CLIMATE CHANGEAND HEALTH IN SIMCOE MUSKOKA

Charles Gardner

Medical Officer of Health

Morgan Levison

Climate Change Lead

MAJOR ENVIRONMENTAL ISSUE

“A triumph that I could swim in

such ferocious conditions but a

tragedy that it's possible to swim

at the North Pole.”

Lewis Gordon Pugh, July 16, 2007

FIRES

The Town of Huntsville declared an emergency at 7 pm

on January 09, 2008.

Flooding occurred along the Big East River corridor from

Lake Vernon to River Cove.

On June 23rd, 2010, an F2 tornado touched down in

Midland.

The tornado caused extensive property damage in a

small geographic area… widespread power outage.

WITNESSES TO CLIMATE CHANGE

• What changes in weather patterns have you seen in your lifetime, in your community?

• What are your concerns?

• What do you think needs to be done, and what have you done to promote this?

WHY DOES PUBLIC HEALTH NEED TO ACT?

“For public health, climate change is the defining issue for the 21st century.” Dr. Margaret Chan,

Former Director-General of

the World Health Organization

ESCALATING RESEARCH

The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health

Review| Volume 391, ISSUE 10120, P581-630, February 10, 2018

Number of academic reports about climate-sensitive infectious diseases, by year.

CLIMATE CHANGE & PUBLIC HEALTH

Rising temperatures

Air quality

Extended warm weather season

Extreme weather events

A HAPPY COINCIDENCE

▪ Walkable Streets

▪ Compact Development

▪ Connected and Open Community

▪ Mixed-Use Neighborhood

Centers

▪ Mixed-Income Diverse

Communities

▪ Reduced Parking Footprint

▪ Street Network

▪ Transit Facilities

▪ Transportation Demand

Management

▪ Access to Civic and Public Spaces

▪ Access to Recreation Facilities

▪ Local Food Production

▪ Tree-Lined and Shaded Streets

▪ Neighborhood Schools

▪ Green Infrastructure and Buildings

Climate

change-

mitigating

design also

improves

health.

COMMUNITY DESIGN

• Physical Activity and related Chronic Diseases

• Air Quality

• Road Safety

• Accessibility

• Food Systems/Food Access

• Social Capital & Connectivity

• Water Quality/Access

WE ARE GENETICALLY ENGINEERED FOR THIS

WE HAVE ENGINEERED PHYSICAL ACTIVITY OUT OF OUR LIVES

GREEN SPACE IN OUR COMMUNITIES

David Suzuki Foundation. March 2015 Toronto Public Health. August 2014

2015 LANCET COMMISSION ON HEALTH & CLIMATE CHANGE

Source: Joel Pett Editorial Cartoon used with the permission of Joel Pett and the Cartoonist Group. All rights reserved.

“The greatest global health opportunity of the 21st century”.

HEALTH BENEFITS CAN PROMPT SUPPORT FOR ACTION ON CLIMATE CHANGE.

Source: Reframing climate change as a public health issue: an exploratory study of public reactions. Maibach, EW, et .al. BioMed Central Public Health. 2010 Jun

OUR QUEST?

URGENT PUBLIC HEALTH ISSUE

Strategic Direction 2016-18

“Implement

the agency wide

action plan to

address climate

change”

Strategic Direction 2012-16

“…identify priority

public health issues

that require a

coordinated and

comprehensive agency

response”

WHAT WE PROPOSED

Environmental Sustainability –Internal Mitigation Strategy

Extreme Heat Strategy – Internal Adaptation Strategy

Climate Change Action Plan (Created March 2015)

THE NEW PUBLIC HEALTH MANDATE

VULNERABILITY ASSESSMENT

Increase

Understanding

Increase Understanding

Support Resilience

SensitivityExposure Adaptive

Capacity

SIMCOE MUSKOKA CLIMATE VULNERABILITIES

SMDHU

RESULTS

WHO IS MOST VULNERABLE?

• Elderly

• Children

• Individuals with pre-existing illnesses

• Individuals living on low income

• Homeless and underhoused

• Women

• Indigenous Peoples

• Individuals without social networks

IMPORTANT DEMOGRAPHICS

Children (0-9 years) = 10% of the population

Seniors (65 years+) = 18% of the population

12% ( 59,000) people live on low income

An ageing population = more chronic illnessChronic

Conditions

Low

Income

Age

PROJECTED TEMPERATURES

1°C (2020s)

3.5°C (2050s)

5.7°C (2080s)

WHY DOES IT MATTER?

• more heat-related illness

• lack of cold acclimatization

HEAT-RELATED ILLNESS

Data Source: Ambulatory Visits & Population Estimates, 2004-2014, IntelliHealth Ontario. Extracted: May 26, 2016; Heat-Related Illness (HRI) defined as any distinct visit using ICD-10 code of X30 or T67.;Temperature data from Barrie-Oro weather station via Envrionment Canada (climate.weather.gc.ca).

— Number of Days with Daily Maximum ≥30°C

— Heat-Related Illness Emergency Visit Rate

AIR CONDITIONING

URBAN HEAT ISLAND

Can be reduced by

installing green roofs

enhancing urban tree canopy

decreasing black surfaces

PROJECTED PRECIPITATION

• Annual precipitation levels

• Summer precipitation levels

• Less frequent, more extreme

precipitation events

OTHER EXTREME WEATHER IMPACTS

• Thunderstorms

• Forest fire risk

• Winter storms

HEALTH IMPACTS OF EXTREME WEATHER

▪ Direct Injuries and Death

▪ Mental health

▪ Foodborne illness with lack of power

▪ Contamination of water due to flooding

▪ Increased air pollutants/ respiratory illness

▪ Infectious diseases

Flooding

Tornadoes

Forest Fires

Winter Storms

Drought

AIR QUALITY

• Climate change will impact levels of important air pollutants such as ozone

• Changes in the volume, timing, and distribution of pollens and moulds

FOOD AND WATERBORNE ILLNESS

• Pathogen survival increases as temperatures rise

• Bacteria better able to colonize

• Overland flows leading to surface water contamination

• Changing human behaviours

REPORTED ILLNESS

Data Sources: Integrated Public Health Information System (iPHIS), Outbreak Module - Sporadic Cases Probable and Confirmed, January 1, 2005 to December 31, 2016, extracted January 23, 2017. Climate data from the Barrie Oro, Egbert, Beatrice and Muskoka Airport weather Stations via Environment Canada (climate.weather.gc.ca). Date Created: January 25, 2017.

Monthly illness counts compared to mean temperatures

CONTAMINATION & AVAILABILITY OF WATER

Extreme rainfall will:

• bacterial contamination

• in blue-green algae blooms

BLUE-GREEN ALGAE

Source: Ministry of Environment Conservation and Parks

*The number of reported blooms confirmed each year depends on a number of variables (e.g., weather).

BLUE-GREEN ALGAE

Source: Simcoe Muskoka District Health Unit

*The number of reported blooms confirmed each year depends on a number of variables (e.g., weather).

FOOD INSECURITY

Data Source: Canadian Community Health Survey (CCHS) 2007-2014, Statistics Canada, Ontario Share File, Distributed by the Ontario Ministriy of Health and Long-Term Care

Marginal, moderate, or severe household food insecurity by family type, Simcoe Muskoka, 2007–2014.

Single Parent

Couples

With Children

Couples

No Children

Unattached

WEST NILE VIRUS

Increased risk of West Nile virus due to:

• Enhanced breeding conditions

• Better conditions for viral proliferation

POSITIVE MOSQUITO POOLS/HUMAN CASES

Data Source: Public Health Ontario (2017). West Nile Surveillance: Number of Positive Mosquito Pool and Reported Confirmed and Probable Human Cases of West Nile Virus: https://www.publichealthontario.ca/en/DataAndAnalytics/Pages/WNV.aspxextracted 29 March 2017

Total # of Positive Pools

Total # of Positive Humans

LYME DISEASE

• Warmer temperatures supports an increased range of blacklegged ticks

SPREAD OF THE LYME DISEASE

Source: Ogden et al, 2008

Source: Ontario Agency for Health Protection and Promotion (Public Health Ontario). Ontario Lyme Disease Estimated Risk Areas Map. Toronto, ON: Queen’s Printer for Ontario; 2017.

Ontario Lyme Disease Map 2015

ESTIMATED RISK AREAS

Source: Ontario Agency for Health Protection and Promotion (Public Health Ontario). Ontario Lyme Disease Estimated Risk Areas Map. Toronto, ON: Queen’s Printer for Ontario; 2017.

Ontario Lyme Disease Map 2018

ESTIMATED RISK AREAS

TICK SUBMISSIONS

Data Sources: Passive Tick Surveillance Spreadsheet, extracted May 8, 2018.

*Ticks are submitted to the health unit by those who have removed it from their (or another person's) body, and are aware to submit it to the health unit for testing. Submitted ticks may originate from anywhere that the submittor has traveled in recent days, and not necessarily from within Simcoe Muskoka. 66% of submitted ticks are acquired in Simcoe Muskoka

Blacklegged Tick Submissions to Heath Unit

■ # of Blacklegged Ticks

■ # Locally Acquired Ticks

■ # Positive for Lyme Disease

UV RADIATION

▪ levels of ultraviolet radiation exposure

▪ Non-Melanoma skin cancer rates

Type of Cancer% Increase

(2050)

% Increase

(2080

Basal Cell

Carcinoma7.8% 13.1%

Squamous Cell

Carcinoma14.8% 24.8%

STRETCH BREAK

CO2 EMISSIONS HAVE YET TO PEAK…

The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health

Review| Volume 391, ISSUE 10120, P581-630, February 10, 2018

Total carbon dioxide emissions

… BUT COAL HAS.

The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health Review| Volume 391, ISSUE 10120, P581-630, February 10, 2018

Global primary coal supply

CLIMATE CHANGE MITIGATION

Denser metro areas have lower carbon footprints

ONTARIO’S CAR CULTURE

GRIDLOCK, NOW…

Level of Service Fall Weekday - 2011

MUCH WORSE IN THE FUTURE.

Level of Service Fall Weekday - 2041

ALTERNATIVES TO DRIVING

WALKING/CYCLING

From: Promoting Safe Walking and Cycling to Improve Pubic Health: Lessons from the Netherlands and Germany. Pucher, J, & Dijkstra, L. American Journal of Public Health. Public Health Matters, Sept 2003, Volume 93, No. 9

Bicycling

Walking

…BECAUSE IT’S A LOT SAFER.

Source: US Department of Transportation, Centers for Disease Control and Prevention, German Instituteof Economic Research, German Federal Statistical Office, German Federal Traffic Institute, Statistics Netherlands; and Dutch Ministry for Transport; Public Works and Water Management

Bicyclist injury rates per 500,000 km traveled

Pedestrian injury rates per 500,000 km traveled

GREEN THIEVES?

LOCAL ACTIONS AND SUPPORTS

LOCAL PLANS

HAVE HOPE!

FINAL THOUGHTS