Critical background information on the issue of climate change resiliency for health care

Background

This background compilation provides an overview of the effects of climate change as they relate to public health and the provision of health care services, as well as the steps needed for health care facilities to become more resilient.


Health Care & Climate Change Resiliency

Health care facilities in Canada are vulnerable to climate change. Climate-related hazards are expected to create risks that can disrupt health care facility services and delivery.

The World Health Organization has called on the health care sector to prepare for climate change impacts through efforts to increase resiliency. Health care organisations in Canada can increase resiliency by continually mainstreaming climate change into risk assessments, considering climate change when developing plans and activities and engaging in broader community discussions and initiatives around climate-related issues.

A resilient health care facility is also one that commits to sustainable practices, such as water and energy conservation, promoting active transportation, and local food procurement. In investing in resiliency activities in these areas, health care facilities can reduce operating costs and increase resilience in the community.

The Canadian Coalition for Green Health Care has co-developed a Health Care Facility Climate Change Resiliency Toolkit to help health care facilities become more resilient to climate-related risks.


Climate change could be the biggest global health threat of the 21st century. Effects on health of climate change will be felt by most populations in the next decades and put the lives and wellbeing of billions of people at increased risk. During this century, the earth's average surface temperature rises are likely to exceed the safe threshold of 2°C above pre-industrial average temperature.
The Lancet, 2009

Risks of Climate Change

Extreme Weather

Canadians across the country can be vulnerable to the health impacts of thunderstorms and lightning, snow storms, freezing rain, tornadoes, hurricanes, and hailstorms – particularly when widespread power outages occur and where health, social, and emergency services are insufficiently robust to handle large or concurrent events.
Natural Resources Canada, 2014
Globally, the number of reported weather-related natural disasters is increasing. Climate change has driven extreme high temperatures and has probably contributed to more frequent and extreme precipitation events and more intense tropical cyclone activity. Together, these trends will increase the risk of weather-related hazards to human health.
World Health Organization, 2011

Extreme Heat

Extreme heat events are an increasing concern in Canada and abroad. As the climate changes, the frequency, intensity and duration of these events are expected to increase, as are their related adverse health effects. In recent years, extreme heat has resulted in a significant number of preventable deaths.
Health Canada, 2011
Extreme heat events pose serious health risks to Canadians; for example, they are associated with sudden, short-term increases in mortality, especially among older adults, people who are chronically ill, people on certain medications and the socially disadvantaged. A 2009 extreme heat event in British Columbia contributed to 156 excess deaths in the province’s lower mainland area and in 2010 an extreme heat event in Quebec resulted in an excess of 280 deaths.
Natural Resources Canada, 2014

Vector-Borne Disease

Climate change may affect health risks from both zoonoses and vector-borne diseases. Surveillance data indicates that Lyme vectors (as a proxy for Lyme disease risk) are spreading into Canada at a rate of 35-55 km per year and are following climate-determined geographic trajectories.
Natural Resources Canada, 2014
Climatic factors like temperature and precipitation interacting with shifts in trade, travel, land use, and demographics are likely to affect the occurrence of vector-borne disease...around the world. Water-borne disease replication, survival, persistence, and transmission are subject to environmental influences and do best under warmer conditions such as those projected for the future.
The Resource Innovation Group, 2012

Food Supply

Climate affects crop productivity, animal production, virility of pests and diseases, pollinator health and water availability and quality. Climate changes will necessitate changes in human activities (e.g. cropping systems, use of irrigation) and lead to flora and fauna reactions.
Natural Resources Canada, 2014
Severe weather events and rising temperatures are likely to cause a decline in livestock productivity. Higher heat places stress on animals, which reduces dairy production and slows growth and conception rates. Marine fish population and distribution are already changing due to higher ocean temperatures.
The Resource Innovation Group, 2012



Health System Resiliency

The Danger of Functional Collapse

Functional collapse occurs when the elements that allow a hospital to operate on a day-to-day basis are unable to perform because the disaster has overloaded the system. These include: architectural spaces such as laboratories or operating theatres; medical records; medical and support services; and administrative processes (such as contracting, procurement, and maintenance routines). Although the measures necessary to prevent a functional collapse (such as contingency planning, improved organization and staff training) require a significantly smaller financial investment, they nonetheless remain a major challenge. Functional collapse, not structural damage, is the usual reason for hospitals being put out of service during emergencies.

Hospitals Safe from Disasters, 2011

Adaptation Strategies

Adaptation measures that respond to climate change impacts can be categorized in the following ways:
  • Increasing design thresholds to recognize more severe weather intensities (design thresholds include design temperatures, wind velocities, mean flood elevations)
  • Increasing warehousing and storage capacities to recognize more severe weather durations (increasing the minimum amounts of on-site food, water, and fuel storage)
  • Enacting requirements for hardening facilities in new geographic regions to respond to changing extreme weather frequencies and patterns (adopting requirements for exterior building envelope or electro-mechanical system resilience)
  • Increasing capabilities for "islanding operation" that recognizes that onsite infrastructure, staff, and supplies may be required for extended periods of time following weather events and that facilities may need to operate for more than 96 hours without aid from the community
U.S. Department of Health and Human Services, 2014




To deal with the future burden of climate change related health issues there is a need to ensure adequate health capacity and infrastructure. Rebuilding of public health capacity globally is seen as the most important, cost-effective, and urgently needed response to climate change. Domestically, there is a need to ensure adequate surge capacity within the health care system to be prepared for an increase in illness related to climate change effects.
Canadian Medical Association, Policy on Climate Change and Human Health