Why is Canada so behind in research on climate change and health?
In 2009, the Lancet identified climate change as the biggest global health threat of the 21st century, putting the lives and well-being of billions of people at increased risk in the next decades. In 2015, the World Health Organization made a similar declaration and since then the Lancet has been leading an annual “countdown” on health and climate change to communicate the urgency of the issue. Major articles in the British Medical Journal and the Journal of the American Medical Association have reiterated the enormity of the health effects of climate change (for example, of extreme weather events and changing patterns of vector-borne diseases) and called for an urgent policy response.
Despite this growing consensus on the magnitude of the problem, Canadian health research seems extraordinarily slow to respond. A search of the Canadian Research Information System—a database of grants and awards funded by multiple agencies and foundations—reveals that since 2009, only 55 of 28,752 funded grants and awards by CIHR (the main health research funding body in Canada) included the term “climate change” in their abstracts. This represents just 0.2 percent of total awards.
As co-authors of this piece, we are a diverse group: a family physician, an emergency room physician, a health research statistician, and a health economist. But we all share a heightened sense of worry about the growing impact of climate change on health, and the dearth of Canadian research related to this.
It’s possible that health researchers “don’t know what they don’t know” on the topic: Climate change is still not covered in the vast majority of medical and nursing school curricula, and many health professionals have yet to make the connections between climate change and health. Researchers may also be daunted by the scope and scale of the problem.
A recent survey by the Institute of Health Policy, Management and Evaluation at the University of Toronto suggests this is the case. The survey of 205 faculty, students, clinicians, researchers, administrators and others working in the health sector found that although 61 percent indicated an interest and willingness to include climate change and environmental sustainability in their programs of research, a majority were not currently doing this. Respondents identified lack of knowledge about the link between climate change and health, lack of awareness of research priorities, lack of collaboration opportunities related to climate change and health research, and lack of funding as key barriers.
Science has an essential role to play in informing our understanding of anticipated health impacts and in guiding policy for mitigating climate change. These health impacts include increasing heat-related illnesses such as heat stroke and death; floods and wildfires associated with stress and displacement from disasters; climate-change related expansion of vector-borne infectious diseases (including Lyme Disease); warmer temperatures resulting in higher pollen levels and a greater burden of allergy-related illnesses; and the increase in wildfire-related air pollution causing more frequent and severe asthma exacerbations.
While it is impossible to attribute each extreme weather event to climate change, the increasing frequency and severity of these occurrences are consistent with the predictions of climate scientists. In Canada, the recent flooding in New Brunswick and British Columbia, last summer’s unprecedented fires in British Columbia and Alberta, and this summer’s extreme heat waves in Quebec and Ontario suggest a growing urgency to understand and begin to address the health effects of these events.
Another related area of relevance in Canada is research on the human health impacts of unconventional extraction of fossil fuels. Fracking (or hydraulic fracturing) is a mining process that involves drilling holes vertically and then horizontally into the ground for several kilometres, followed by the forcible injection of large amounts of water, chemicals and sand to release methane (otherwise known as natural gas). Canada is the fourth-largest producer and exporter of natural gas worldwide, and fracking is now the main method for production in Canada, with most of it occurring in British Columbia and Alberta. Both the leakage of methane as a potent greenhouse gas during the fracking process, and the possibility of exposure to hundreds of chemicals—some of which have known carcinogenic or hormone-disrupting activity—have potentially major implications for population health.
Of particular concern is the fact that fracking in Canada predominantly takes place in rural and Indigenous communities, and the absence of Canadian research in this field is another example of health inequity between our Indigenous and non-Indigenous populations. Research into the local health impacts of resource extraction, with a focus on impacts on Indigenous populations, is one of the priority recommendations of the 2017 Lancet Climate Countdown Canadian Public Health Association briefing for Canadian Policymakers.
Whatever the reasons behind our collective blind spots in these areas of research, it is long overdue for our national and provincial health research funding bodies to begin to align policy with the climate health emergency. Over the past decade, strategic research investments by Canadian funding agencies have been made in a number of areas, including chronic diseases, primary care, frailty and patient-oriented research. Where is the funding callout for the health effects of climate change or the cumulative health impacts of fossil-fuel extraction in Northern communities? And if not now, then when?
Dr. Margaret McGregor is a family physician and health services researcher. She is a clinical associate professor at the University of British Columbia, Department of Family Practice, and a research associate at the Vancouver Coastal Health Research Institute’s Centre for Clinical Epidemiology & Evaluation and the UBC Centre for Health Services Policy Research. Her research interest is in the health care of frail seniors in primary care and community settings. @1mcg8
Dr. Stirling Bryan is an economist with a career-long specialization in health care. He is a professor in UBC’s School of Population & Public Health, and a senior scientist at Vancouver Coastal Health’s Centre for Clinical Epidemiology & Evaluation. In 2016, he was appointed Scientific Director for the BC SUPPORT Unit, a component part of B.C.’s Academic Health Sciences Network, focused on promoting patient-oriented research. @StirlingBryan
Dr. Penny Brasher (far right in photo) is a senior research scientist at Vancouver Coastal Health Research Institute’s Centre for Clinical Epidemiology & Evaluation and an associate member of the Department of Statistics at UBC. Dr. Brasher’s research interests include clinical research methodology, secondary use of administrative data and statistical education.
Dr. Courtney Howard (second from right in photo) is a UBC and McGill-trained emergency physician in Yellowknife and board president of the Canadian Association of Physicians for the Environment. Dr. Howard does research on the health impacts of wildfires in the subarctic and was first author on the Lancet Countdown 2017 Report: Briefing for Canadian Policymakers. @courtghoward