The Regional Municipality of Halton. Chair and Members of the Health and Social Services Committee

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1 The Regional Municipality of Halton Report To: From: Chair and Members of the Health and Social Services Committee Bob Nosal, Commissioner and Medical Officer of Health Date: October 15, 2013 Report No. - Re: MO Health Department Assessment of Program Vulnerability to Climate Change RECOMMENDATION 1. THAT Report No. MO re: Health Department Assessment of Program Vulnerability to Climate Change be received for information. 2. THAT the Regional Clerk forward a copy of Report No. MO to the City of Burlington, the Town of Halton Hills, the Town of Milton and the Town of Oakville for their information. REPORT Executive Summary The Health Department undertook an assessment of its potential program vulnerability to a changing climate in Halton Region. Climate change is happening now and is likely to have an impact on Health Department programs due primarily to warmer temperatures, more smog days and more extreme weather. In some program areas, efforts are already underway to address impacts from a changing climate. Some barriers to addressing changing climate were also identified. Overall, Health Department programs were identified as being very or somewhat vulnerable to a changing climate. Three areas were identified that require attention. First, program planning should address anticipated impacts that have been identified. Second, work should begin in program areas identified as having no efforts underway. Third, work should begin to develop solutions to identified barriers to preparing for a changing climate. 1

2 Background Recently, the Halton Region Health Department completed an assessment of how climate might change in the Region and how a changing climate might impact human health (Staff Report MO and related attachment: Climate Change in Halton: A Health Perspective, Halton Region Health Department, 2012). Staff Report MO concluded that Climate change is already happening and will impact human health, primarily by amplifying existing health hazards. In Halton Region, by the period, projected change in seasonal temperature is approximately C higher than the reference period ( ) and impacts are likely to include more heatwaves and poor air quality and, to a lesser extent, more extreme weather events and increases in some infectious diseases. The report recommended that Health Department staff be directed to undertake a vulnerability assessment of its programs to determine how best to prepare for the human health impacts of a changing climate in Halton Region. The vulnerability assessment has been completed and this report presents the results. Discussion Methods A presentation was made to each departmental Director and their team on the potential impacts of climate change in Halton Region. Directors then distributed a questionnaire to managers and supervisors of Health Department programs. The questionnaire was designed to determine the sensitivity to climate change of Health Department programs by eliciting feedback from the experts responsible for program delivery, presuming that they would know best what pressures a changing climate might place on their work. Health Department divisions and programs are shown in the table below. Division Chronic Disease Prevention & Oral Health Community Health Services General Health Health Protection Services Paramedic Services Programs Chronic Disease Prevention Oral Health Baby & Parent Health Mental Health Older Adults School Years Epidemiology Administration & Quality Assurance Air Quality Communicable Disease Control Sexual Health Food Safety & Inspection Control Healthy Environments Enteric/Vector Borne Diseases Operations Logistics Program Development & Quality Improvement 2

3 Of 29 completed questionnaires, Paramedic Services provided 11 responses and all other Health Department programs provided 18 responses. To avoid responses from Paramedic Services overweighting the results, the questionnaire responses were split into Paramedic Services (PS) and Public Health (PH). Results Impact of Climate Change on Program Areas When asked Do you think that climate change will have an impact on your program area? responses were generally similar from PS and PH (Figure 1). About 90% of both PS and PH respondents indicated that climate change was very likely or somewhat likely to have an impact on their program areas. No respondents thought it was not at all likely that climate change would have an impact on Health Department programs (Figure 1). When asked what aspects of a changing climate might impact a program area, the top three choices were warmer temperatures, more smog days and more extreme weather for both PS and PH. Figure 1. Percentage of respondents from Paramedic Services and Public Health who indicated that a changing climate is very, somewhat, not very, or not at all likely to have an impact on their program areas. For PS, changes are expected to lead to increased call volume due to more heat related illnesses, more respiratory problems due to increased smog days, and increased use of paramedic services by those with chronic conditions. More calls due to trauma resulting from extreme weather are also anticipated and there are likely to be impacts on staff and equipment due to changes in working conditions. For example, extreme heat will impact 3

4 staff, patients, and medical supplies that need to be kept cool thereby resulting in more ambulance idling and changes in maintenance schedules. For PH, responses were more varied than for PS although two themes emerged: reduced/missed client outings and program attendance (due to extreme weather, including heat alerts); and impacts on staff delivering the programs. Other impacts identified included concerns related to temperature control for vaccine refrigerators both in the Region and with health care providers; extended duration of risk for vector-borne and food- and water-borne diseases; increased heat alerts, cold alerts, smog alerts; increased air quality complaints and smog impacts on vulnerable populations; and possible impacts on quality and quantity of well water supplies. Efforts Underway, Barriers & Overall Vulnerability So as not to presume that nothing was being done about climate change, the question was asked Are there efforts already underway to address impacts of climate change in your program area? Responses from both PS and PH indicated an almost equal split between yes efforts are underway and no there are no efforts underway. Responses to the question Are there any barriers that you can think of that could prevent addressing climate change impacts in your program area? showed marked differences between PS and PH respondents. PS responded fairly evenly but responses from PH were more likely to indicate that there were barriers. Generally, barriers identified related to resources and timely communications, both internally in the Health Department and externally with clients. When asked how vulnerable do you think your program is to a changing climate in Halton Region?, there were slight differences in responses between PS and PH (Figure 2). PS respondents were more likely to indicate that their program area was very vulnerable or somewhat vulnerable to a changing climate than were PH respondents. 4

5 Figure 2. Percentage of respondents from Paramedic Services and Public Health who indicated that their program area was very, somewhat, or minimally vulnerable to a changing climate. Preparing For a Changing Climate Results from this internal Health Department survey are consistent with knowledge and opinions expressed across the broader Ontario public health sector and, generally, at the national level. For example, a recent study reported results of interviews of provincial and federal health officials and others in public health and health relevant sectors at the municipal level. Respondents recognized that climate change will impact the health of Ontarians and expressed concerns generally related to human health and climate change but specifically to extreme heat (71% of respondents), severe weather (68% of respondents) and poor air quality (57% of respondents). At the international level, a survey of Annex I countries party to the United Nations Framework Convention on Climate Change (UNFCCC the Annex I sub-group includes 41 developed and transition economies of which 38 were included in the analysis) found that the majority recognized the health risks of climate change and were taking groundwork action, but adaptation actions were less commonly reported. Groundwork actions are necessary first steps to inform and prepare for adaptation, such as impact and vulnerability assessments, whereas adaptation actions are changes made in response to predicted or experienced impacts of climate change, such as departmental development, public awareness and outreach, and surveillance and monitoring. 5

6 The Halton Region Health Department has undertaken a combination of both groundwork actions and adaptation actions and is generally well positioned to address health impacts related to a changing climate. Results from this vulnerability assessment suggest three areas for particular attention to help ensure the Health Department is prepared to address any impacts on program areas related to a changing climate: program planning should address anticipated impacts that have been identified by respondents, for example, increased call volumes for Paramedic Services and the impacts this will have on the program area and on the staff responsible for delivery. For other Health Department programs planning for service delivery during heat/smog events and extreme weather will be important, both to provide as high a level of service as possible in given circumstances and to reduce impacts on staff delivering the programs groundwork should begin in program areas identified as having no efforts underway to address the impacts of climate change. Groundwork actions could range from internal awareness-raising to a more structured review of actions necessary to improve the resiliency of specific program areas to a changing climate some barriers were identified that prevent program areas from addressing impacts related to climate change. Program planners should begin to develop solutions to these barriers In addition, the vulnerability of all programs in the Regional corporation to climate change will be assessed during the next twelve months. FINANCIAL/PROGRAM IMPLICATIONS Costs for this climate change vulnerability assessment were included in the approved budget for 2013 Air Quality Program activities. 6

7 RELATIONSHIP TO HALTON REGION S ACTION PLAN Key Action Recommend actions to address health related climate change impacts. Key Initiative Address health related climate change impacts. Priority Area Air Quality Respectfully submitted, Robert M. Nosal MD FRCPC Commissioner and Medical Officer of Health Approved by Jane MacCaskill Chief Administrative Officer If you have any questions on the content of this report, please contact: Dr. Bob Nosal Tel. # 7806 Peter Steer Tel. # 7871 Attachments: None 7