Climate Change and Health in Canada

Ford, Lea Berrang

There will also be a number of indirect effects on Canadian health and health care. In many cases, these indirect pathways are difficult to identify, predict, and quantify, but may nonetheless be important for changing health systems in Canada. For example, changing sea temperatures are likely to impact the distribution and availability of fish and tree species through impacts on local weather, affecting the viability or focus of fisheries and forestry industries, and by extension the community health and well-being of resource-dependent communities. In this case, the concern is not the loss of traditional species per senew species are likely to emerge to fill changing niche conditions -but the rate of change in ecological systems, and the ability of industries and communities to adapt to these changes. Similarly, the dramatic spread of the pine beetle has been facilitated -and many suggest triggered -by increasingly favourable weather conditions (74) (75) (76) (77) . As in the case of the pine beetle, many of the impacts of climate change on health in Canada are likely to be the result of indirect causal processes, and in some cases unforeseen events. The implications of climate change for health are not limited to global and national impacts. They will also be manifest at the municipal level (Table 2 ) and within Canada's health sector (41, 55, 78) . For Canada's health system, this will result in changing risks. For example, the increased emergence of new, re-emergent and exotic diseases will mean that conventional expectations of likely diagnoses by family physicians and primary health care providers will be insufficient. The potential for malaria infection in patients with no history of travel is one such example (63) . The increase in extreme weather events such as heatwaves, floods and storms will increase pressure on disaster preparedness and emergency health services and programming (79) . Program planning for emergency health provision will need to consider future rather than historical experiences or trends in demand and frequency of health crises (34, (80) (81) (82) . Increased health surveillance will be required to document baseline health measures and monitor changing health outcomes. This is particularly important in Canada's northern communities where health provision and surveillance have faced significant challenges and where climate impacts will develop earlier and more rapidly than in the South (83, 84) .