This is what a health system looks like

  • Published as “Human behaviour is affected by factors beyond personal choice”

Many of the conditions we live in and the behaviours we adopt are not freely chosen, no matter how much we may wish to think so

Dr. Trevor Hancock

14 February 2023

699 words

Last week I started to sketch out the elements of a health system – a system designed to keep people healthy so they don’t need to use the illness care system (which we usually call the health care system). The key point is that although illness care is an important part of a health system, most of what keeps us healthy happens beyond ‘health care’, beyond the scope of the Ministry of Health and most health care professionals.

The most fundamental determinants of our health are what I and others call the ecological determinants of health: Air, water, food, fuel, materials, and other ‘ecosystem goods and services’ we derive from nature. A second major set of determinants are the social factors that enable us to meet our basic needs: Healthy food, adequate shelter, clean air and water, sanitation, basic education and health care, an adequate income, social connections and support and other factors.

A vivid illustration of these social determinants came from former Saskatchewan Premier Roy Romanow, who chaired a Federal Commission on the Future of Health Care. In his 2004 address to the inaugural meeting of the Health Council of Canada, he suggested seven things we could do to stay healthy: Number one was “Don’t be poor”.

This was followed by “Pick your parents well; Graduate from high school and then go on to college or university; Don’t work in a stressful, low-paid, manual job in which you have little decision-making authority or control; Don’t lose your job and become unemployed; Be sure to live in a community where you trust your neighbours and feel that you belong, and finally, live in quality housing, but not next to a busy street, in an urban ghetto or near a polluted river.”

Clearly, these are not really conditions we can freely choose, influenced as they are by the socio-economic, Indigenous or ethnic status of the families and communities into which we are born. Which is why the third major set of determinants – human behaviour, can be problematic.

Because while there is of course an element of personal choice, our behaviour is very much shaped by our culture, our society, our community, our family and our peers, as well as – these days – a multi-billion dollar industry that markets unhealthy products and behaviours. Roy Romanow’s tongue-in-cheek advice reminds us that many of the conditions we live in and the behaviours we adopt are not freely chosen, no matter how much we may wish to think so, for a wide variety of reasons.

A final major category, of course, is human biology, but much of that – our genetic inheritance – cannot be changed easily, if at all. Of course, when our body or mind does not work well, or is damaged, we try to fix it, or help people to adapt to live with the damage; that is what the illness care system is mainly focused on.

This broad understanding of what keeps people healthy is hardly new; it is as old as humanity, as well as being a modern insight. One of the things that inspired me to work in public health was the 1974 federal government ‘Lalonde Report’ on the health of Canadians. Among other things, it stated: “there is little doubt that future improvements in the level of health of Canadians lie mainly in improving the environment, moderating self-imposed risks and adding to our knowledge of human biology.” But unfortuantely we have largely ignored that important insight ever since.

Which brings us to the latest attempt to drag our focus back to creating health. As I laid out in a series of columns in January and February this year, the World Health Organization has started calling for the creation of Wellbeing societies. These are societies that will “provide the foundations for all members of current and future generations to thrive on a healthy planet.”

Of the five key action areas proposed, I have previously dealt with the first two – valuing and respecting the earth and its ecosystems, and creating a wellbeing economy. Over the next two weeks I will look at the third – develop healthy public policy for the common good – and the fourth, achieve universal health coverage.

© Trevor Hancock, 2023

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

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


Time for a radical re-think of health care

If you had to remake the health system from scratch, what would you do? Turn the system on its head, making the hospital the place of last resort and beginning with what keeps people healthy.

Dr. Trevor Hancock

7 February 2023

699 words

Last week I suggested we need to radically re-think Canada’s  ‘health care system’ – actually, thirteen separate, mainly publicly-funded, often privately operated non-systems for illness care, with federal cost-sharing.

Having worked as a family physician in primary care; as a public health physician in health planning and as a Medical Health Officer; as an advisor and consultant on health promotion to the World Health Organization – mainly in Europe; as a medical consultant in population and public health at B.C.’s Ministry of Health, and as a health futurist, I have had lots of time to observe and think about Canada’s ‘health care system’.

Back in the 1990s and into the 2000s I sometimes led workshops on health care reform which, over time, I came to call ‘Blow it up and start again!’. Now obviously we can’t blow up the system, so I did a thought-experiment, inspired by Albert Einstein’s approach to physics: What if the health care system disappeared overnight and we had to rebuild it from scratch? What would we build, knowing what we know today?

Well, we would not start with the hospital, which is what happened in Canada. If you look at the history of health care, the federal government first got involved by supporting the building of hospitals in the late 1940s, then supported public insurance for hospital care in the late 1950s, and then brought in public insurance for physician care outside hospitals in the late 1960s.

Unfortunately, we got it backwards. For the most part, ever since, we have been running around trying to plug holes in the system, without stepping back and seeing if perhaps we need an entirely different system.

What I propose instead is a true health system, one that is designed to first create good health. So the first thing to do is keep people healthy, because clearly, the best way to deal with an over-burdened illness care system is to stop over-burdening it. The second important way to reduce the burden is to increase people’s capacity for appropriate self-care, so they don’t seek medical care when they don’t really need it.

We need to begin, then, with a clear vision of what a true health system would look like, including what an illness care system within such a system would look like. Then every decision we make should be one that takes us closer to that vision.

Thus in my thought experiment I turned the system on its head, making the hospital the place of last resort and beginning with what keeps people healthy.  After all, various estimates suggest that medical care is responsible for around 10 – 20 percent of avoidable premature mortality. The other 80 – 90 percent is attributable to human biology, personal behaviours, social  and economic factors that shape our behaviours and our communities, and the quality of our built and natural environments. So that is where we need to start.

The model I created – first published in 1993 – is an upside down triangle, with each layer in the model involving fewer people needing services. The better the layers higher up in the model do their work, the fewer people the lower levels need to care for.

Thus the first couple of layers of the model, which affect the whole population, are about creating a Wellbeing society, something the World Health Organization has been calling for recently. Such a society puts the wellbeing of people and the planet at the centre of all decision-making, testing all policies, especially economic policy, against their ability to either improve or harm wellbeing.  It also ensures that people are protected from harmful activities by the private or public sectors.

Then come layers that are about people learning to look after themselves, both to keep healthy and to manage their minor ailments and injuries, activities the health system must support. The first real contact with the health care system involves receiving preventive services and quality primary care, then – if needed – specialty ambulatory care and home care. Only if all that is insufficient do people actually need to be admitted to a community facility or hospital.

In the next couple of columns I will describe this in more detail.

© Trevor Hancock, 2023

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

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

Canada does not have a health care system

(Published as “If doctors operate as a business, what’s wrong with surgery through private clinics?”)

Dr. Trevor Hancock

1 February 2023

700 words

There is much wringing of hands these days about the state of the Canadian health care system, as well there should be. But in fact there is no such thing as a Canadian health care system, although there is a Canadian way of funding health services. In the 1990s, when I helped organise study tours for Swedish health system managers to visit Canada, I used to describe the ‘Canadian health care system’ to them as ten publicly-funded private non-systems.

Let me pick that apart. First, there is no Canadian health system, because when Canada was formed in 1867, the federal government got what was then important in politics – foreign affairs, defence, international trade etc., while the provinces got the less important stuff; health, education, social support etc. So constitutionally, health is a provincial, not a federal responsibility.

That is why we have 10 health ministries and ministers, 10 sets of licensing and regulatory Colleges for physicians, nurses and so on; 13 if you include the territories. Each province licences its professionals – which is why it is hard to transfer from province to province, even though – in my experience – the human body and its diseases, and the treatment of those diseases, is the same across the country. Hardly a system, certainly not an efficient one.

As a result we have ten different provincial systems, each of which has its own policies and programs, negotiates its own fee schedule and salaries with staff, its own approved drug lists and so on. The only thing that really unites them are the five principles enshrined in the Canada Health Act; if the province is to receive federal funding the provincial system must be comprehensive, universal, accessible, portable and publicly administered.

Importantly, the principles only apply to physician and hospital services (and selected dental surgical services), which is why almost all dental care, as well as home care, pharmacy, physio, psychological counselling and similar services  are either not covered or only partly covered. This lack of coverage is why one quarter of all health expenditure in Canada is funded though the private sector – mainly out of your own pocket or through private insurance as part of a benefits package, unless your income is low enough that you qualify for public assistance.

An important area of confusion is that health services only have to be publicly administered, not provided by public authorities. So insured services can and are provided by the private sector. In fact a large part of the publicly funded system is privately owned and operated, starting with your doctor.

A 2016 brief from the Canadian Medical Association reported “the vast majority of physicians are self-employed professionals operating medical practices as small business owners”. Similarly, if you have had lab or X-ray work, chances are it was a privately operated lab or X-ray. But because they are providing an insured service and billing the single public payer, this is fine.  

Which is why the recent furore over providing surgery through private clinics is a bit puzzling. Now don’t get me wrong, I am opposed to a two-tier system in which the wealthy can jump the queue and get better services. Apart from anything else, that may draw staff and resources away from the public sector, leading to its deterioration.

But if you can go to a family doctor and then a surgeon who are private business people, and get your lab and X-ray work-up done by private businesses, then what is wrong with having your surgery done in a privately owned and operated clinic, as long as it is a procedure that the public system insures (if it isn’t, you would have to pay privately anyway), is as safe as and has outcomes at least as good as in the public system, is no more expensive than the public system, and bills only the public system, not the patient.

Finally, a system? Really? Well, if so, it is a badly-designed system, because, as the Institute for Healthcare Improvement likes to say, “every system is perfectly designed to achieve the results it gets”, and this ‘system’ is not delivering what we need. Time for a radical re-think, a topic I will return to soon.

© Trevor Hancock, 2023

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

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

Morgan’s columns should come with a health warning

Fossil-fuel advocate Gwyn Morgan’s columns are an example of ‘discourses of delay,’ which argue that we need oil and gas to fuel our society and change is impossible — thus delaying action on climate change.

Dr. Trevor Hancock

24 January 2023

702 words

Fossil fuel advocate Gwyn Morgan recently provided yet another nonsensical defence of his industry (“Net-zero fantasy has empowered dictators”, 11 Jan 2023). But as Professor Roland Clift – a past member of the UN Intergovernmental Panel on Climate Change and the U.K. Royal Commission on Environmental Pollution – wrote in response, it is Morgan who is the fantasist: “It is people like me who live in the real world; the fantasists are those who think we can continue to dig up and burn fossil carbon.”

Of course, Morgan completely ignored the environmental, health and economic costs of the fossil fuels he touted, as several letter writers pointed out. “Unfortunately, he either ignores or unfairly dismisses environmental concerns about fossil-fuel production”, wrote Steve Housser of Shawnigan Lake.

Short of outright denial of climate change, ignoring the problem is the next best thing, perhaps best understood as the ostrich strategy: Just close your eyes, stick your head in the sand and hope the problem will go away.

Unfortunately for Morgan, his timing was off. He wrote: “As 2022 made painfully clear, however, there’s nothing at all funny about the enormous damage currently being inflicted by pursuit of this technically impossible goal” of net-zero. But this appeared opposite an article titled “U.S. climate disasters racked up $165 billion in damage in 2022” and another titled “Landslides, sinkholes, floodwaters plague California”.

His main point – that a reliance on renewable energy had made Germany vulnerable to Russia’s weaponizing of oil and gas – was ably refuted by Thomas Pedersen of Saanichton: “Morgan’s views are exactly backward”, he wrote, arguing that in promoting “untrammelled consumption of oil and natural gas and [decrying] adoption of renewables”, Morgan “has contributed to keeping demand for fossil fuels high, thereby enriching coffers in Russia and other autocracies like Saudi Arabia.”

Another criticism of Morgan’s article came from Ed Wojczynski, former chief energy planner for Manitoba Hydro, who wrote that Morgan’s “learning from the European crisis is to expand oil and gas while Europe’s learning instead is to increase renewables and nuclear to enhance self-reliance and minimize gas requirements.”

Full marks to Mr. Morgan, however, for his persistence in trying to obfuscate the science of  climate change and clean energy; he never gives up peddling the distortions, half-truths and downright lies of the fossil fuel industry that he represents. His column is an example of what one group of researchers have called ‘discourses of delay’.

In an article in the journal Global Sustainability in 2020, a team of researchers  explained that these ‘discourses of delay’, which “pervade current debates on climate action  . . . accept the existence of climate change, but justify inaction or inadequate efforts.”

The team identified four categories of climate delay discourses. First are proposals to redirect responsibility: Examples include arguing that we are small and should wait for others to act, or that if we act, others won’t, so it’s better we do nothing.

The second category, which Morgan’s column is full of, is pushing non-transformative solutions: Rather than expand alternative energy to reduce our dependence on fossil fuels – be they from Russia or elsewhere – we should ramp up production. No mention, of course, of the enormous health, environmental, social and economic costs that will ensue.

The third category – emphasize the downsides of climate policies – is in many ways the opposite of the second: Morgan argues that controls on fossil fuels make us vulnerable, while again ignoring the downsides of fossil fuel use and the benefits of alternatives.

Finally, is the category of surrender to climate change, which is inherent in all he writes: We need oil and gas to fuel our society, change is impossible, the alternatives are unfeasible – none of which is true, by the way – so just carry on as we are.

I realise that the media feel they need to provide ‘balance’, but the fossil fuel industry continually tries to mislead us. Given his persistent ignoring of the ‘inconvenient truth’ of climate change and its health, environmental, social and economic costs, I think Gwyn Morgan’s columns should come with a health warning: “This article may contain unfounded, biased and distorted information that may harm your health or that of your descendants. Read with care.”

© Trevor Hancock, 2023

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

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

We must  tax the rich, for the benefit of all

Dr. Trevor Hancock

17 January 2023

699 words

My recent columns on the need to reduce inequality and social injustice by, among other things, increasing taxes on the rich and introducing or expanding wealth taxes, have elicited responses from some people along the lines of ‘you advocate stealing from the rich’.

But the reality is that the rich have increasingly been taking – stealing, if you like – from the poor in recent decades. This is one of the many damaging consequences of the neoliberal ideology that has dominated political and economic thought and practice since the 1980s.

They do so in many ways. One obvious way is to keep wages low, keep work temporary and part-time, and avoid paying benefits to people, while pushing up prices, especially on necessities. Another way is to avoid paying taxes, or minimising taxes for the wealthy, which shifts more of the tax burden to middle and low-income people, while reducing government revenue and weakening the capacity to assist those in need.

A third way is to move industries to countries that have lower wages, fewer social protections and less effective occupational and environmental protection, all of which reduces costs and boosts profits. In addition, rich countries extract resources from low-income countries, while taking advantage of the same deficiencies, resulting in a transfer of benefits to the rich and environmental and social costs to the poor.

The consequences are documented in the latest Oxfam report on inequality, released this month. Titled “Survival of the Richest”, the report spells out what has been happening in painful detail.

The rich are getting richer, while the poor are getting poorer, says Oxfam. In fact “extreme wealth and extreme poverty have increased simultaneously for the first time in 25 years.” Since 2020, the top 1 percent got even more – almost two-thirds of the $63 trillion dollars in new wealth created. The rest of us – the remaining 99 percent – shared the remaining one-third, and you can be sure it was not going to the people at the bottom.

In fact, states the report, over 70 million additional people were pushed into extreme poverty in 2020, an 11% rise, while almost one-tenth of the global population was affected by hunger in 2021. The effects of the pandemic, the war in Ukraine, climate change and corporate behavior, notes Oxfam, have led to soaring food and energy prices that “deals another blow to the world’s poorest people”

Yet many food and energy companies in particular are making unacceptable windfall profits. For 95 food and energy corporations that made windfall profits in 2022, Oxfam notes, 84 percent of the $306 billion in windfall profits they made went to shareholders.

And yet, reports Oxfam, “worldwide, only four cents in every tax dollar now comes from taxes on wealth”, while rich people’s (mostly unearned) income “is taxed on average at 18 percent, just over half as much as the average top tax rate on wages and salaries.” Yet taxes used to be much higher, playing “a key role in expanding access to public services like education and healthcare”, until “governments across Africa, Asia, Europe, and the Americas . . . slashed the income tax rates on the richest.”

The way things are, as Oxfam CEO Danny Sriskandarajah states, “is an affront to basic human values.” Moreover, states Oxfam, “extreme concentrations of wealth undermine economic growth, corrupt politics and the media, corrode democracy and propel political polarization”. So, unsurprisingly, Oxfam calls for higher income taxes on the rich, higher capital gains taxes, inheritance, property, land and net wealth taxes, and taxes on windfall profits.

The benefits of just an annual wealth tax of up to 5 percent on the world’s multi-millionaires and billionaires would be massive. Among other things, the $1.7 trillion a year it would raise would be “enough to lift 2 billion people out of poverty, fully fund the shortfalls on existing humanitarian appeals, deliver a 10-year plan to end hunger, support poorer countries being ravaged by climate impacts, and deliver universal healthcare and social protection for everyone living in low- and lower middle-income countries.”

Imagine what raising taxes in all those other areas could do. What’s not to like – unless you are a billionaire or millionaire lacking any form of social conscience.

 © Trevor Hancock, 2023

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

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

Coming generations need the UN to focus on their future

Dr. Trevor Hancock

10 January 2023

700 words

There is a long-standing environmental adage that we do not inherit the Earth from our parents, but borrow it from our children. It is a fine sentiment, and the right principle, if only we lived by it. But we do not. Which is why I was so pleased to see the UN Secretary General’s 2021 report ‘Our Common Agenda’ has “a new focus on the world’s young people, and future generations”.  

As an accompanying report put it, this means thinking about the needs of “the next generation – nearly half the world’s population who are under the age of 30 – and . . . future generations – the 10 billion people who are yet to be born this century”. That report, ‘Our Future Agenda’, authored by eight UN Foundation Next Generation Fellows aged 19 – 30, is itself an indication of Mr. Guterres’ commitment to young people.

Mr. Guterres cautions that “unless we change course, we could bequeath to our children and their children a barely habitable world”, adding that they “will inherit the consequences of our decisions – but are barely represented at the global table of decisions.” So he proposes a number of changes at the UN that will strengthen its focus on the future.

Now UN reform may seem a bit arcane, but at a time of unsettling global challenges and instability we desperately need a better-functioning UN to help the world come together to address these major challenges, both for now and for the future.

Mr. Guterres proposes the creation of a Special Envoy for Future Generations “to give weight to the interests of those who will be born over the coming century.” He also proposes a new United Nations Youth Office to “upgrade engagement with young people across all our work, so that today’s young women and men can be designers of their own future.”

The authors of ‘Our Future Agenda’ have their own ideas for how to address “crises that we did not cause”. Their New Deal for a New Generation has three pillars: The right to learn, “where we learn what we need to thrive”; The future of work – “a world where we find secure and meaningful work”, and Saving our planet “a world where we respect our shared home.”

Their aim is to ‘”unleash a new generation” by, among other things, engaging young people as designers of a sustainable future and supporting youth-led movements and civic education to strengthen democracy.

They also propose actions to deepen the engagement of the next generations in the work of the UN. These include an annual High-Level Meeting for Young People, a Global Network of Youth Envoys and a Contract for the Future setting out obligations to future generations.

That latter idea is an important part of Mr. Guterres’ recommendations; he proposes the UN adopt a Declaration on Future Generations. The Declaration, he suggests, would “specify duties to succeeding generations and develop a mechanism to share good practices and monitor how governance systems address long-term challenges.”

He also proposes establishing “a Futures Lab that will work with governments, academia, civil society, the private sector and others, bringing together all our work around forecasting, megatrends and risks.” He expects the Futures Lab to issue regular reports on megatrends and catastrophic risks. 

But he also recognizes that this will not work without some high-level buy-in and direction. So he proposes re-purposing a currently dormant body, the Trusteeship Council – originally set up to supervise the administration of International Trust Territories – “to make it into a deliberative platform on behalf of succeeding generations.”

A key step in turning these ideas into reality, Mr. Guterres proposes, is a Summit of the Future. Now scheduled for September 2024, the Summit is where the world would come together “to forge a new global consensus on what our future should look like, and how we can secure it.”

For all our sakes, but especially for the sake of today’s young people and future generations, we must all hope there is enough goodwill, common sense, and yes, even wisdom to bring Mr. Guterres’ plans to fruition. For our part, we need to let the Canadian government know that this is a priority initiative that they need to get behind.

© Trevor Hancock, 2023

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

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

The world should pay heed to Antonio Guterres

Dr. Trevor Hancock

3 January 2023

701 words

Regular readers of my column will know that I have frequently quoted Antonio Guterres, the UN Secretary General. A former Prime Minister of Portugal, he was elected to the post in 2016 and re-elected in 2021, He is the most important political leader on the planet today, heading up the most important organization on the planet.

What makes him so important, first and foremost, is that he is the only political leader whose focus is global, with a commitment to the whole world, the whole of humanity, the whole Earth. Every other President, Prime Minister, King or Sheikh has at the forefront of their mind their own country’s interests – or perhaps their own or their party’s or their faith’s interests or their families’ and cronies’ interests.

At its worst, such narrow self-interest can lead to war, as we see in Ukraine and many other parts of the world. It also leads to economic and other policies that might seem to be beneficial to a country, or a segment of its population, but harm others because they are in another country, or harm the environment elsewhere on the planet. Only too often, those policies are also short-sighted, geared to short-term gain even if it results in long-term pain, because (where they have elections) the next election matters, the next generation – not so much.

The second thing that makes him so important, rooted in his global perspective, is that he has been making some remarkably blunt comments on the state of the world and what we need to do to avoid – or at least lessen – the impact of the multiple ecological and social crises we have created.

What makes the UN the most important organization on the planet is that at a time of accelerating global ecological, social and other crises, the UN is key to bringing people and nations together to find common interest, common purpose and a common agenda. It is, as Mr. Guterres has said, “the only institution with universal convening power.”

Yet only too often, the UN gets criticized for its apparent weakness and failings. I think we forget how hard it is to find a common agenda among almost 200 widely differing nations; it makes herding cats look like a walk in the park, to mix my metaphors. In fact, it’s remarkable how often agreements are reached. But after 75 years without major reform, the UN needs updating, to become what Mr. Guterres has called UN 2.0, a UN “fit for a new era.”

So I thought it might be useful to summarise some of what he has been saying about the state of the world and the need for a reformed UN and strengthened multilateral approaches. The best place to begin is with his very important September 2021 report ‘Our Common Agenda’, requested by the General Assembly to mark the UN’s 75th anniversary, and to look for ways to address the challenges of global governance.

In introducing his report, Mr Guterres was clear: “On almost every front, our world is under enormous stress.” He identified those stresses as “the climate crisis . . . our suicidal war on nature and the collapse of biodiversity . . . Unchecked inequality (which) is undermining social cohesion . . . Technology moving ahead without guard rails . . . (and) Global decision-making fixed on immediate gain, ignoring the long-term consequences of decisions.”

But, he noted “the international community is manifestly failing to protect our most precious global commons: the oceans, the atmosphere, outer space, and the pristine wilderness of Antarctica. Nor is it delivering policies to support peace, global health, the viability of our planet and other pressing needs.” As a result, he said, “we risk a future of serious instability and climate chaos”.

To address these short-comings, he proposed a four-point action plan to strengthen multilateral approaches: Strengthen global governance; focus on the future, on young people and future generations; renew the social contract; and ensure a United Nations fit for a new era.

Making the UN work better is vital if we are to successfully manage the challenges facing us in the 21st century, so I will delve into these ideas in more detail in future columns.

© Trevor Hancock, 2023

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

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

Today the sun stands still: Thoughts on Solstice

Trevor Hancock, 21 December 2022

Based on remarks at the Gorge Tillicum Community’s ‘Lights on the Gorge’ event, where children are an important part of the audience


Today is Midwinter’s Day, and today the sun stands still!

Now that may sound a bit worrying, even a little scary, but, it is actually very good news. You see, for six long months the sun has risen and set a bit further south each day, so each day the nights have grown longer, the days have grown shorter, the weather colder.

But now, finally, the sun will stop moving south. It will stand still, and then it will start its annual trek back to the north again, bringing shorter nights, longer days and warmer weather. Then comes Midsummer’s Day, when once again the sun will stand still, and then start heading south, beginning the whole cycle again.

The fact the sun stands still twice a year – on Midwinter’s and Midsummer’s Days – is what gives us one of the other names for this day – Solstice. Why Solstice, what does that mean? Well, it comes from Latin; sol – the sun – and sistere – to stand still.


It is reassuring to know the sun stood still this time last year, and the year before that, and the year before that – way back into the depths of history. The ancient ones knew it, they were keen observers of the sun and the moon and the stars, more so than most of us are today.

Think back a few thousand years, before coal and oil and electricity, before towns and cities and street lights. Imagine how dark it was, how ever-present was the the sky at night, the vast arc of the Milky Way, the moon, the stars, the moving stars that are the planets, perhaps the Northern Lights. – how impressive, how awe-inspiring it all was.

But imagine also how scary such darkness must have been, full of predators and scary monsters and things that go bump in the night. And for half a year our ancestors would have seen the days getting shorter, the nights longer and darker and colder, the crops all harvested, nothing growing, hunting difficult, their animals shivering and barely surviving. The winter was a time of hardship.

So wouldn’t you long for the end of that long, slow slide towards darkness and cold? Wouldn’t you long for the turning of the year, the day when the sun stops its southward drift, when – even though we know there are still cold, dark, hard days ahead – the days start to get longer, the darkness starts to go away.

But wouldn’t you also worry that perhaps this year the wheel won’t turn, the slide into darkness and cold will continue, that the light will never return. Wouldn’t you pray for the return of the light, make offerings  to ensure the wheel turns.

So wouldn’t you celebrate that night – the shortest night, the turning of the year – with its promise of longer, warmer days to come, of spring and summer, of new crops and easier living, even knowing that the wheel of time will keep turning, that in its turn the longest day will come and the cycle will start all over again. Wouldn’t you light fires – and perhaps jump over them – wouldn’t you light the lamps, wouldn’t you feast a bit, and drink a bit, and sing a bit, and dance a bit – perhaps even a lot!


But all that hinges on being strongly aware of and connected to nature, to the land and the waters and the sky, and to what Indigenous people call ‘all our relations’. Sadly, that is no longer the case. There is a famous and true story from Los Angeles at the time of the 1994 earthquake, when power failed and the lights went out. People saw a strange glowing mass in the sky, and they were worrried, some were scared and some even went so far as to call the emergency services to report it – was the sky falling, were aliens attacking, what was going on?

Well, you guessed it – for the first time in their lives, people were seeing the Milky Way, and they didn’t know what it was. It is a powerful example of one of the great tragedies of our age, and an important contributor to the many challenges we face; our huge disconnect from nature, from Mother Earth, from all that sustains us.

We need to re-establish that connection with nature if we have any hope of addressing our challenges. We need to learn again to respect and cherish and protect nature, to make peace with nature, as the UN Secretary General has put it.

In particular, we need to ensure that our children and grandchildren have a strong connection to nature – why else would they respect and cherish and protect and live in peace with nature.

One important place to begin is to re-connect to the great cycles of nature, to the summer and winter solstice, to the spring and fall equinoxes – another Latin word, one that means equal nights, the two times a year when day and night are of equal length.

Which is why we are here, to mark the Winter Solstice, the turning of the year, when the days start to lengthen again, when the light starts to return.

A Happy Solstice to you all!

Reconciliation must include the Earth

  • (Published as “Reconciliation with the planet includes Indigenous Peoples’)

In the rush to protect nature, the human rights of Indigenous people should not be violated — as has happened in the Democratic Republic of the Congo, Tanzania and Nepal.

Dr. Trevor Hancock

13 December 2022

701 words

“Reconciliation between Aboriginal and non-Aboriginal Canadians, from an Aboriginal perspective”, wrote the Truth and Reconciliation Commission in 2015, “also requires reconciliation with the natural world. If human beings resolve problems between themselves but continue to destroy the natural world, then reconciliation remains incomplete.” As Commissioners, they added, “this is a perspective that we have repeatedly heard: that reconciliation will never occur unless we are also reconciled with the earth.”

That astute observation is particularly pertinent as the nations of the world meet at COP15 in Montreal to negotiate a new Global Biodiversity Framework. A prominent theme going into the negotiations has been the role of Indigenous people in protecting and enhancing biodiversity, something the UN has been emphasising for several years.

In a speech on the state of the world in December 2020, UN Secretary General Antonio Guterres spoke specifically to the importance of Indigenous people as protectors of nature, calling on nations to “heed their voices, reward their knowledge and respect their rights.” The rights of Indigenous peoples with respect to their traditional lands, territories and resources are addressed in a number of Articles (especially Articles 25 -29 and 32) in the UN Declaration on the Rights of Indigenous Peoples, which both Canada and B.C. have recognised and adopted into legislation.

Pointing out that “Indigenous peoples make up less than 6 percent of the world’s population yet are stewards of 80 percent of the world’s biodiversity on land”, Mr Guterres noted that “nature managed by indigenous peoples is declining less rapidly than elsewhere.” Thus, he suggested, “Indigenous knowledge, distilled over millennia of close and direct contact with nature, can help to point the way” towards protection of nature.

His remarks were rooted in a number of UN agency reports, including 2019 reports from the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, the UN Department of Social and Economic Development Affairs and the UN Environment Programme’s Global Environment Outlook, as well as the 2020 Human Development Report, all of which stressed the importance of Indigenous knowledge and approaches.

With COP15 being held in Montreal, headquarters of the Secretariat for the Convention on Biodiversity, Canada is not surprisingly playing a leading role. At the opening ceremony, Prime Minister Trudeau joined the call by the UK, France and Costa Rica, to conserve 30 percent of the Earth’s land and waters by 2030. He claimed Canada is on track to protect 25 percent by 2025 and that 30 percent by 2030 is “quite feasible.”

In an accompanying news release, Trudeau noted “Indigenous Peoples have been caring for the lands and waters of Canada since time immemorial” and that they “have unique relationships with nature and knowledge of responsible stewardship as a way of life.” He announced $800 million over seven years, starting in 2023-24, to support up to four large-scale Indigenous-led conservation initiatives in Canada’s North. Canada has also just created the First Nations Guardian Network – a world first – to support Guardians in stewarding and monitoring their territories.

Which all sounds good, except that there are questions about what ‘protection’ really means, and the potential impacts on Indigenous peoples. A December 8th article in The Narwhal reports that Trudeau revealed in an interview that “some resource extraction may be allowed in conserved areas.”

Presumably that is what prompted James Snider of World Wildlife Fund Canada, in the same article, to ask “what do we mean by protected and conserved areas?”, while Charlotte Dawe, of the Wilderness Committee, comments that she has  “stood in freshly logged ‘protected areas’ supposedly made for the conservation of wildlife”. That hardly equates to protection.

Moreover, the protection of nature must not come at the expense of Indigenous people, a point stressed by the International Indigenous Forum on Biodiversity as well as by three UN Special rapporteurs on human rights. Both groups are concerned that in the rush to protect nature, the human rights of Indigenous people may be violated. Indeed Indigenous people have been evicted or threatened with eviction from ‘protected’ areas, in the Democratic Republic of the Congo, Tanzania and Nepal.

So not only must reconciliation include the Earth, it must also – of course – include reconciliation with Indigenous Peoples in Canada and around the world.

© Trevor Hancock, 2022

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

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

The other COP – Biodiversity is fundamental to our health

Published as “In tackling biodiversity loss, it’s actions that matter, not words”

The degradation of nature and loss of biodiversity is a degradation of and loss to humanity, an existential threat to society, and indeed to humanity as a whole.

Dr. Trevor Hancock

6 December 2022

700 words

Speaking at the Stockholm+50 conference in June, UN Secretary General Antonio Guterres identified a “triple planetary crisis” – climate change, biodiversity loss and pollution.  The first of these – climate change –  was the subject of the UN’s 27th Climate Summit (COP27) in Sharm el Sheikh last month. The second – biodiversity loss – is the subject of the 15th Conference of the Parties to the Convention on Biological Diversity (COP15), which began in Montreal, this past week.

The web of life is absolutely fundamental to our health and wellbeing, indeed, to our very existence. The air we breathe, the water we drink, the food we eat, the materials and energy we use – they all come from nature. We are part of the web of life, and as the Duwamish elder, Chief Seattle, is recorded as saying more than 150 years ago, “whatever we do to the web of life, we do to ourselves”.

The degradation of nature and the loss of biodiversity – the loss of the other beings that are, as Indigenous people put it, ‘all our relations’ – is a degradation of and loss to humanity, an existential threat to society, and indeed to humanity as a whole. As an editorial in The Lancet Planetary Health journal put it, the global biodiversity crisis is “one of the great threats to planetary health.”

The scale of biodiversity loss is dramatic and unnerving, but is not as widely understood and has not generated as much public concern as it should. The 2020 report ‘Global Biodiversity Outlook 5’ (GBO-5) stated “Biodiversity is declining at an unprecedented rate, and the pressures driving this decline are intensifying.” Those pressures include economic growth, population growth, unsustainable resource extraction (forests, fisheries and the like) and an unsustainable high-meat diet.

The GBO-5 was also a report on the world’s progress in achieving the 20 Aichi Biodiversity Targets that were adopted in 2010. None were fully met, and only  6 were even partially met. So while the intention at COP15 is to agree to a new global biodiversity framework for the next decade, it will be actions, not words, that matter.

This loss of biodiversity is also seen in Canada and in B.C.  A joint report released this month by the federal, provincial and territorial governments finds Canada is home to about 80,000 species (not including bacteria or viruses). The report covers 50,534 species; however, there is only enough data available to provide an assessment for 24,483 species.

Of these, one in five are either critically imperiled, imperiled or vulnerable, while 128 species  – mainly plants and insects – are considered extirpated (likely disappeared from Canada, but still found elsewhere), while 7, not found elsewhere, are considered extinct globally.

One of the keys to biodiversity conservation is habitat protection. Canada is steward of the second-largest remaining areas of intact nature in the world, and in 2020 Canada pledged to protect 30 percent of our lands and waters by 2030. But at the time, Canada was only protecting 12 percent, and a 2022 release from Environment Canada reports “at the end of 2021, Canada had conserved 13.5 percent of its land area [and] 13.9 percent of its marine territory.”

Given that “expanding to 30 percent from 12 percent means adding an area roughly equivalent to Alberta, Saskatchewan and Manitoba combined”, according to UBC researcher Matthew Mitchell, it seem unlikely that target will be reached. And it is certainly not helped by the outrageous plans by the Ontario government to pave over large parts of Toronto’s green belt for housing, which will also worsen urban sprawl.

As to B.C., which a November report from the Wilderness Committee and Sierra Club BC notes is “home to the highest amount of biodiversity in Canada, but also home to the greatest number of species at risk”, their report finds “current federal and provincial legislation are not safeguarding biodiversity and species at risk.”

Most glaringly, of course, is John Horgan’s failure to keep his 2017 commitment to bring in a Species at Risk Act. For the sake of all of us, and all our relations, let’s hope Premier David Eby has more integrity and a greater commitment to protect and restore BC’s environment and biodiversity than his predecessor.

© Trevor Hancock, 2022

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

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