Treating the climate with coal phase-out

*Reprinted with the permission of National Observer

Canada, the UK and partners announced a global alliance to phase-out coal power at COP23 in Bonn, Germany. It was an honour to speak on behalf of the health community at the launch, as coal-power phase-out is a key recommendation of the 2017 Lancet Countdown Report and the Countdown’s associated UK brief, as well as the Canadian Brief which I co-authored on behalf of the Canadian Public Health Association.

The Lancet tells us that climate change is the biggest global health threat of the 21st century…and that tackling climate change could be the greatest global health opportunity of the 21st century.

Phasing out coal is about reducing the 44 per cent of global carbon dioxide emissions due to coal—and the trauma, displacement and heat-related deaths associated with severe weather events due to climate change. It’s about a future with less burns and cough-inducing smoke clouds from wildfires, less conflict and migration, and less undernourished children.

Phasing out coal is also about seeing less kids with asthma puffers from air pollution—less costly ER visits for asthma, less time off school and work. It’s about less morbidity and deaths from the long-term health impacts of coal-related air pollution—cancer, cardiovascular disease, stroke, lower respiratory infection. It’s about less neurodevelopmental problems from mercury, and less polluted water and habitat loss from coal extraction.

Health professionals worldwide are beginning to treat climate change with coal phase-out.In Canada, organizations such as the Canadian Association of Physicians for the Environment and the Canadian Public Health Association have been key contributors to coal phase-out commitments in Ontario, Alberta and Canada-wide.

Earlier at COP23, the World Health Organization Director General, Dr Tedros Adhanom, repeated his commitments to make action for a healthy climate one of the four priorities of his presidency, and met with myself and other members of the Global Climate and Health Alliance to discuss collaboration on both adaptation and mitigation work in service of health.

At the Global Climate and Health Alliance Summit, held in association with the World Health Organization, we spoke with health professionals from across the world, including medical students, to teach them what advocacy techniques work and who they need to partner with in order to support coal phase-out in their home countries. With income being a major social determinant of health, health professionals believe that active support of workers is key to a just and healthy transition.

The health professions are late to the climate fight, but we learn fast, we don’t need a lot of sleep and we’re used to dealing with crisis.

As we move forwards towards actioning the coal phase-out in Canada and beyond, health professionals will be looking to see as much coal as possible replaced with renewables as opposed to natural gas. An increasing proportion of natural gas in Canada is being produced via hydraulic fracturing—for which increasing studies are demonstrating negative impacts. One assessment of the peer-reviewed literature on the impacts of hydraulic fracturing found that 84 per cent of studies on public health, 69 per cent of studies on water and 85 per cent of studies on air pollution found concerning findings. A direct transition to healthy, low-carbon energy should be our goal.

As an Emergency doctor I know what it’s like to act too slowly and to have patients die. The first time a child died under my care was on a pediatric malnutrition project in the Horn of Africa. It was one of the worst moments of my life. I also know what it’s like to act quickly, to do the right thing, and to pull someone from the spiral back to where we can thrive.

The health professionals of the world are applying the skills they’ve learned from treating people—to work to resuscitating the planet.

COP23 has seen new initiatives, new alliances, and new skills created. In partnership with the global health community and our decision-makers, I’m looking forward to treating the climate with coal phase-out and moving forward to a healthier planet.

Op-Ed By Dr. Courtney Howard, CAPE President, Dec. 3 2017

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Climate Change Health Impacts Demand Urgent Action

“The human symptoms of climate change are unequivocal and potentially irreversible – affecting the health of populations around the world, today. Whilst these effects will disproportionately impact the most vulnerable in society, every community will be affected.”

This is one of the conclusions expressed in the new report, The Lancet Countdown: Tracking Progress on Health and Climate Change, that was released on October 31, 2017.  Produced by the prestigious medical journal, The Lancet, with an interdisciplinary team of researchers from 24 academic institutions and inter-governmental organizations, the new report identifies 31 indicators that can be used to measure the impact, adaptation, mitigation, economics, and politics of climate change on a global scale.

The Countdown notes that global inaction to mitigate climate change is moving us towards a 2.6°C to 4.8°C increase in the global temperature by the end of the century – “a level which would be disastrous to health even with maximal adaptation efforts”.  It states that “adaptation has limits” and that action is needed to “prevent the potentially irreversible effects of climate change.”

The message delivered by the Countdown is urgent and dire, but not without hope.  It also reports that “Whilst progress has historically been slow, the last five years have seen an accelerated response, and the transition to low-carbon electricity generation now appears inevitable.”

In Canada, the Countdown was released along with The Lancet Briefing for Canadian Policymakers,  authored by CAPE President-Elect, Dr. Courtney Howard, the Canadian Public Health Association (CPHA), and the Lancet Countdown team. The policy brief examines several Countdown indicators that are particularly relevant to Canada.  For example, it reports that annual weather-related disasters in Canada have increased by 44% from 1994-2000 to 2000-2013, and notes that these events have affected hundreds of thousands of Canadians, if not more.

Canadians Impacted by Extreme Weather

  • 2013, Calgary flood – 100,000 people affected
  • 2014, Manitoba flood – 6,900 people affected
  • 2014, Yellowknife, Northwest Territories wildfires – poor air quality from smoke
  • 2015, La Ronge, Saskatchewan wildfires – 13,000 evacuated
  • 2016, Fort McMurray, Alberta wildfires – 88,000 people evacuated
  • 2017, Williams Lake, British Columbia wildfires – 24,000 people evacuated
  • 2017, Calgary and Vancouver – poor air quality from wildfire smoke

The policy brief reports that to meet the Paris Agreement, and keep global temperatures from exceeding a 2°C increase, global greenhouse gas (GHG) emissions must be reduced to nearly zero by 2050.  This will require halving emissions every decade between now and then.

Several global policy priorities, which have the potential to produce immediate health benefits as well as long-term climate benefits, are discussed in the policy brief with Canadian data.  These include:

  • the need to replace coal-fired power plants with low to zero emitting sources by 2030;
  • the need to dramatically reduce the use of private motorized vehicles with public transit use, active modes of transportation, and telecommuting; and
  • the need to increase low-meat and plant-rich diets.

For more information, read the Lancet Briefing for Canadian Policymakers and see the CBC interview with CAPE President-Elect Dr. Courtney Howard.

Prepared by Kim Perrotta, Executive Director, CAPE, November 3, 2017

Other Blogs on this topic:

https://physiciansfortheenvironment.wordpress.com/2017/06/06/a-national-cycling-strategy-a-triple-win-for-public-health/

https://physiciansfortheenvironment.wordpress.com/2017/03/08/coal-plants-have-a-significant-impact-on-air-quality-and-health-incomplete-facts-dont-change-the-truth/

https://physiciansfortheenvironment.wordpress.com/2017/01/18/ontarios-coal-plant-phase-out-produced-many-health-and-environmental-benefits/

CAPE helps take legal action against Minister McKenna over Volkswagen scandal

CAPE and Environmental Defence, with legal support from Ecojustice, are taking legal action against Federal Environment Minister McKenna, to force the federal government into investigating and punishing Volkswagen for their illegal importation and sales of emissions-cheating diesel vehicles in Canada.

In 2015, approximately 105,000 Volkswagen vehicles were sold in Canada that were capable of emitting up to 35 times the legal level of nitrogen oxides (NOx). The vehicles which did not comply with Canada’s emission standards were imported into the country with illegal software that would prevent emission testing devices from identifying the problem. The U.S. Environmental Protection Agency prosecuted Volkswagen, and the company agreed to pay a $15 billion settlement. In the same period of time, Canada has failed to conclude their investigation and no punitive measures have yet been taken.

“Volkswagen has already admitted that it perpetuated fraud against the public and put human health at risk by selling emissions-cheating vehicles,” said Amir Attaran, lawyer with Ecojustice’s law clinic at the University of Ottawa. “In taking zero enforcement action and levying no fines as other countries have, the Canadian government is leaving billions of dollars on the table – money that it could use to clean the environment.”

In 2008, the Canadian Medical Association estimated that 21,000 Canadians die every year from heart and lung diseases from polluted air. The Medical Officers of Health in the Greater Toronto and Hamilton Area (GTHA) have also estimated that traffic-related air pollution is responsible for 700 premature deaths and over 2800 hospital admissions for heart and lung conditions, per year, in the GTHA alone. The pollutant that Volkswagen’s illegal diesel vehicles were emitting –  NOx – is one the major ingredients in smog.  Once in the air, NOx are transformed into ground level ozone and fine particulate matter – the two air pollutants most clearly linked to hospital admissions, premature deaths, and chronic heart and lung diseases.

“Traffic-related air pollution is a huge problem in Canada. It is responsible for thousands of deaths and hospital admissions each year,” said Kim Perrotta, executive director of CAPE. “Volkswagen exceeded the legal standards and they tried to hide it with emissions-cheating devices. The federal government has to take action to demonstrate that companies cannot get away with this type of blatant disregard for Canada’s emission standards and human health.”

The federal government needs to put Canadian health interests first, and punish companies that do not follow emissions regulations. The inefficient investigation underway with Volkswagen sets the standard that Canada’s environment and health standards do not need to be upheld. Instead, a more transparent and proactive approach needs to be taken on by the Ministry of the Environment that will protect Canadians and their health for years to come.

A National Cycling Strategy: A Triple Win for Public Health

On June 1, 2017, CAPE participated in the National Bike Summit organized by Canada Bikes where we declared our support for the development of a National Cycling Strategy. Here is why.

A National Cycling Strategy would be a triple win for public health. It would help us to reduce the rate of chronic diseases in Canada. Chronic diseases such as diabetes and heart disease are escalating at alarming rates across the country. They place a heavy burden on the health care system while also producing pain, disability, and premature deaths for hundreds of thousands of Canadians each year. For example, cardiovascular disease alone costs $12 billion each year in Canada.

Physical activity is one of the most effective “treatments” for chronic diseases. We know that one hour of moderate to vigorous activity per week can reduce the risk of premature death by 4 to 9%. And yet, most Canadian do not get the 2.5 hours of physical activity required to maintain good health. Time—or the lack of it—has been identified as the number one barrier to physical activity.

Active modes of transportation—such as cycling—overcome this barrier. They allow people to get the “exercise” they need while travelling to work or school. One study found that people who cycle or walk to work reduce their risk of developing a chronic disease by 11%. But we know that most people, particularly women and children, will not ride to school or work unless cycling routes feel safe. Experience in other jurisdictions has demonstrated that many people will cycle for travel if they have protected bike lanes that look and feel safe.

A National Cycling Strategy would reduce acute and chronic health impacts associated with air pollution. In 2008, the CMA estimated that air pollution produces 21,000 premature deaths each year in Canada. We know these deaths are the tip of the iceberg. They represent a broad array of adverse health impacts including lung cancer, asthma, stroke, and heart disease. The CMA estimated that air pollution costs Canadians $10 billion per year in direct health care costs and lost time, and that was based on a limited number of health impacts for which the evidence was the strongest.

The transportation sector is one of the most significant sources of air pollution in Canada, particularly in large urban centres and along major traffic corridors. Modelling studies have demonstrated that we can significantly reduce air pollution, adverse health impacts, and health care costs by getting residents to use their bikes, instead of their cars, for short trips.

A National Cycling Strategy would also reduce greenhouse gases that contribute to climate change. The World Health Organization (WHO) has called climate change the most significant public health threat of the 21st century. It has estimated that 250,000 people will die prematurely each year by 2030 from climate change unless dramatic action is taken to significantly reduce our carbon emissions. Climate change is already claiming the lives of tens of thousands of people each year from heat stress, diarrhea, malaria, and malnutrition. Many of the victims are children and the elderly living in some of the poorest countries in the world. While Canadians will not experience the worst of these impacts, we are not be immune to the impacts of climate change.

Already, in Canada, we are experiencing health impacts from wild fires, floods droughts, heat waves, and severe storms that are increasing in frequency and intensity; from insect-borne diseases such as West Nile Virus and Lyme Disease that are spreading as the climate warms; and from injuries and deaths resulting from melting permafrost and shifting snow cover. The transportation sector in Canada is responsible for about one quarter of all greenhouse gas emissions. Modelling studies have demonstrated that we can significantly reduce these emissions by getting people to replace short car trips with bike trips.

A National Cycling Strategy is the holy grail of public health; the public policy the serves many public health goals with one investment. It is an investment that will pay for itself many times over in health care savings alone.

Prepared by Kim Perrotta, CAPE Executive Director, June 2017

Read more:

Canada Bike’s National Cycling Strategy

Prescribing Active Travel for Healthy People and a Healthy Planet: A Toolkit for Health Professionals

The Fight for a Bike and Pedestrian Highway Overpass in Montreal

[version français ici]

Above: Félix Gravel, Sylvie Bernier, and Dr. Eric Notebaert at a rally in support of the Turcot Dalle-Parc project in June 2017.

A MAJOR PUBLIC HEALTH AND ENVIRONMENTAL CHALLENGE FOR MONTRÉAL: THE RETURN OF THE ‘DALLE-PARC’ IN THE TURCOT INTERCHANGE

This spring, the Canadian Association of Physicians for the Environment is partnering with the Conseil Régional de l’Environnement de Montréal and several environmental groups in a major campaign to promote active transportation: the Return of the Turcot Dalle-Parc project.

Dr Éric Notebaert, CAPE board member, speaking at the campaign’s launch event.

The Turcot Interchange, a major highway interchange in southwest Montreal, is currently under renovation. This is a major infrastructure project—costing more than $4 billion—which originally included a large, green overpass connecting two zones of Montreal in the plans. This overpass, the “Dalle-Parc”, is a project that connects the upper part of the city (Notre-Dame-de-Grâce–Westmount) and the lower part (Verdun–Pointe-Saint-Charles). This slab that passes over the highway and the railway is a structure that can allow pedestrians and cyclists to cross this area in a safe way. It is a great project that greatly benefitspedestrians and cyclists, and is also connected to a rail shuttle service to the Montreal airport in Dorval.

Dalle-Parc Turcot
Image of the planned overpass for pedestrians and cyclists from the 2010 project plan.

This Dalle-Parc project not only greatly favours active transportation, but it will give people in many neighbourhoods easier and safer access to hospitals and other employment and development centers. If it is not implemented, cyclists will have to make a 10km detour to traverse a distance of barely 1km. The Dalle-Parc project will also significantly reduce pollution and greenhouse gases emitted by the city.

In the initial project to renovate the Turcot Interchange in 2010, this Dalle-Parc was the only truly interesting environmental aspect of this huge construction site. The Dalle-Parc therefore had the support of all the environmental groups and citizens of the city. However, in the latest version from the Quebec Ministry of Transport (MTQ) in 2015, the Dalle-Parc was simply gone. No one at the MTQ seems to be able to explain this decision. It is important to note that the cost of the Dalle-Parc is estimated at $40 million, or 1-2% of the total cost of refurbishing of the interchange.

Left: 2010 project plan, including the Dalle-Parc. Right: 2015 project plan, the Dalle-Parc has disappeared.

We are asking the MTQ for the reinstatement of the Dalle-Parc. The current campaign has several components: meeting with municipal, provincial and federal politicians; social, festive, cultural, and sporting events; meeting with local groups; meeting with the media; etc.

This campaign will certainly last several months. But it will last as long as it takes. We are absolutely determined to win this battle for the health of the population… and the planet.

Dr Éric Notebaert 21.03.2017

Retour de la Dalle-Parc Turcot

[English version here]

Ci-dessus: Félix Gravel, Sylvie Bernier, et Dr. Eric Notebaert lors d’un rassemblement à l’appui du Dalle-Parc Turcot en juin 2017.

UN ENJEU MAJEUR DE SANTÉ PUBLIQUE ET D’ENVIRONNEMENT POUR MONTRÉAL : LE RETOUR DE LA ‘DALLE-PARC’ DANS L’ÉCHANGEUR TURCOT

Ce printemps, l’Association Canadienne des Médecins pour l’Environnement s’associe au Conseil Régional de l’Environnement de Montréal et à plusieurs groupes environnementaux dans une importante campagne de promotion du transport actif.  Il s’agit du projet Retour de la Dalle-Parc Turcot.

Dr Éric Notebaert, membre du conseil d’administration de l’ACME, en parlant à l’événement de lancement de la campagne.

Le grand échangeur routier du sud-ouest de Montréal, l’échangeur Turcot est actuellement en réfection. Il s’agit d’un projet majeur de plus de 4 milliards de dollars, dans lequel une grande plate forme verte entre 2 zones de Montréal était initialement prévue dans les plans. Cette plate forme, la Dalle-Parc est un projet qui permet de relier la partie haute de la ville : Notre Dame de Grâce-Westmount et la partie basse : Verdun-Pointe St-Charles. Cette dalle qui passe au dessus de l’autoroute et de la voie ferrée est un ouvrage qui peut permettre aux piétons et cyclistes de traverser cette zone de façon sécuritaire. Il s’agit d’un beau projet qui favorise grandement les piétons et cyclistes, et qui est, de plus, en lien avec une navette ferroviaire dans l’axe Montréal-Aéroport de Dorval.

Dalle-Parc Turcot
Image du Dalle-Parc Turcot prévu tiré du plan de projet de 2010.

Ce projet de Dalle-Parc permet non seulement de favoriser grandement le transport actif, mais grâce à lui, les citoyens et citoyennes de plusieurs quartiers ont plus facilement accès aux centres hospitaliers et autres pôles d’emplois et de développement, et ce, de façon très sécuritaire. S’il n’est pas réalisé, les cyclistes auront à faire un grand détour de 10 Km pour parcourir une distance d’à peine 1Km. Le projet de la Dalle-Parc permet en outre de diminuer de façon substantielle la pollution et les Gaz à Effet de Serre émis par la ville.

Dans le projet initial de réfection de l’échangeur Turcot en 2010, cette Dalle-Parc était le seul aspect véritablement intéressant au niveau environnemental de ce gigantesque chantier. La Dalle-Parc avait donc le soutien de tous les groupes environnementaux et des citoyens et citoyennes de la ville. Or dans la dernière version du Ministère des Transports du Québec (MTQ) en 2015, la Dalle-Parc était tout simplement disparue. Personne au MTQ ne semble pouvoir expliquer cette décision. Il est important de souligner que le coût de la Dalle-Parc est estimé à 40 millions de dollars, soit 1-2% du budget total de réfection de l’échangeur.

À gauche: projet présenté en 2010, avec la Dalle-Parc. À droite: projet présenté en 2015, la Dalle-Parc a disparu.

Nous demandons dont au MTQ la réinsertion de la Dalle-Parc. La campagne actuelle a plusieurs volets : rencontre avec les politiciens municipaux, provinciaux et fédéraux; rencontre avec les groupes locaux, événements sociaux, festifs, sportifs, culturels, rencontre avec les médias, etc…

Cette campagne durera certainement plusieurs mois. Mais elle durera le temps qu’il faudra. Nous sommes absolument déterminés à gagner cette bataille. Il en va de la santé de la population…et de la planète.


Dr Éric Notebaert 21.03.2017

 

Prescribing Active Travel for Healthy People and a Healthy Planet: A Toolkit for Health Professionals

As health professionals, we know how important it is for our patients to be physically active. After all, physical activity is known to reduce the risk of chronic diseases such heart disease and diabetes. It also improves mental health and provides some relief from arthritis. But we also know that many people have difficulty finding the time to get the levels of physically activity needed to maintain good health. Studies bear this out; the number one barrier to physical activity is time. This is particularly true for women with young children. This is where active modes of transportation (such as walking and cycling) and transit use come in. Research has demonstrated that many people can fold physical activity into their lives if they combine it with other activities such as errands, commuting to work, or taking the kids to school.

As health professionals, we are well positioned to encourage our patients to think about active transportation as a way to get the physical activity they need to stay healthy. When we use the phrase “active transportation”, we mean any activity used to get people from one destination to another that involves physical activity. It can include skate boarding or in-line skating, but usually involves walking or cycling. When we use the phrase “active travel”, we are referring to transit use as well as active transportation because many trips on transit begin or end with walking or cycling.

Unfortunately, many communities across Canada have not been designed to encourage and foster active modes of transportation or transit. Many were built during a time when it was considered wise to separate homes and schools from workplaces and amenities. This led to communities designed around cars; sprawling neighbourhoods with winding roads and cul-de-sacs separated from shopping malls that grouped all amenities into one place. Experience and research has demonstrated the problem with this thinking. We now understand the need for compact neighbourhoods that have enough people in them to support efficient transit service and attract restaurants, stores, and other services. We know that streets built on a grid encourage people to walk and cycle to nearby amenities. We know that streets lined with sidewalks encourage walking by making it safer and easier to do. And we know that busy streets with separated bike lanes are safer for cyclists and encourage more people to ride their bicycles.

But changing the design of communities and streets can be difficult. Resistance can come from a number of different sources. As health professionals, we can play an important role in community decisions. We can help educate the public and decision-makers about the many health benefits of community and street designs that support and foster a healthy lifestyle.

CAPE has produced a new toolkitPrescribing Active Travel for Healthy People and a Healthy Planet: A Toolkit for Health Professionals—to help health professionals become advocates of active transportation and transit with their patients and in their communities. The toolkit is designed with five stand-alone modules so people can focus on the ones of most interest to them. Module 1 describes the health, environmental and social benefits of active travel. Module 2 provides strategies to motivate patients to use active travel. Module 3 explains the links between active transportation and community design. Module 4, designed for health professionals in southern Ontario, focuses on Ontario’s Growth Plan and how it impacts active travel. Module 5 provides strategies for promoting change in one’s community. The toolkit also includes two factsheets and brochures that health professionals can give to their patients, two backgrounders that can be used in meetings with the public or decision-makers, and a series of memes that can be used on Twitter or Facebook to make people think about the many benefits of walking, cycling, and transit for society as a whole.

The toolkit and its various supporting documents can be found at https://cape.ca/active-travel-toolkit/

Prepared by Kim Perrotta, Executive Director, CAPE, March 20, 2017