Climate Adaptation Leadership Program for Nova Scotia’s Health Sector

Authors: Kyla Milne, Meredith Flannery

Climate change is a complex problem that requires a coordinated response from stakeholders across the health sector. This ability to act collectively and strategically in the face of uncertainty is one of the core competencies needed for successful adaptive action. The Province of Nova Scotia is currently implementing a cutting-edge program designed to bring stakeholders from across different sectors together to advance collaborative adaptation planning, while simultaneously providing experiences and training designed to enhance a sector’s underlying adaptive capacity.  The health sector in Nova Scotia is one of the first programme participants to take part.  Funded and run by the Province of Nova Scotia with funding support from Natural Resources Canada’s Building Regional Adaptation Capacity and Expertise program, the Climate Adaptation Leadership Program moves away from silo-based patchwork projects to take a value-chain approach to health system risk assessment and adaptation planning. It focuses not just on adaptation outputs but also changes in behaviours and relationships, across health sector partners.  It takes stakeholders through a 5-step learn-by-doing assessment and strategy implementation process, that is supported by a tailored learning curriculum. An innovative approach to climate adaptation, the program is addressing Nova Scotia’s need for health sector climate adaptation planning.

Poster #1: Climate Adaptation Leadership Program for Nova Scotia’s Health Sector

Utilizing Health Professionals as Climate Change Communicators: An Exploratory Study in Northern Ontario

Authors: Robert Sanderson​, Lindsay Galway, Charles Levkoe, Helle Møller, Paul Berger

Health professionals are recognizing and experiencing the impacts of climate change in their work, and understand the need to communicate this information to their clients. Improved climate change communication utilizing health professionals’ trusted position in society has been highlighted as a means to effectively create engagement and empower support for climate action. However, there are few studies that examine how health professionals are taking up the communication in their work. This qualitative study investigates how health professionals who identify as climate change leaders perceive and communicate the health impacts of climate change and the health co-benefits of climate change mitigation in Northern Ontario. 

Poster #2: Utilizing Health Professionals as Climate Change Communicators: An Exploratory Study in Northern Ontario

Social Prescribing for Climate Resilience: Connecting People to Nature and Community

Authors: Kate Mulligan​, Sonia Hsiung​, Sara Bhatti

Social Prescribing leverages peoples’ access to the health care system to reconnect them with nature and community through a supported referral from a health care provider to community supports. It also provides a mechanism for measuring and tracking the outcomes of health promotion and community development. In Community Health Centres, social prescribing supports people to participate in locally-driven resilience-building action, from community gardens and conservation activities to social care and neighbourhood political action. This concurrent session will share local lessons and how-tos from the front lines of social prescribing in Ontario – the international award-winning Rx: Community Project – and invite participants to consider how social prescribing might be incorporated into their own climate and health work.

Poster #3: Social Prescribing for Climate Resilience: Connecting People to Nature and Community

Surveillance of Heat-Related Illness in Peel

Authors: Lydia Cheng, Monali Varia​, Greg Kujbida

Background: Understanding and monitoring the local health impacts of increasing temperatures is important when developing public health strategies to adapt to climate change.

Objectives: Peel Public Health analyzed Environment Canada weather data and two sources of local emergency department (ED) visit data to (1) describe the epidemiology of heat-related illness in Peel and (2) explore the association between temperature and ED visit rates. These findings were used to inform and operationalize a real-time surveillance system for heat-related illness.

Results: Heat-related ED visit rates in Peel between 2003 and 2017 were higher among males and in those aged 15-24 years and 75 and older. Modelling of daily mean apparent temperature and daily heat-related ED visits demonstrated a statistically significant positive association. Separate models exploring the effect of increasing temperature on daily syndromic ED visits available from the Acute Care Enhanced Surveillance (ACES) system resulted in crude associations with the number of all-cause ED visits, “ENVIRO”, asthma, and mental health visits. These syndromes were monitored daily during summer 2019.

Conclusion: Our work demonstrated that heat-related ED visits increase with increasing temperature. We also highlight a method by which local public health agencies can prioritize ACES syndromes for monitoring of heat-related illness.

Poster #4: Surveillance of Heat-Related Illness in Peel

Development of Local Climate Change Adaptation Strategies for Middlesex County

Authors: Fatih  Sekercioglu, Jaelyn  Kloepfer, Randy Walker​

This study aims to answer the following question: In the face of pending climate change, is our rural population ready? The researchers explore local climate change adaptation strategies for Middlesex County as the Middlesex-London Health Unit has identified a need to improve engagement with rural residents and associated community partners to enhance planning specific to climate change.

Poster #5: Development of Local Climate Change Adaptation Strategies for Middlesex County

Addressing climate-driven, vector-borne infectious diseases in Canada - Empowering the next generation of nurses and & health care provider

Authors: Julia  Thomas​, Cynthia Baker

There is clear evidence that climate change has significant impacts on population health.  It has been linked to an increase of adverse health effects related to poor air quality, extreme weather events, food insecurity, water contamination and the spread of vector-borne diseases. Current evidence indicates that the trends in climate change in Canada observed to date will continue, as will the risk of climate-driven infectious diseases.Nurses have an important role to play in addressing health challenges related to climate change. While nursing organizations have called upon the profession to participate in actions to mitigate the impact of climate change;nurses, nurse educators and nursing students need greater awareness of these issues and more evidence-based knowledge.In response, the Canadian Association of Schools of Nursing (CASN) is conducting a Public Health Agency of Canada-funded project to increase the knowledge of the effects of climate-driven, vector-borne infectious diseases on population health amongst nurse educators, and to foster the integration of this knowledge into Canadian nursing education programs. As part of this project, CASN is developing national nursing education guidelines on this topic and an accompanying series of online learning modules, encompassing teaching and learning tools in a dynamic, easy-to-use format​.

Poster #6: Addressing climate-driven, vector-borne infectious diseases in Canada - Empowering the next generation of nurses and & health care providers

Heat Alert and Response System in Rural BC
Authors: Heather Deegan, Sue Pollock, Gabriel Ramirez, Jenny Green, Michelle Allen

Increasing temperatures worldwide have caused more frequent, drastic and long lasting extreme heat events. This is a growing public health concern, as heat-related illness is potentially life-threatening and is 100% preventable. Communities can play an important role to prevent heat related illness and death through coordinated planning and action. Several rural communities in the interior region of British Columbia (BC) experience some of the highest temperatures in the province. In 2018, the Interior Health Authority undertook the development of a Heat Alert and Response System (HARS) in collaboration with a small rural community.  A community-driven, community-based approach allowed HARS to be incorporated into existing community response plans and established infrastructure. The knowledge acquired through the demonstration community supported similar collaborative planning processes in other rural communities in the interior region of BC.
This session will provide an overview of the selection, development and implementation of a HARS in a small rural community. Specifically, we will showcase some of the innovative tools developed and case-specific considerations for communities with limited resources that are a far distance from larger urban centres. We will also describe how this experience is informing the expansion of HARS to other rural communities across Canada.

Poster #7: Heat Alert and Response System in Rural BC

Monitoring Extreme Heat Events using ACES

Authors: Nancy VanStone​, Adam van Dijk, Paul Belanger, Kieran Moore

Monitoring health impacts in real time enables immediate availability of information for decision-makers to enable action to alleviate emergency situations.  This presentation will showcase how syndromic surveillance data from the Acute Care Enhanced Surveillance (ACES) system can be used to monitor extreme heat events and improve public health action to decrease local health impacts in communities across Ontario. ACES provides real-time surveillance of emergency department (ED) activity, including estimates of direct and indirect impacts of exposure to extreme temperatures. ACES can provide several important surveillance requirements, for example:

1. situational awareness—during an extreme heat event, emergency management has access to ED volumes and the main reasons for people seeking health care to help assess the impact of an event as well as make decisions regarding resource allocation or other public health action; and

2. real-time assessment of public health action—as decisions are made and relief resources activated, ED volumes can be monitored to assess the impact of those actions.  

This presentation will highlight the benefits and general methods recommended to use ACES to monitor extreme heat events, as well as how ACES data can complement traditional surveillance methods for assessing local health vulnerabilities

Poster #8: Monitoring Extreme Heat Events using ACES

Drought and human health in a changing climate

Authors: Anna Yusa, Peter Berry​, Livia Bizikova 


​Climate change is already impacting the health of many Canadians. In southern Canada, including Ontario, it is projected that some parts will see a drop in precipitation alongside warmer temperatures in the summer, which could lead to reduced water availability during the warm season (Bush & Lemmen, 2019). Discussions around the impacts of drought have traditionally focused on agriculture and related economic losses. However, important human health risks in Canada associated with drought in the context of climate change were identified through a literature review (Yusa et al., 2015). Changes to drought with climate change could impact these risks. Public health officials may be less aware of the human health-related impacts of drought than other risks that are expected to be impacted by climate change such as extreme heat. This presentation will identify drought-related health impacts and vulnerabilities that are relevant to public health practitioners in Ontario. It will also discuss potential indicators that can be used to conduct local to regional climate change and health vulnerability and adaption assessments to inform robust measures to protect health (Berry et al., 2019, Yusa et al., 2015).

Poster #9: Drought and human health in a changing climate

Disability, Walks, and My Neighbourhood: experiencing the urban environment and climate change as a person with dysautonomia

Authors: Kendra Cheeseman


Understanding the lived experience of illness and wellbeing are powerful perspectives for the city-builder seeking to develop an inclusive strategy for healthy built environments in a time of climate crisis. A reflexive approach of the experience of living with dysautonomia or autonomic dysfunction is employed. The landscape architectural researcher analyzes urban design in Southwestern Ontario by asking participants who have dysautonomia to share their experiences of navigating their neighbourhoods. By inviting participants on go-along interviews, this serves as a valuable tool to gain insight into the unique experiences of populations that are typically less represented in research and to learn about the participant’s experience of a place while walking through it (Carpiano, 2009; Finlay, 2009). Through analysis of go-along interviews that explore how individuals navigate their own communities with dysautonomia, landscape design recommendations are shared that consider the social, physical, and emotional health of those with chronic illnesses and disability within the built environment. Interviews took place in the month of August, which demonstrate some of the strongest flares in these conditions. Finally, a toolkit of policy recommendations that consider building codes are shared as they relate to municipalities in Southern Ontario in our time of climate crisis.

Poster #10: Disability, Walks, and My Neighbourhood: experiencing the urban environment and climate change as a person with dysautonomia

Neglecting Human Health: Gaps in Canadian Pipeline Project Impact Assessments

Authors: Hunster Yang​, Simran Sharma​, Hailey Morton​


In Canada, there are over 840,000 kilometres of pipelines that provide a variety of benefits, such as economic growth and the creation of jobs. However, they also involve serious environmental and human health implications that are not as clearly measured or addressed. This study outlines various impacts of pipeline projects through a scoping review and key informant interviews. This paper also identifies gaps within the Health Impact Assessment (HIA) protocol for pipeline projects, informing recommendations for future policies. The findings reveal that there lacks a comprehensive and cumulative HIA for proposed pipeline projects. The current proposed Bill C-69 is a step in the right direction, however there is still room for improvement in regards to analyzing the numerous health implications posed by pipelines for diverse Canadian communities. Specifically, future policies should include greater collective efforts for establishing a more comprehensive, cumulative, and time-sensitive HIA for pipeline projects, taking into account the multitude of factors involved: the impacts on toxicological health, environmental health, and social determinants of health. It is critical to strengthen the coordination and collaboration between community, industrial, and governmental stakeholders, in order to evaluate and address the major health implications posed by Canadian pipeline projects.

Poster #11: Neglecting Human Health: Gaps in Canadian Pipeline Project Impact Assessments

Impacts of Climate Change on Vector-borne diseases in Windsor and Essex County

Authors: Amandeep Hans​, Phil Wong

Windsor and Essex County (WEC) has experienced the impacts of climate change in recent years such as rising temperatures, and record levels of rain combined with standing water from widespread flooding. These episodes have created ideal conditions for the survival of invasive mosquito species and a greater presence of insects that carry diseases not commonly found in our region. Based on Windsor-Essex County Health Unit’s mosquito and tick surveillance programs, there is introduction and possible establishment of some invasive mosquito species like Aedes albopictus and Aedes aegypti and lone star tick. The lone star tick is a vector for multiple pathogens and its bite can trigger an allergy to red meat. Aedes albopictus and Aedes aegypti mosquitoes transmit viruses not normally seen in Canada, such as Zika, Dengue fever, and Chikungunya. This presentation will cover the surveillance and monitoring of these invasive species, their possible presence and establishment in our area, and the next steps.

Poster #12: Impacts of Climate Change on Vector-borne diseases in Windsor and Essex County

Health Impact Assessment & Climate Change

Author: Faiza Waheed​

The broader health impacts of climate change are often not completely assessed due to the pressing nature of other immediate physical impacts, such as flooding, fires, heat waves, etc. However, climate change-related events also result in long-term and indirect health impacts often overlooked until they become newsworthy. For example, changes in population of fish due to climate change causes not only a loss of food source for communities who are heavily reliant on the fish, but may also have cultural and spiritual implications when these communities can no longer fish as a way of life.

A health impact assessment (HIA) identifies both the potential positive and negative health impacts due to a policy or project, as well as the distribution of those impacts within the community. An HIA is guided by the determinants of health, and views a policy or project not only through a health lens, but also through an equity lens. Given that climate change is the defining determinant of health of our time, the HIA framework can serve as a valuable systematic and transparent tool to assess the broad health implications of climate change and inform the decision-making process.

Poster #13:
Health Impact Assessment & Climate Change

Prospective Environmental Public Health Professionals and the Need for Climate Change Education
Author: Wendy Pons 

Climate change is expected to impact the services and programs delivered by local health units. Environmental public health professionals must be prepared to manage a variety of health outcomes related to climate change events including extreme weather, food security, vector-borne disease, air quality, wildfires, and other emergencies. Consequently, students in the public health field require a curriculum that addresses these issues and prepares them to consider how climate change may impact local health initiatives. The purpose of this poster is to highlight what emerging professionals are being taught related to climate change and if opportunities exist to implement additional content into the curriculum.  

Poster #14: Prospective Environmental Public Health Professionals and the Need for Climate Change Education

Ontario Public Health Association

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