Public health and urban planning are natural partners

Public health and urban planning are natural partners

Dr. Trevor Hancock

10 July 2018

697 words

In North America we are 80 percent urbanised and on average spend 90 percent of our time indoors. The fact that we spend about 21-22 hours a day indoors may come as a bit of a surprise. But if you stop and think about it – or if you keep a time diary for a week, which is what I have my students do – you will see how much time is spent indoors.

To begin with, we sleep and eat there, which is about half a day, and we work, go to school, shop and often play indoors – even in health and nature-conscious Victoria. On top of that, on average North Americans spend about half their ‘outside’ time in vehicles, so in the end we only spend about five percent of our time – a bit over one hour a day – truly outdoors. And since we are 80 percent urbanised, we spend most of that time outdoors in a built environment.

So although ultimately our health depends upon the natural environment that provides the most basic determinants of our health such as air, water, food, fuel, materials and other ecosystem goods and services, the built environment is by far our most important immediate environment. Yet in recent decades we have paid suprisingly little attention to how the built environment influences and shapes how we lead our lives and the implications of that for our health.

It was not always so. In the mid-19th century, the appalling conditions of the slums and factories of the industrialising cities of Britain led not only to the birth of modern public health but also of modern town planning as new approaches to improve health. And of course, building codes were established largely to ensure the health and safety of those who lived and worked in those buildings.

By 1875 Sir Benjamin Ward Richardson, a leading Victorian public health practitioner, could describe a city of health that he called Hygeia, and that had many elements we would recognise today – and some we still aspire to. His writing influenced Ebenezer Howard, founder of the Garden City movement that continues to influence urban planning.

In Canada, the connections between public health and urban planning were even more apparent. In 1909 the federal government established a Commission on Conservation; today we would call it a Commission on Sustainable Development – there really is nothing new under the sun! However, their notion of conservation was not limited to the conservation of natural or physical resources but included the conservation of ‘vital resources’ – meaning the health and longevity of the population.

Thus the Commission established a Public Health Committee, which became concerned about health in Canada’s burgeoning towns and cities. So in 1914 they invited Thomas Adams – a leading British town planner and Secretary of one of the first Garden Cities, Letchworth – to become the Commission’s Town Planning Advisor. In the five years he spent in that role, Adams had a hand in preparing town planning bills in most of the provinces. He also helped to organize the Civic Improvement League and the Town Planning Institute of Canada.

But over time, the links between urban planning and public health weakened and become lost. In part I think this is because both public health and urban planning came to see their work together as having been successful, and moved on to other concerns. Public health became more medicalised, while planning became more focused on the automobile and the grander symbols and techniques of high rise towers and urban redevelopment.

But in the past three decades, there has been a slow re-awakening of the links between the design of the built environment – from individual rooms to entire cities – and the health of the people who live there. To a large extent this has arisen from the ‘Healthy Cities’ movement, and the urban planning interest in sustainable communities.

In BC this led to the creation of the Healthy Built Environment Alliance a decade ago, bringing together architects, urban planners, public health staff and others to learn from each other. One of the fruits of that collaboration has been the Healthy Built Environments Toolkit, which will be the topic of next week’s column.

© Trevor Hancock, 2018

 

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Population growth only part of our ecological problem

Population growth only part of our ecological problem

Dr. Trevor Hancock

2 July 2018

701 words

My recent columns about the ecological crisis we face and the need to reduce our ecological footprint, generated e-mails from several people saying I should address the issue of population growth. They have a good point, but the issue is complex, and the solution not just a matter of family planning.

There is a famous ‘equation’ proposed by Paul Erlich and John Holdren in 1972: I (human impact on the Earth) = P (population) x A (level of affluence, usually measured by GDP per person) x T (technology). While affluence is not quite the same as material consumption, land damage and pollution production (all key indicators of impact on the Earth), it is not a bad proxy; as we get wealthier, we consume more stuff and produce more waste.

The point is simple; it’s not just how big the population is, but how much each person consumes – and our technology can either make things worse, because we become more powerful and more damaging, or make things better if we become more efficient.

The latest World Bank data tracking changes since 1960 shows that between 1960 and 2017 global population grew from 3.03 to 7.53 billion, or almost 2.5 times. In that same period, GDP per person grew from $3,694 to $10,634, measured in constant 2010 US dollars (which adjusts for inflation), or almost 3 times. Put these two together and humanity’s impact has grown more than seven-fold in these 67 years.

It is illuminating to compare Canada on those same metrics. Between 1960 and 2017 Canada’s population increased just over two times and the GDP per person increased just over three times, so our impact on the Earth increased more than six times over those 67 years, measured this way. But on top of that, our per person impact is much higher than the global average – and greater than the Earth can sustain – so further increases in our already excessive footprint will be far more damaging than increases in the GDP and ecological footprint of low and middle-income countries.

The Global Footprint Network has just released its latest data. Overall, the global footprint for humanity in 2014 was equivalent to 1.7 Earth’s worth of biocapacity. If everyone in the world lived the way we do in Canada, we would need 4.8 Earths. So we live at almost three times the global average, meaning a child born in Canada will have roughly three times the impact on the Earth of an average child – and six times the impact of a child born in a lower middle-income country .

Thus we need to both reduce population and reduce consumption per person. But from a global impact perspective, reducing both these factors in high-income countries such as Canada will have a far greater beneficial effect than doing so in low-income countries. So attempts by some high-income countries to increase population size – and a 2017 article in The Independent newspaper in the UK identifies ten countries that are doing so – are very misguided.

Moroeover, we have good evidence dating back decades that one of the most important ways to reduce population size is through education – particularly for women. In a 2015 interview with the World Economic Forum, Wolfgang Lutz – founding director of the Wittgenstein Centre for Demography and Global Human Capital and lead author of World Population and Human Capital in the 21st Century – noted “Education leads to lower birth rates and slows population growth”. He also linked education to poverty eradication, economic growth and environmental consciousness.

But universal education is expensive, and requires sufficient economic development to create enough wealth to achieve it. (It also requires enlightened leaders and policies that prioritise universal education, especially for girls and young women.)

So in summary, from the point of view of global impact on the planet, the key priority is to reduce the size of both the population and the ecological footprint per person of high-income countries. But for low-income countries, we need to support their economic development (while helping to ensure it follows a 21st century sustainable development path, not a 19th/20th century industrial development path) and support the creation of universal education, especially for young women, contributing to their emancipation.

© Trevor Hancock, 2018

 

Finding hope for the future

Finding hope for the future

Dr. Trevor Hancock

26 June 2018

697 words

In an article about Canada’s health care system a few years ago, two of my colleagues came up with what is my favourite definition of hope: Finding positivity in the face of adversity. But finding hope can be challenging these days, what with the global ecological crisis, high levels of poverty and inequality, nasty xenophobic and nationalistic politics and the general failure of governments and societies to respond effectively to these and other challenges of the 21st century.

Which is why it was such a pleasure to attend several meetings in the past month where people of good will who care about others and the planet came together to find common cause and work for a healthier, more just and sustainable future. They are working on the basis of a long-standing maxim: Think globally, act locally.

The first meeting was hosted by the Victoria Foundation and the BC Council for International Development, and was the topic of my column two weeks ago. The meeting focused on the UN’s Sustainable Development Goals (SDGs) and included participants not only from the social justice and environmental groups that one would expect to find there, but also from local government, the Chamber of Commerce and others from the business sector, faith communities, the academic community and others.

Among the priority issues for Victoria that emerged in the discussions were addressing poverty, climate change and the sustainability of our lands. The Foundation’s commitment to addressing SDG 11, the creation of sustainable cities and communities, is exactly about bringing all the SDGs down to the local level. The fact that the SDGs are to be treated as a single unit, with all being addressed together, ensures an holistic approach to the challenges we face.

The second meeting was a public gathering of Greater Victoria Acting Together. GVAT is a group of 19 organisations (and growing) that includes many from the faith communities and the labour movement, but with others from the environmental, educational and social justice sectors. They are motivated by concern for future generations and the need to find and pursue the common good because, as one speaker put it, “the next generation deserves a better world than this”.

GVAT’s approach involves in-depth listening and discussion over a long period of time to arrive at a clear and shared understanding of what the common concerns are and what common action can be taken. The process includes training in community organising and empowerment. The intention is to “hold market and governmental decision makers to account by speaking with one voice”.

Then there was a recent Conversation for a One Planet Region, with leaders from several faith communities exploring the role of faith communities in creating a One Planet Region. Since this issue will be the topic of a future column, I will not get into it in any detail. Suffice it to say that within many if not all faiths there is both a concern for ‘the poor’ and a reverence for nature, the latter often in the context of nature as an expression of ‘the Creator’. As noted in the two examples above, faith communities are important players in this work.

Finally, there was the first meeting and training session for the One Planet Saanich team of ‘Community Integrators’. These are 15 – 20 people of varying ages who have volunteered to work with a Stakeholder (businesses, community groups, and schools who want to join the initiative) to develop a One Planet Action Plan. The group, which came from a variety of backgounds, from architecture to psychology, business to education, farming to energy systems, was enthused and engaged. Their plans, large and small, will help move Saanich towards the goal of being a One Planet community.

These are just a few examples of which I am aware of people and organisations from a wide cross-section in our communities who are brought together by shared concerns about the social and ecological challenges we and future generations face. But while concerned, they are not paralysed; they are determined to find ways to address these challenges and create a healthier, more just and sustainable community. They are finding positivity in adversity, and they give me hope.

© Trevor Hancock, 2018

The carbon tax is good for our health

The carbon tax is good for our health

Dr. Trevor Hancock

19 June 2018

697 words

Doug Ford, the new Premier of Ontario, has just joined the ranks of the political dinosaurs – chief amongst them Donald Trump and his Cabinet as well as several other provincial Premiers – that downplay or ignore the environmental, social, economic and health impacts of climate change. He announced that one of his first acts would be to cancel Ontario’s cap-and-trade system and to challenge the federal government’s carbon tax.

Mr. Ford’s spin on the story – like his twin in the White House – is that a carbon tax is a job killer and bad for families. But in fact a 2011 UN Environment Program report found the transition to a green economy would result in at least as many if not more jobs than ‘business as usual’, while a  2016 report from Canada’s Green Economy Network found that investing in renewable energy would create about one million new jobs, and a2014 study by REMI found that a revenue-neutral carbon tax in the US would create jobs and increase GDP.

As for being bad for families, while the carbon tax is not a job killer, the high-carbon economy that Mr. Ford and his ilk support is a people killer – and how is that good for families? This is because carbon emissions cause climate change, and there are significant health impacts from this. The World Health Organization (WHO) notes that “climate change is expected to cause approximately 250,000 additional deaths per year between 2030 and 2050”.

Canada is already experiencing the health effects of climate change, which include the physical and mental health impacts of large forest fires, urban heat events, floods, droughts and – in the North – disappearing sea ice, melting permafrost and changing animal migration patterns. Moreover, as Health Canada notes, “climate change impacts on health will disproportionately affect vulnerable populations, including the poor, elderly, and the young and those who are chronically ill”, as well as the “socially disadvantaged and people living in vulnerable geographical areas” such as the North.

In addition, air pollution is a major cause of death, and has a large economic impact. Globally, general outdoor air pollution – much of it due to fossil fuel combustion – was responsible for more than 3 million premature deaths in 2010, according to the Global Burden of Disease study. Almost 90 percent of those deaths occur in middle and low-income countries, the 2017 report of the Lancet Commission on Pollution and Health noted.

In Canada, a report from the Canadian Medical Association (CMA) estimated that 21,000 Canadians would die as a result of air pollution in 2008. In addition, there would be 11,000 hospital admissions, 92,000 emergency department visits and620,000 visits to a doctor’s office for treatment.

Moreover, our supposedly economically wise leaders also ignore or discount the economic costs of these health impacts, and the economic benefits of preventing air pollution. For climate change, the WHO states “The direct damage costs to health . . . is estimated to be between USD 2-4 billion/year by 2030”, while the CMA estimated the health care costs alone in Canada due to outdoor air pollution in 2010 would amount to $438 million, while productivity losses would be $688 million.

Failure to implement a carbon tax and take other steps to rapidly and dramatically reduce carbon emissions and associated air pollution due to fossil fuel combustion leads to major health problems, globally and in Canada. Clearly Mr. Ford  and others of his persuasion don’t care about people dying in other parts of the world, or even in their own backyards; they prefer short-term gain and don’t mind inflicting long-term pain to get it.

But for those of us who do care, carbon taxes – while not the whole answer – are an important part of the strategy. Just as we raised taxes on tobacco as part of a much broader public health campaign, so too we need to raise taxes on fossil fuels – which some people call ‘the new tobacco’. By doing so we can help to reduce the health impacts of climate change around the world, reduce local air pollution, and create jobs in the emerging clean energy sector.  So wake up, Mr. Ford, and smell the clean air.

© Trevor Hancock, 2018

Meeting the SDGs in the Greater Victoria Region

Meeting the SDGs in the Greater Victoria Region

Dr. Trevor Hancock

11 June 2018

699 words

I can see it now – lots of furrowed brows: What the heck are SDGs? Well, they are the world’s new Sustainable Development Goals, adopted by all the members of the UN in 2015, they are extremely ambitious, to be achieved by 2030 – and Canada, like all the rest of the world’s countries has signed on. But what exactly have we signed on to, and what does it mean at the local level?

These questions were explored in a recent meeting organized by the Victoria Foundation and the BC Council for International Cooperation, which is working to publicise the SDGs and encourage and support local action based on them. The Council estimates there are more than 2000 groups in BC alone working on some aspect of the SDGs, with three-quarters of that effort focused on local, provincial or national work.

I am not going to review all 17 of the goals, never mind the 169 targets; you can find them easily on the internet. But it is important to understand that they are a unit, not a menu; all countries have signed on to deal with all of them, not just the ones they fancy. So I want to highlight both key themes and ambitions and those that may have particular resonance locally.

The first group of goals are about meeting basic needs; nobody, anywhere, should be living in poverty (Goal 1) or going hungry (Goal 2) in 2030, and there should be clean water and sanitation for all (Goal 6); linked to this is Goal 10 – reduced inequalities. Then there is a group of SDGs that focuses on what I would call human and social development: Goal 3 (good health and wellbeing); Goal 4 (quality education); Goal 5 (gender equality) and Goal 16 (peace, justice and strong institutions).

Of course, there is a group of SDGs focused on the Earth’s natural systems: Climate action (Goal 13) and affordable and clean energy (Goal 7) as well as life below water (Goal 14) and on land (Goal 15). The economic dimension is addressed through Goal 8 – decent work and economic growth, with the latter linked to Goal 9 (industry, innovation and infrastructure) and all in the context of Goal 7 (clean energy) and Goal 12 – responsible consumption and production.

Clearly there are many groups and organisations focused on these four big issues: Poverty, human and social development, protection of the Earth’s natural systems, and the creation of an ecologically sustainable and just economy. That is why Goal 17 – partnerships for the SDGs – is so important; we cannot just work in isolation within those four major themes but must treat them as an interacting whole, a set of challenges that require a comprehensive, integrated, holistic set of responses.

We must recognize that ‘sustainable’ in this context means socially as well as ecologically sustainable. Poverty and high levels of inequality are not socially sustainable, and among other things this results in a huge loss of human potential and social capital, which in turn undermines the economy.  But we must also understand that the economy must be the servant to ecologically and socially sustainable human development, not the master of it, as is too often the case today.

Finally there is the goal that brings it all down to the local level and which the Victoria Foundation has embraced: Sustainable cities and communities (Goal 11). Fortunately there are a number of groups emerging in this region that are attempting to create at a local level the holistic approach noted above, with some attention beginning to focus on the concept of a One Planet region.

These include five initiatives in which I am personally involved to varying degrees, and which take different approaches: The One Planet Saanich initiative I wrote about in my last column; the Conversations for a One Planet Region that I coordinate; Greater Victoria Acting Together; Creatively United for the Planet, and Common Vision, Common Action. The latter has developed a policy platform for candidates who chose to run on the themes of ecological and social justice and sustainability in the up-coming municipal elections.

So if you share our concerns and values get involved, get active, and vote your values.

© Trevor Hancock, 2018

Shedding light on our ecological footprint

Shedding light on our ecological footprint

Dr. Trevor Hancock

4 June 2018

703 words

Last week I described the measurement of the ecological footprint (EF) of this region. Here I discuss the findings in more detail, and the implications for our way of life and public policy. What must we do if we are to reduce our EF by around two-thirds, to get from two to three planet’s worth of impact to our fair share, which is one planet’s worth? And what would that mean for our health and wellbeing?

The largest single benefit in terms of reducing our EF, Dr. Jennie Moore and Cora Hallsworth suggest, will come from eliminating carbon emissions from the fossil fuels we use for heating, cooling and electrical supply in our buildings; so we must oppose the mining and export or use of coal, oil and gas and strongly support clean, green, renewable energy.

But one of their most surprising findings is that almost half of our ecological footprint is attributable to our food, and mainly our high-meat, high-dairy diet, which accounts for almost three-quarters of our food EF. This is because it takes a lot of land, energy and other resource inputs to produce meat, especially beef, and – to a lesser extent – dairy.

Not surprisingly then, one of their key suggestions is that we reduce our meat consumption by 25 percent, replacing it with chicken (or non-meat alternatives); they also suggest reducing dairy food consumption by 25 percent

This would be not only environmentally beneficial, but good for health. Evidence suggests a low-meat diet has a number of health benefits, including reduced rates of cardiovascular disease, diabetes and cancer.So I like a slogan I saw recently – “Make meat a side dish”; this is completely in line with Michael Pollan’s simple guide to food policy and consumption – “eat food, not too much, mostly plants”.

In addition to changing what we eat, they suggest we reduce overall food purchasing by 25 percent. Eating less is perhaps the most important way in which we can reduce obesity rates, and purchasing less food overall will also reduce food waste. But this means demanding that food producers, stores and restaurants of all sorts reduce portion size, as well as providing more low-meat or vegetarian alternatives.

Our current transportation system is another important contributor to our EF, accounting for about a quarter of it, with most of that due to private vehicles. Moore and Hallsworth suggest that half of all private vehicles need to be electric powered, although of course, that electricity needs to come from clean, renewable energy systems, not from fossil-fueled plants.

However, while switching to electric vehicles will reduce both carbon emissions and air pollution, it will not solve other problems such as congestion, injuries or a sedentary lifestyle. For that, we need to change the way we move around.

In her assessment of the EF of Vancouver, Dr. Moore also suggested a marked increase in active transportation, with as much as 86 percent of all trips made by walking, biking, rolling or using public transit; that would also apply here.

The health benefits of these transportation policies include reduced air pollution, reduced injuries (public transit is far safer), reduced greenhouse gases (and thus reduced health impacts from climate change), increased physical activity and reduced commuter stress.

We now have an exciting opportunity to look at some of these ideas in more depth right here in Saanich. Bioregional is a UK-based non-profit organisation that encourages and supports One Planet planning. With funding from a Danish foundation, they are starting a one-year project in 4 cities around the world, one of which is Saanich; the others are Elsinore (Denmark), Durban (South Africa) and Oxfordshire (UK).

Here they are partnering with the District of Saanich and a Vancouver-based group, One Earth. The project involves recruiting andtraining a team of 10 – 15 ‘One Planet Integrators’ who will then support up to a 24 business, school, and community organization stakeholders to make their own One Planet Action Plansover the next year.

To learn more visit the website at www.oneplanetsaanich.orgor come to hear Pooran Desai, Bioregional’s founder, speak at a special session at UVic co-hosted by Conversations for a One Planet Region, Wednesday June 20th, 7 – 9PM, in the HSD Lecture Theater (Room A240).

© Trevor Hancock, 2018

We need to shed a couple of planet’s worth of footprint

We need to shed a couple of planet’s worth of footprint

Dr. Trevor Hancock

29 May 2018

692 words

The concept of the ecological footprint was developed by Mathis Wackernagel and Bill Rees at UBC in the early 1990s. They were trying to find a way to express in simple terms our impact on the Earth. The widespread use of the concept since then suggests they succeeded.

The ecological footprint (EF) measures our impact in terms of the amount of biologically productive land and sea we need to provide the crops and fish we use for food, the grass and feed crops we use for livestock, the timber we use for paper and wood, and the land we need planted in trees to absorb our carbon emissions (‘energy land’). This is then compared to the actual biological capacity (biocapacity) of the Earth.

Of course, like all indicators, it is only a partial representation of reality – for example, it does not include mining’s impacts, nor the area needed to absorb persistent organic pollutants, since there is no good way to measure it. Nonetheless, the EF has proven quite useful, and has been applied to everything from individuals to hospitals to the entire global population.

Globally, we surpassed the Earth’s biocapacity in about 1970 and currently use about 1.7 times the biocapacity of the Earth, with about half of that due to our carbon emissions. Clearly this is not sustainable, and is even less so in high-income countries, which have much larger footprints. If the whole planet lived the way we do in North America, we would need more than five Earths to support ourselves, which is obviously impossible – something has to give.

Recently Dr. Jennie Moore, Associate Dean of the School of Construction and the Environment at BCIT, together with Cora Hallsworth, a Victoria-based environmental consultant, measured the EF of both Saanich and the City of Victoria. Between them these municipalities are about half of the regional population, and probably fairly representative of the whole region She presented the results at a recent Conversations for a One Planet Region meeting; her presentation is available on the Conversations website.

Dr. Moore uses a somewhat different approach, measuring the EF using data on household purchasing and consumption and waste composition studies. When combined with data on greenhouse gas emissions from the two municipalities, they calculated the footprint due to our food consumption, transportation, construction and operation of our buildings and the creation and disposal of many of the products we consume.

Measured in this way, the total ecological footprint for Saanich and Victoria is about two planet’s worth, with most of that coming from energy land and cropland. Specifically, almost half our footprint comes from food, with much of that attributable to the large land area needed to support our diet high in meat, eggs and dairy products. Roughly another quarter is attributable to our transport system, with half of that from use of private vehicles.

However, this approach does not measure energy used in manufacturing goods that are exported, nor what Dr. Moore calls ‘senior government services’ – resources used in providing government services that we do not purchase directly, but pay for through our taxes. Thus it underestimates the impact of our activities, meaning our footprint is in excess of two planet’s worth of the Earth’s biocapacity.

So we use considerably more than our fair share of the Earth’s biocapacity. If the rest of the world’s people are to have a fair shake at a decent way of life, we are going to have to figure out how we can shed perhaps as much as two planet’s worth of footprint – while at the same time maintaining a good quality of life and good health for everyone. This is what we mean by a ‘One Planet Region’.

Now we have the data, we can start to discuss this, understand the implications and what we need to change, and then begin to imagine and design what our community would be like in the future. To my mind this is the most important challenge facing us in the 21st century. Next week, I will go into Dr. Moore’s findings in more detail, and their implications for our way of life and public policy in this region.

© Trevor Hancock, 2018

 

Public health is biased, and you should be glad

Public health is biased, and you should be glad

Dr. Trevor Hancock

17 April 2018

701 words

From time to time, those who work in public health are accused of being biased – and it’s true. In spite of the urgings of some – usually from the corporate or neo-liberal world – that pubic health be neutral, that is not their job. They are and should be biased in favour of health, and biased against anything that harms health – be it government policies, corporate practices or individual behaviours. For that, we should be glad.

That is not to say that public health assessments of potential health hazards are biased – they are not. Public health begins with an objective assessment of the evidence as to possible harm to health from whatever it is that is of concern. If the conclusion is that it is not a health hazard, then no action is taken.

But if there is an assessment that something is harmful, public health is duty-bound to do something about it, based on an assessment of the severity of the problem. Is this a minor problem, something that only affects a small number of people and has only short-lived and non-life-threatening effects? Or is it a major problem, one that affects many people and has potentially serious, even life-threatening consequences? Most often, it is somewhere in between.

The challenge, of course, is that often there is incomplete or insufficient evidence to come to a definitive answer. But that is understood and indeed an approach to dealing with uncertainty is even written into law. For example, BC’s Public Health Act states “A health officer may issue an order . . .  only if the health officer reasonably believes thata health hazard exists”, and there are numerous other places in the Act where it is clear the reasonable belief of a health officer is sufficient reason to take action.

Ontario’s Health Protection and Promotion Act is even broader, stating in numerous places, regarding numerous situations, that “A medical officer of health or a public health inspector may [take some form of action] where he or she is of the opinion, upon reasonable and probable grounds”, that there is a health hazard of some sort and that action is needed to reduce or eliminate it.

Note that public health officers are expected to form an opinion, and that there does not have to be definitive proof, just “reasonable belief” or “reasonable and probable grounds” to act to protect the health of the public.

This is, in effect, a codification of the precautionary principle, which was defined as follows in the 1992 Rio Declaration of the Earth Summit: “Where there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used as a reason for postponing cost-effective measures to prevent environmental degradation”.

This principle is in a number of international treaties to which Canada is a signatory, and is one of the guiding principles in the 1999 Canadian Environmental Protection Act, which the government has the duty to administer – although how well it is implemented is debatable.

I can think of very few cases in a 40-year career in public health where the hazard to health turns out to be less than expected; it almost always is worse. Which is why public health must be biased in favour of protecting the health of the public, and be guided by the precautionary principle.

Almost inevitably, this brings public health into conflict with powerful forces, be they private corporations interested in making money, or governments implementing their policies – or, more often, declining to take action in the face of a threat, especially if that threat comes from a powerful corporation that is a supporter, funder or ideological partner.

That is why both these powerful forces want public health to be neutral; just stick to the facts, don’t have opinions, don’t act until you have definitive proof, don’t speak out. The problem is that only too often, definitive proof comes a bit late, in the shape of dead, sick or injured citizens.

So as citizens we should be glad of and support strong and independent health officers, acting in the public interest, biased towards health, and applying the precautionary principle. We must not let governments weaken our protectors and thus our health.

© Trevor Hancock, 2018

It’s in national, global interest to stop Kinder Morgan pipeline

It’s in national, global interest to stop Kinder Morgan pipeline

Dr. Trevor Hancock

9 April 2018

703 words

As I write, it looks as if the fight to stop the Kinder Morgan pipeline may be successful; the company has announced it is suspending non-essential spending. Credit is due to Premier Horgan, who along with the Green Party has been steadfast in his opposition, but even more so to the First Nations who are fighting to protect the land, the many groups and organisations working to take the fight to the courts, and the countless individuals who have turned out to protest and be arrested. But this is just the first step in a longer and larger stuggle to close down the tarsands industry.

Let’s be clear; the tarsands are not in the national interest. On the contrary, they are a threat to health and the environment both locally and globally. The World Health Organisation calls climate change one of the major threats to the health of the world’s population in the 21stcentury. The health of future generations – not to mention many other species – thus depends on our ability to dramatically reduce carbon emissions over the next couple of decades. This in turn depends on our ability to keep much of the known fossil fuel reserves where they are – in the ground.

It is particularly important to keep the tarsands in the ground because according to the Energy Education team at the University of Calgary “the greenhouse gas emissions for oil sands extraction and processing are significantly larger than for conventional crude oil”. In a 2012 paper published in his role as a UVic climate scientist, Green Party Leader Andrew Weaver and his co-author noted that “if the entire Alberta oil-sand resource . . .  were to be used, the associated carbon dioxide emissions would induce a global mean temperature change of roughly 0.36 °C”.

At a time when we have already seen 1 degree C warming since 1880, according to NASA, and the nations of the world are struggling to keep global warming below 2 degrees C, this is an unacceptable amount for just one country to contribute.

Moreover,the health and environmental impacts of the tarsands are not limited to climate change. The  Energy Education team also reports that the volume of water used in the tarsands operations in a year is equivalent to that used by 1.7 million Canadians, and that “if water use is not changed then the downstream flow of the Athabasca [River] is expected to decrease by 30%” by 2050.

Once used, that water is contaminated with chemicals that are “toxic to animals, particularly aquatic organisms”, so it ends up stored “almost indefinitely” in tailings ponds that, together with their infrastucture, cover an area “about 1.5 times larger than the city of Vancouver”.

To these impacts we can add air pollution. A 2016 study in Natureby Environment Canada scientists found the tarsands generate air pollutants called secondary organic aerosols (a key component of particulate air pollution) in amounts comparable to the emissions of the Greater Toronto area.  This makes the tarsands the largest or second largest source of this form of air pollution in Canada, according to one of the researchers interviewed by CBC News.

On top of that, of course, is the threat to BC’s environment from a pipeline leak or – even worse – a tanker accident along our beautiful but fragile coast.

How is any of this in the national interest? ForJustinTrudeau and Rachel Notley to continue to support the pipeline – and thus the tarsands – is an absolute abdication of responsibility for the health of people around the world and for future generations; it is the complete anthithesis of climate leadership, whether in Canada or on the global stage.

What is in the national – and global – interest, what would be climate leadership, would be to dramatically reduce our greenhouse gas emissions by phasing out the tarsands and other fossil fuels (including coal and the LNG that Premier Horgan has inexplicably developed a fondness for), stopping all tax breaks and subsidies for the fossil fuel industry and transferring them all to the clean and renewable energy and energy conservation industries. Leading Canada to a clean energy future is technically possible – so why does it seem to be politically impossible?

© Trevor Hancock, 2018

 

 

The wonder drugs we really need

The wonder drugs we really need

Dr. Trevor Hancock

2 April 2018

702 words

We hear a great deal – in fact way too much – about the newest wonder drugs that will solve all our problems.  Our fascination with quick-fix technologies is fuelled by carefully planted stories from Big Pharma and the universities and researchers that stand to benefit from a successful drug. Almost invariably, it turns out that the drug is less effective than the hype suggests, while its side effects are more numerous and worse than we are led to believe.

Meanwhile, we are not fed stories about – and thus overlook – the much more effective strategies that really can make a difference – mainly because they are simple, obvious, might need a bit of effort and take some time, and worst of all, don’t make money for Big Pharma.

Almost 15 years ago, three of my friends and colleagues published a book about the adverse public health impacts of urban sprawl. In it they suggested that the antidote to urban sprawl is Smart Growth, an approach to urban planning that emphasises compact multi-use urban centres that are more walkable, bikeable and ecologically sustainable, while encouraging infill development and re-development that densifies the community.

They reported that the evidence showed that health benefits of this approach included “protecting respiratory health, improving cardiovascular health, preventing cancer, avoiding traumatic injuries and fatalities, controlling depression and anxiety, improving wellbeing”. In fact, they compared Smart Growth to “a medicine that treats a multitude of diseases”, adding that “In the medical world, such an intervention would be miraculous”.

There are other equally ‘miraculous’ interventions that are much more useful than many of the drugs we are peddled. Here are a few.

First, the benefits of ‘green nature’, which were explored almost 20 years ago by the innovative ‘Healthy Parks, Healthy People’ program in Melbourne, Australia. They found evidence that being in – or even viewing – nature – something as simple as a neighbourhood park, some street trees, local gardens – could reduce crime, foster psychological wellbeing, reduce stress, boost immunity, enhance productivity and promote healing in psychiatric and other patients. More than that, they concluded “it is most likely essential for human development and long-term health and wellbeing”.

Another friend and colleague, Ming Kuo, looked at people living in social housing where some, by chance, had access to more green nature – what she sometimes calls ‘Vitamin G’ – in their immediate environment. She found that, among other things, those with more green contact showed higher levels of mutual caring and support among neighbours and higher levels of optimism and sense of effectiveness. Among children, she found improved symptom relief for attention-deficit disorder and, among girls, better scores on tests of concentration and self-discipline.

Here in Canada, people working in the field of recreation and parks looked at the societal benefits of their programs and services. In addition to all the benefits of access to ‘Vitamin G’, they found evidence that their activities provide the key to balanced human development and a foundation for quality of life; help reduce self-destructive and anti-social behavior; build strong families and healthy communities; reduce healthcare, social service and police/justice costs, and are a significant economic generator.

Then there is the area of emotional wellbeing. The top public health figure in the USA is the Surgeon General. In 2015, the then Surgeon General, Vivek Murthy, gave a TEDMED Talk  (the TED Talks for health and medicine) in which he discussed the health benefits of emotional wellbeing, which he equated to happiness. And he had this to say:

“Imagine if there was a force in your life that could reduce your risk of having a heart attack or stroke, that could help you live longer, that could make your children less likely to use drugs and engage in crime, and that could even help you lose weight. It turns out, it is not a new prescription medication or medical procedure. The force I’m talking about is emotional well-being.”

Smart Growth, access to nature, recreation and parks services, attention to emotional wellbeing – these are some of the ‘wonder drugs’ we really need. We would be much healthier – and much better off – if we put more of our effort and investment into developing these than in yet more pills.

© Trevor Hancock, 2018