The inequities of climate change—Intersections between environmental health and health disparities

Climate change has been a global crisis of interest for decades; however, the physical and psychological impacts of climate change, particularly on Canada’s underserved populations, are underexplored. The impacts of climate change are readily visible in the country, with Canada’s average temperatures warming at twice the mean global rate.[1] However, recent extreme weather events, including wildfires raging through Western Canada and heat-induced storms in Ontario and Quebec, have brought the devastating health consequences of climate change to light. Canada has experienced unprecedented impacts from this wildfire season, with more than 5800 reported fires and over 15 million hectares burned to date.[2] Over 29 000 Albertans were left displaced by wildfires in the period of a few months, and thousands in British Columbia and the Northwest Territories were required to evacuate their communities as flames strained emergency services.[3] However, as we saw these events unfold, it became increasingly clear that the health hazards related to these environmental changes are not experienced uniformly across all populations in Canada,[4] and the differential impacts on physical and mental health outcomes have the potential to exacerbate existing health inequities for oppressed and underserved populations.

Differences in regional distribution and adaptive capacities are key factors contributing to potentially disproportionate exposure to climate-related events and resulting harms. For instance, lower socioeconomic regions, as well as northern and remote communities, face challenges in responding to and recovering from environmental hazards and disasters secondary to various factors, including lack of critical infrastructure and decreased capacity for emergency planning and response.[4] In particular, Indigenous communities have been overrepresented in wildfire evacuations, experiencing 42% of evacuation events, despite representing only 5% of the country’s population.[1,5] Limited resources, resulting from chronic underfunding and remote locations, make it all the more challenging to access emergency resources and support in times of crisis, thus prolonging and intensifying the detrimental impacts of climate events.[1]

Physical impacts of climate change and environmental disasters are exacerbated by underlying health determinants such as poor housing, overcrowding, and geographic proximity to areas more prone to wildfires. A Health Canada report estimated that, annually, 54 to 240 premature deaths in Canada can be attributed to short-term exposure to wildfire, and 570 to 2500 premature deaths to long-term exposure.[4] Furthermore, access to and availability of basic amenities such as clean water are already strained in Indigenous and northern communities, with disproportionately higher frequency and duration of boiled-water advisories.[4] Extreme weather events can easily overwhelm fragile water treatment systems and exacerbate issues related to water sanitation and exposure to environmental contaminants.[4]

Beyond the physical health impacts, there are significant cultural and mental health implications in the context of place attachment and psychosocial impacts of migration. Evacuees are at risk for posttraumatic stress disorder and anxiety as a result of needing to adapt to new and often less-desirable conditions and loss of social structures and cultural practices tied to the land.[6,7] These impacts extend beyond acute natural disasters; climate change also results in permanent modifications of local landscapes, with detrimental impacts on foraging, trapping, and other culturally significant practices that may affect the mental and emotional health of Indigenous people. For instance, one study identified that environmental changes are closely intertwined with mental health impacts on Indigenous populations in Atlantic Canada, resulting from intangible losses that disrupt core drivers of psychological wellness and health in Indigenous communities.[8]

The record heat and wildfires seen earlier this year are only pieces of an alarming trend of the devastating effects of climate change, and it is expected that these changes will become more catastrophic and more frequent in coming years. It is imperative that the disproportionate impacts these changes have on Canada’s Indigenous, northern, and remote populations are addressed through the development of legislation and federal programs to support building protective infrastructure, with the involvement of Indigenous leadership and partnerships in research efforts to identify needs. It is our responsibility to explore and understand the disproportionate impacts on Canada’s oppressed and underserved populations to ensure an inclusive and sustainable direction to our collective climate solution.
—Min Jung Kim, BHSc, UBC Faculty of Medicine, class of 2024
Vancouver

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References

1.    Bush E, Lemmen DS, editors. Canada’s changing climate report. Ottawa: Government of Canada, 2019. https://changingclimate.ca/CCCR2019/.

2.    Allen RW, Cleland S. Wildfire smoke is an increasing threat to Canadians’ health. PreventionWeb. 27 August 2023. Accessed 19 June 2023. www.preventionweb.net/news/wildfire-smoke-increasing-threat-canadians-health.

3.    O’Neill N. Air quality advisories in Western Canada due to fires, as East Coast braces for May snowstorm. CTV News. 8 May 2023. Accessed 7 November 2023. www.ctvnews.ca/canada/air-quality-advisories-in-western-canada-due-to-fires-as-east-coast-braces-for-may-snowstorm-1.6388974.

4.    Public Safety Canada. The first public report of the national risk profile. Modified 11 May 2023. Accessed 19 June 2023. www.publicsafety.gc.ca/cnt/rsrcs/pblctns/2023-nrp-pnr/index-en.aspx.

5.    Statistics Canada. Indigenous population continues to grow and is much younger than the non-Indigenous population, although the pace of growth has slowed. 21 September 2022. Accessed 7 November 2023. www150.statcan.gc.ca/n1/daily-quotidien/220921/dq220921a-eng.htm.

6.    Agyapong VI, Juhas M, Omege J, et al. Prevalence rates and correlates of likely post-traumatic stress disorder in residents of Fort McMurray 6 months after a wildfire. Int J Ment Health Addict 2021;19:632-650.

7.    Hrabok M, Delorme A, Agyapong VI. Threats to mental health and well-being associated with climate change. J Anxiety Disord 2020;76:102295.

8.    Kınay P, Wang XX, Augustine PJ, Augustine M. Reporting evidence on the environmental and health impacts of climate change on Indigenous peoples of Atlantic Canada: A systematic review. Environ Res: Climate 2023;2:022003.