Month: March 2023

Dr. Trevor Hancock

21 March 2023

702 words  

Given that we only have one planet, we need to live within the carrying capacity of the global ecosystem that is the Earth. Yet as I noted last week, Canada’s Ecological Footprint per person is equivalent to using 5.1 planet’s worth of biocapacity and natural resources every year.

By March 13^th we had already used our fair share of biocapacity for the year. After that our demands are taking from other people around the world, future generations and other species, who need that biocapacity to meet their needs.

But troubling as this is, the reality is worse than the Ecological Footprint suggests because, to paraphrase statistician George Box’s observation about models, ‘all indicators are wrong, but some indicators are useful’. The problem with both models and indicators is that they can only give us a partial picture of reality.

So while useful in many ways, it is important to understand the limitations of the Ecological Footprint. The Global Footprint Network goes to some lengths to clarify both its strengths and its weaknesses on their website (go to their FAQs for more details).

The key point is that the Ecological Footprint measures the ecosystems’ annual capacity to produce biological materials (in essence, microbes, fungi, plants and animals, all of which are renewable resources). These can then be used to meet the demands of humans and to absorb our wastes, primarily our carbon emissions. However, it does not measure things that are “not created by biological processes nor absorbed by biological systems”.

So the Ecological Footprint does not reflect the extraction of non-renewable resources such as metals and minerals, since they are not produced biologically, although the energy and any biologically produced materials used in extracting, refining, processing, and shipping these mineral resources are included. Moreover, if they are toxic, then when they or their wastes enter the environment, they may cause a loss of bioproduction that can be measured

However, the Ecological Footprint does not measure the impact of pollutants that are not produced biologically and “cannot be absorbed or broken down by biological processes”. Thus it cannot directly measure the impact of persistent organic pollutants, heavy metals or plastic, although if they cause harm to ecosystems the resultant loss of bioproductivity can be measured, but this is in practice difficult.  

Fossil fuels are a little different. They were initially produced through a biological process millions of years ago, and when combusted, produce carbon dioxide and other pollutants. Carbon dioxide is used by biological systems so the Footprint of carbon is “the amount of productive area required to sequester the carbon dioxide emissions and prevent its accumulation.”

Importantly, of the 2.8 hectares per person of biocapacity being used globally to meet current global consumption and waste production, 1.7 hectares per person – just over 60 percent of our total global footprint – is needed just to absorb our carbon emissions. For Canada, our carbon Footprint is 5.3 hectares per person, 65 percent of our total footprint

Yet the Earth’s annual biocapacity per person is only 1.6 hectares. In other words, absorption of our global carbon emissions requires a bit more than all the bioproductive land available today, while on a per person basis, Canada’s carbon emissions require more than three times the total global biocapacity available per person.

So if the whole world lived the way we do today in Canada, we would need more than 2 new planets just to absorb our carbon emissions. This is why we have to drastically cut carbon emissions globally, as the IPCC reported just this week, and why high-emitting countries such as Canada have to lead the way.

Finally, the Global Footprint Network notes, the Ecological Footprint “is not an indicator of the state of biodiversity, and the impact of a particular activity or process on biodiversity does not directly affect the Ecological Footprint calculation for that activity.” So that too is not reflected in the Footprint.

Thus in reality, our global impact is even greater than the ecological footprint would lead us to believe, making it all the more urgent to rapidly reduce our ecological footprint, while also reducing our extraction of metals and minerals, our production of pollutants and our devastating impacts on biodiversity.

© Trevor Hancock, 2023

thancock@uvic.ca

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

Dr. Trevor Hancock

14 March 2023

700 words  

Just a few days ago, on March 13^th, Canada overshot its fair share of the Earth’s biocapacity and resources, as measured by the ecological footprint in 2018, the latest year for which data is available. That is to say, by March 13^th, Canada had already consumed its fair share of the Earth’s bounty for the year. Collectively, humanity passed its 2022 Earth Overshoot Day on July 28^th.

So what does this mean? Well, first, we need to understand the concept of the ecological footprint, which is, put simply, a measure of “how much nature we have and how much nature we use”, as the Global Footprint Network puts it.

The amount of nature we have is measured in terms of a nation’s or the world’s biocapacity, which “represents the productivity of its ecological assets (including cropland, grazing land, forest land, fishing grounds, and built-up land).” It reflects “the ability of an ecosystem to produce useful biological materials and to absorb carbon dioxide emissions.”

Because of its large land area and abundant forests, farms and fishing grounds, Canada has a large biocapacity. But of course a lot of that is exported, as the world depends upon Canada’s natural resources to meet its needs. In addition, a lot of it – forests and other natural areas – is not used directly by humanity and would seem to remain relatively untouched, although this is in fact the carbon sinks that absorb our carbon dioxide pollution.

The amount of nature we use, on the other hand, is measured as a nation’s or the world’s ecological footprint. In a nutshell, this is the amount of bio-productive land needed “to produce the natural resources it consumes (including plant-based food and fiber products, livestock and fish products, timber and other forest products, space for urban infrastructure) and to absorb its waste, especially carbon emissions.” Those ecological assets can be anywhere in the world, as we import food, raw materials and products from around the world and pump out carbon dioxide and other greenhouse gases.

Globally, the world had the equivalent of 1.6 hectares of bio-productive land per person in 2018, but collectively we consumed the equivalent of 2.8 hectares. In other words, at present rates of global consumption, it takes the equivalent of 1.8 Earths to meet our collective needs.

But Canadians, with our high incomes, high consumption of resources and high levels of carbon emissions, actually require the equivalent of 8.1 hectares of bio-productive land, or 5.1 times as much as is available per person, globally. So if the rest of the world lived as we do, we would need another 4.1 planets, which we clearly do not have.

One way to look at this is that it is like every Canadian spending their annual income by March 13^th each year and then living off loans, or everyone on Earth doing so by July 28^th. Clearly, that is not sustainable for very long – and yet we seem to expect that every year the Earth will somehow, magically, cover our ecological debt.

Moreover, in ‘borrowing’ the equivalent of 4.1 planet’s worth of biocapacity, Canadians are consuming more of the Earth’s biocapacity and resources than we are entitled to, if everyone on Earth were to get their fair share. In doing so we are, in effect, taking precious resources not only from others around the world who need them for their own human and social development, but from future generations and from other species.

Clearly, we only have one planet – no matter what fantasies crazed billionaires may entertain – and we need to learn to live on it. The implications for Canada are profound. In particular, it means we need to reduce our footprint by 80 percent, and quite rapidly, to become a One Planet Canada – a country that uses only its fair share of the Earth’s biocapacity and resources.

I have only been able to provide an overview of the ecological footprint in this column. In my next column I will dig deeper into this important indicator. In particular I will look at what it has to say about our use of fossil fuels, and why it is itself an underestimate of our true impact on the Earth.

© Trevor Hancock, 2023

thancock@uvic.ca

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

(Published as “Learning self-care should start in school”)

Dr. Trevor Hancock

7 March 2023

700 words

Last week I suggested self-care should be a strategic priority for Canada’s health system. Done well, it can reduce unnecessary demand for professional care while at the same time, improving outcomes, empowering patients and enhancing personal and community capacity for caring.

While self-care is often seen as being about the self-management of minor ailments and injuries (coughs and colds, upset stomach, cuts, bumps and bruises, sprains etc.) and chronic diseases, it is – or should be – much more than that. It is about all the things we do for ourselves and with our families, neighbours and communities that make us healthier, protect us from harm and even prepare us for our end of life passage.

Importantly, self-care is not simply about education, although obviously education is important. A 2010 article on self-care in the British Medical Journal noted the literature on changing health behavior “shows that mere provision of information has little effect. Changing behaviour often requires multiple interventions that work at several levels: the individual, the immediate family or social circle, and society in general.”

A comprehensive strategy must begin in school, where children need not only to learn about how their body works, but how to look after their health and deal competently with minor health problems. While the usual lifestyle issues of diet, physical activity, use of tobacco, alcohol and other drugs should be addressed, so too should mental wellbeing. Given the crucial importance of social connections, children should be supported in the development of social skills that will help improve their ability to create and maintain social networks.

In the latter years at school, they should also learn first aid and CPR, a set of skills that should be maintained over the years through refresher training. After all, while not in the literal sense self-care, the ability to provide emergency first aid before the professionals arrive is a form of collective self-care.

But since most of us are well past childhood, we also need a system of education, training and support that enables adults to acquire the skills they need to keep themselves and their families healthy, to manage minor ailments and injuries, and live well with chronic diseases and disabilities. They also need to learn when it is appropriate, and indeed necessary, to access the illness care system, and to work with their primary care team to ensure they receive the preventive services laid out in BC’s Lifetime Prevention Schedule.

With HealthLink BC, British Columbia has in place an important component of this support system. Available by phone or online 24/7, and in many languages, the service can provide you with health information, help you navigate the health care system and find health services across the province, or connect you with a registered nurse, registered dietitian, qualified exercise professional, or pharmacist.

When it comes to chronic diseases, B.C. supports an independent program, Self-Management BC, provided through the University of Victoria. The program serves people with chronic pain, diabetes, cancer and other chronic conditions, and has programs tailored to the Chinese, Indigenous and Punjabi communities. These programs are delivered by trained volunteers, and range from one-on-one coaching by phone to both in-person and web-based group learning and support. Importantly, Self-Management BC also trains health care professionals to use self-management support strategies when interacting with patients.

But self-care can and should reach even further. Social prescribing is an approach that refers people needing social support to community groups and activities. Learning the skills needed to work with people in mutual support can enable us to work with others in our own community to make it healthier. The BC Healthy Community initiative is just one of the many organisations that supports such work in B.C.

Finally, at the end of life, being supported in making preparations for one’s own death, including being supported in having conversations with family, friends and care providers about one’s wishes, is perhaps the ultimate form of self-care.  

While not cost-free, when done well self-care should should cost less overall than business as usual, making it cost-saving for the illness care system while improving the health and wellbeing of the population. To be truly effective, then, the health system must invest in self-care support.

© Trevor Hancock, 2023

thancock@uvic.ca

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

If we really want to reduce the burden on the illness-care system, we need to prioritize self-care, so people do not inappropriately access the system.

Dr. Trevor Hancock

27 February 2023

700 words

The most important task in creating a health system is to keep people healthy, so they do not need to use the illness-care part of the system. My three most recent columns looked at ways in which we could keep the population healthy through societal change.

The next most important way to reduce the burden on the illness care system is self-care. If people know how to recognise and manage their own and their families’ minor ailments and injuries and chronic diseases, they will not need to use the health care system.

A couple of recent articles in this newspaper by local physicians have lamented the lack of healthy living and self-care skills and the lack of ‘common sense’ among the general public. This leads to people not making healthy choices in the first place, and not knowing how to care for minor problems when they occur, both of which result in an unnecessary burden on the illness care system.

But the real problem is that self-care has never been afforded the respect and attention it requires. Yet in reality, most care is self-care, a simple fact that the professionally-oriented illness care system has never fully recognised. A 2010 UK survey found half of those with a minor ailment self-treat, while almost one quarter do nothing.

Self-care is also hugely important in chronic illnesses. For example, a UK study found that “people with diabetes have on average about 3 hours contact with a care professional and do self-care for the remaining 8757 hours in a year”. Moreover, self-care is effective. A recent article in BMC Public Health noted: “In chronic illness, higher levels of self-care have been associated with better health outcomes, including decreased hospitalization, costs, and mortality.”

But it’s no good lamenting people’s unwise use of the illness care system if we have not trained them in self-care in the first place. In fact, not only have we not given them the knowledge and skills they need to look after their own minor ailments and injuries, we have only too often implied that they shouldn’t risk being wrong, but should consult a health professional.

So it should be a strategic priority for the health system to help people develop the knowledge and skills needed to stay healthy, to care adequately and appropriately for minor ailments and injuries and chronic illnesses, and to know when it is time to seek professional care. And when they do, they need to be secure in the knowledge that appropriate professional care will be there when they need it.

It is important  to stress that self-care is not about abandoning people to their own devices. As Swedish doctoral student Silje Gustafsson noted in her 2016 dissertation: “Just as health is more than the absence of disease, self-care is more than the absence of medical care.”

Self-care does not just happen, we are not born with a set of self-care skills. We need both to train people in self-care from an early age and put in place a support system – including mutual-support groups – that enables them to practice self-care with confidence. People also need support from health professionals – who themselves need to be trained and supported so they can in turn support self-care.

Yet while self-care is arguably the largest and most important part of the entire illness care system, we do not have a robust self-care strategy. In fact, no province that I am aware of has prioritised self-care or created a proper self-care strategy. The only group I am aware of that has argued for a national self-care strategy is an industry association, Food, Health, and Consumer Products of Canada. However, unsurprisingly, their motivation is self-interest and focuses on improving access to, and reducing the cost of and taxes on their products

But if we really want to reduce the burden on the illness care system, we need to prioritise self-care, so people do not inappropriately access the system. At a time when the federal government and the provinces are squabbling over money for hospitals and primary care, we should demand that they also put money into a comprehensive national self-care strategy. Next week, I will discuss what that might look like.

© Trevor Hancock, 2023

thancock@uvic.ca

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy