The health impacts of climate change have received significant attention in the international scholarly literature. Despite this, there is an absence of research evaluating existing policies aimed at promoting and protecting population health. This chapter provides an implementation analysis of the Ontario Public Health Standards (OPHS), 2008/2014--the provincial policy statement that governs mandatory public health activities in the province which includes taking action on climate change. This chapter responds to two specific questions: First, how are Ontario's 36 regional health units interpreting and implementing this policy statement; and second, how are those interpretations translated into practice. Using a web-scan and in-depth interviews with practitioners from twenty Ontario health units, this paper presents four interpretations of the OPHS, a typology of best practices related to regional adaptation, and policy recommendations to bolster domestic and international adaptive capacity to emerging infectious diseases associated with climate change, and a variety of other health-related climate impacts.
TopBackground: Climate Change In Ontario, Canada
Canada’s climate is rapidly changing, and as a result, so too are the health risks posed to Canadians (Séguin, 2008). While global average temperatures are projected to increase by between two and four degrees Celsius by the end of the twenty-first century, Canada will experience more rapid temperature increases (IPCC, 2013). Between 1948 and 2006, southern Ontario has already experienced a 1.3 degrees Celsius increase, and projections for the province indicate that it will experience a two to four degree Celsius increase by 2050 (Feltmate & Thistlewaite, 2012).
Climate change has been called the greatest public health threat of the twenty-first century (Costello et al., 2009). Accordingly, the Canadian experience of climate change will mirror that occurring in other democratic countries with a well-established public health sector. Primary risks include the direct biological consequences of extreme weather events (i.e., heat, cold, violent weather), temperature-enhanced air pollutants in urban areas, and increased exposure to UV radiation; secondary risks include risks mediated by biophysical or ecological processes including food security/foodborne disease, water scarcity/waterborne disease, and changes in disease vectors as previously inhospitable climates become warmer. For Ontario, Canada, there are significant concerns about emerging vectors contaminating drinking water and recreational water sources and food contamination, with increased risk of E. coli, Cryptosporidium, Giardia, and S. typhi all being linked to warmer temperatures (Health Canada, 2008). Changes in the ecology of various disease-carrying insects also pose significant concerns for the spread of mosquito borne vectors including the West Nile Virus (Paz, 2015) and Eastern Equine Encephalitis (Parham et al., 2015). There is also cause for concern surrounding the spread of Lyme disease spread by tick populations (Ostfeld et al., 2015) and the possible emergence of new diseases and those previously eradicated across the country (Cambell-Lendrum et al., 2015). Tertiary risks include a host of mental health issues, displacement and migration, and the exacerbation of existing health inequalities (Friel et al., 2011; McMichael, 2013; Séguin, 2008).