A hotter future is already here — and Canada is not ready

Two weeks ago, the Canadian Institute for Climate Choices released a report on the public health impacts of climate change and the need for action to adapt to a new reality of extreme threats.

"Climate change," Ian Culbert, executive director of the Canadian Public Health Association, wrote in the report's introduction, "is an escalating public health emergency, and we need to start treating it that way."

The historic and deadly heat wave in British Columbia made those words frighteningly real — even before it triggered a forest fire that destroyed most of the village of Lytton, British Columbia.

"We are now committed to a certain degree of warming in the world because of the emissions of the past," Ryan Ness, the adaptation research director for the institute and co-author of the report, said in an interview on Friday.

"So while, in the longer term, it's absolutely critical to reduce greenhouse gases as much as possible, as fast as possible, to keep things from getting even worse, there is a certain amount of climate change that we can no longer avoid. And the only way to really deal with that is to prepare, to adapt and to become more resilient to this change in climate."

That means countering the increased risk of floods and forest fires. It also means accounting for how climate change will threaten Canadians' health.

A hotter, more dangerous world

Adaptation will require much greater action from governments — and learning some of the lessons of the other public health crisis we've spent the past year and a half fighting.

The institute's report estimates that increased economic, social and health care costs related to several of the effects of climate change — ground-level ozone (smog), soaring heat and the spread of Lyme disease — will amount to billions of dollars by mid-century, even in a "low-emission" scenario. Damages and costs will only increase if emissions are not reduced.

But because some costs are difficult to project, researchers didn't model all potential impacts — on mental health, for instance, or the effects of poor air quality due to wildfires, or weather-related threats to health care facilities.

This summer in Canada may be remembered for its record-breaking and deadly heat. But it follows a similarly fatal wave in Montreal in 2018. And the future promises only more heat.

The report notes that, between 1971 and 2000, Ontario and Manitoba saw approximately 50 days each year in which temperatures were high enough to cause heat-related deaths. By the 2050s, the Institute estimates, that annual total will be 1.5 times higher.

That additional heat will put more people in hospitals. Looking specifically at coronary heart disease, stroke, hypertensive disease and diabetes, the report estimates a 21 per cent increase in the rate of heat-related hospitalizations under a low-emissions scenario.

And more people will die: the report estimates that, by mid-century, heat will account for an additional 200 to 425 deaths in Canada per year.

The Institute did find that two measures to retrofit buildings would reduce the death toll. "If shading technologies were installed on 25 per cent of homes in Canada by the 2050s, there would be an average of 21 fewer deaths per year," the report says. "If 50 per cent of all residential, commercial, and institutional buildings had green roofs installed by the 2050s, an average of 46 deaths would be avoided annually."

But while green roofs and shading might reduce the impact of generally higher temperatures, such things won't necessarily be enough to protect people from extreme events.

"When it comes to these extreme heat emergencies, the response systems really need to be in place to be able to identify the people who are going to be most affected by this and to get them the care that they need, whether it's cooling centres, whether it's medical attention, whether it's a place to get off the streets," Ness said.

"And in the longer term, it's going to be important to address the underlying root causes of what makes some people more vulnerable than others.  Because it's not really the average person who's likely to die from a heat wave event. It's somebody who is living on the street, somebody who has pre-existing health conditions because they aren't able to access the health care that they need, or seniors who don't have the supports they need to to help them out in these situations."

What the pandemic should have taught us

The province's coroner has said that many of the 300 people who died suddenly in the recent heat wave in B.C. were seniors living in homes with poor ventilation.

That's a disturbing echo of what happened in this country during the current pandemic. When COVID-19 arrived, it was seniors living in inadequate long-term care facilities who suffered most.

Throughout the pandemic, it was often low-income and racialized Canadians who saw higher rates of infection and were made to accept the greatest amount of risk as "essential workers." The Climate Choices report makes clear that climate change has the potential to exacerbate existing inequities.

Those vulnerabilities need to be accounted for in responding to climate change — but reducing or eliminating those disparities in general would also create a society that is better prepared to withstand the stress a changing climate will inflict.

"Addressing vulnerability and giving people the resources and the best chance possible to achieve good health before these things happen is incredibly important," Ness said.

And while the focus now may be on heat, Ness notes that worsening air quality could pose problems that "dwarf" the impact of higher temperatures.

The federal Liberal government has committed to developing a National Adaptation Strategy — though a recent report from the International Institute for Sustainable Development noted that Canada is behind some European countries in such planning.

The federal government also has committed billions of dollars in funding to disaster mitigation, improving infrastructure and public reporting (including the recently released "National Issues Report" on climate change's impacts on Canada). But the Institute for Climate Choices found that only three per cent of climate adaptation funding announced in recent budgets was specifically targeted to public health.

Though adaptation might be coming to the fore now — a new coalition of insurance companies and environmental organizations has come together to push for federal action — it has generally run second in the public discussion around climate change, perhaps with some justification. Mitigating future climate change by reducing greenhouse gas emissions is far preferable to merely learning to live with its effects.

But the world is long past the point when some amount of dangerous climate change could be avoided. And we no longer need to look to the future to imagine what that change could look and feel like. The climate crisis is here.