By: Ilona Hale, MD, FCFPC Jennifer Phillips, CCFP Mehrnaz Makuei, PhD, EIT
Climate resilience 101: Preparing for a changing climate
Issue: BCMJ,
vol. 67, No. 10, December 2025,
Pages 367,369 Council on Health Promotion
Climate change and associated climate events are now a fact of life. It is predicted that these events and their related health impacts will intensify over the coming years. In British Columbia, events such as the 2021 heat dome and recurring wildfire seasons have caused hundreds of deaths, worsened chronic disease outcomes, and disrupted health system operations.[1] However, there are many opportunities to prepare for these changes to minimize the associated health harms.
Climate resilience in health systems refers to our ability to withstand climate events while maintaining care and recovering quickly from disruptions. Because of the intimate connection between climate and health, those working in the health system play a critical role in strengthening our systems and communities for the changes to come.
Recognizing climate risks enables more focused, long-term infrastructure and operations planning. In practice, climate projections are now incorporated into building design and maintenance to better align with expected future conditions. To support continuity of care during climate emergencies, measures such as reliable backup power, improved ventilation, and diversified supply chains have proven effective in enhancing facility preparedness. Looking ahead, every facility should undertake a climate change vulnerability and risk assessment and consider climate resilience in all facility-level decisions. Together, these efforts position the health system to better anticipate, absorb, and recover from future climate impacts.
Building resilience isn’t limited to infrastructure. It also involves helping patients strengthen their ability to cope with climate-related health challenges. Individual health care providers play an important role in protecting the health and enhancing the resilience of their patients. Certain populations are more vulnerable to the health effects of climate events, including those who are required to work outside and those with impaired mobility, limited social connections, and precarious housing or income. Medical issues such as respiratory illness, mental health problems, and certain medications can also put people at increased risk. For example, providers must monitor patients who are taking strong anticholinergics, nonselective beta blockers, or anti–Parkinson disease agents, as these patients can have impaired thermoregulation and are particularly vulnerable to heat stress.[2] Providers must also recognize that patients with respiratory, cardiac, or other conditions need particular attention during wildfire season, and primary care providers should identify and provide anticipatory guidance and information about understanding the importance of monitoring the air quality index and installing even simple air filters for their homes.
Physicians should ensure patients have adequate medication in case of evacuation. Patients living in flood-prone areas should be provided with information about chemical/microbial hazards, wounds, and drinking-water safety after flooding events.
Although we must continue to work toward reducing our collective impact on the climate, for the foreseeable future, we need to prepare ourselves and our patients to be as climate resilient as possible.
Resources for climate resilience
For health system leaders: Reports that describe opportunities to make health care and infrastructure safer and more resilient:
- Climate Change and Health in British Columbia: From Risk to Resilience (https://nrs.objectstore.gov.bc.ca/xedyjn/Projects/2023/ClimateReadyBC/page_health_r2r/Final.pdf).
- Climate Resilience Guidelines for BC Health Facility Planning & Design (https://bcgreencare.ca/resource/hf-climate-resilience-guidelines/).
For patients and providers:
- The BC Centre for Disease Control offers an excellent collection of patient and provider resources, including one-page talking points for extreme heat, wildfire, and flooding (www.bccdc.ca/health-info/prevention-public-health/climate-change-health).
—Ilona Hale, MD, FCFP
Council on Health Promotion Member
—Jennifer Phillips, CCFP
Council on Health Promotion Member
—Mehrnaz Makuei, PhD, EIT
Climate Resilience Coordinator, Interior Health Authority
hidden
This article is the opinion of the authors and not necessarily the Council on Health Promotion or Doctors of BC. This article has not been peer reviewed by the BCMJ Editorial Board.
 |
| This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. |
References
1. Egilson M. Extreme heat and human mortality: A review of heat-related deaths in B.C. in summer 2021. BC Coroners Service Death Review Panel. 7 June 2022. Accessed 20 October 2025. www2.gov.bc.ca/assets/gov/birth-adoption-death-marriage-and-divorce/deaths/coroners-service/death-review-panel/extreme_heat_death_review_panel_report.pdf.
2. Hospers L, Dillon GA, McLachlan AJ, et al. The effect of prescription and over-the-counter medications on core temperature in adults during heat stress: A systematic review and meta-analysis. EClinicalMedicine 2024;77:102886. https://doi.org/10.1016/j.eclinm.2024.102886.
