for climate change and health research compared with the risks posed

For emerging public health risks such as climate change, the Canadian federal government has a mandate to provide information and resources to protect citizens' health. Research is a key component of this mandate and is essential if Canada is to moderate the health effects of a changing climate. We assessed whether federal support for climate change and health research is consistent with the risks posed. We audited projects receiving federal support between 1999 and 2009, representing an investment of Can$16 million in 105 projects. Although funding has increased in recent years, it remains inadequate, with negligible focus on vulnerable populations, limited research on adaptation, and volatility in funding allocations. A federal strategy to guide research support is overdue.