Loneliness is an emerging public health concern

Loneliness is an emerging public health concern

Dr. Trevor Hancock

14 August 2018

698 words

It is ironic in this internet age, when everything and everyone seems to be connected, that we seem to be increasingly disconnected and lonely; moreover, many more of us are living alone. The 2016 Census found that the proportion of one-person households has been increasing steadily since 1951 (when it was 7.4 percent) to 2016, when it became the most common type of household, at 28.2 percent; more than households of couples, either with or without children,

Now living alone is not the same thing as being lonely; at various times we probably all want to be alone, and some people like to be alone a lot. But while being alone can be a choice, that is very different from loneliness, which the Oxford Dictionaries define as “sadness because one has no friends or company”.  That kind of being alone is involuntary, and the key word in the definition is sadness, which is only a step or two away from depression. After all, humans are social animals, sowhile being lonely on occasion is part of being human,chronic social isolation and loneliness is problematic.

In a 2017 report on connection and engagement, the Vancouver Foundation found that “14% of residents say they feel lonely often or almost always” – which is one in seven people. But among people with a household income less than $20,000 more than one in three people are often or almost always lonely, while it is almost one in three of 18 – 24 year-olds and around one in four of those who are unemployed or are aged 25 – 34. Clearly, loneliness is an issue that affects the young and the poor, not just an issue among seniors, although it is often thought of that way.

Indeed the mental and physical health consequences of loneliness are an emerging public health concern; the UK actually appointed a ministerial lead on loneliness earlier this year. This was greeted with derision in some quarters, perhaps in part because of a failure to understand both the difference between loneliness and being alone and the severe health consequences of loneliness.

In his landmark book Loneliness: Human Nature and the Need for Social Connections,the late Dr. John Cacioppo, director of the University of Chicago’s Center for Cognitive and Social Neuroscience, described loneliness as ‘social pain’ and ‘a deeply disruptive hurt’ analogous to physical pain. He reported loneliness affects our immune system and our stress hormones, and can lead to suicidal thoughts and other mental and physical health problems.

Even more dramatically,he noted“social isolation has an impact on health comparable to the effect of high blood pressure, lack of exercise, obesity, or smoking”. In fact a 2015 review based on 70 studies from around the world found that on average those who reported they were lonely at the beginning of the study were 26 percent more likely to die – greater than the increased risk of death due to obesity overall, and comparable to the mortality risk for moderate and severe obesity.

If loneliness is largely a lack of social connection, then presumably the answer is to create social connections among those who are lonely or are at risk of being lonely. But it is not that easy, especially among those who are chronically lonely. Cacioppo makes the point that loneliness itself can “create a persistent, self-reinforcing loop of negative thoughts, sensations, and behaviours” that make it difficult to reach out or get out and make connections.

In a 2015 article in Perspectives on Psychological Science, Cacioppo’s team largely dismissed such seemingly common-sense approaches as providing social support, encouraging social engagement or teaching social skills, commenting “interpersonal contact or communication per se is not sufficient to address chronic loneliness in the general population”. Instead they suggested a combination of cognitive behavioural therapy and some hoped for medication in the future.

I find that completely unsatisfactory, not only because it would be individualized and very expensive, but because with such a large scale problem we need a population-wide public health approach, just as we do for smoking or obesity. Clearly we need to give a lot more thought to how we combat loneliness at a community level and strengthen social connections.

© Trevor Hancock, 2018

 

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Making homes truly healthy

Making homes truly healthy

Dr. Trevor Hancock

8 August 2018

703 words

Interestingly, we have two different words for the place in which we live – house and home. The Oxford English Dictionaries define the former as “A building for human habitation”and the latter as “The place where one lives permanently, especially as a member of a family or household”. That matches my own sense of the term: A house (or apartment) is a building, but when we add people it becomes a home, a social setting, not simply a physical space.

Curiously, we don’t make this distinction for other important buildings in our lives such as schools or workplaces; I am unaware of a different word for these or any other buildings that distinguish the physical building from that same building as a social space. Which suggests that the home is seen as something different, something special.

Last week I suggested we should aspire to more than housing that is not a threat to basic health; surely we want to create homes, places that improve our overall physical, mental and social wellbeing – and that do so without harming the natural environment. In the 1990s, Canada Mortgage and Housing Corporation suggested “a truly healthy house (is) one that is good for the people who live in it, good for the community and good for the earth”.

But we should be careful not to be too environmentally deterministic. We might be able to design and build clean, green, healthy and beautiful houses, but that does not mean the people or family that live there will be healthy; there are lots of unhealthy and unhappy people living or working in seemingly healthy buildings. Conversely, there can be happy and healthy people living in housing that is far from ideal – although meeting the basic needs I discussed last week is a vital prerequisite for good health.

Nonetheless, it is interesting to consider how the physical design of a house can improve mental wellbeing. Oddly, I cannot find much work from architects explicitly focused on the impacts of their design on the mental wellbeing of the inhabitants of houses. However, there is quite a bit about designing healthy workplaces, schools and hospitals, and much of that would carry over into designing healthy homes.

In an  article in the Winter 2016/17 edition of Sustainable Architecture & Building, a Canadian magazine, Kaitlyn Gillis and Michelle Biggar suggest that “architects and interior designers now face the challenge of embracing  . . . an approach that puts people at the centre of the process” of design. They describe several aspects of this approach in a workplace context, but with some obvious implications for designing domestic interiors.

In addition to discussing the importance of natural light and ‘biophilic design’, which is about “integrating nature and natural forms and processes into the built environment”, they discuss aesthetics and livability. While noting that the impact of aesthetics on health needs more research, they note that “the use of wood . . . can enhance user experience when left exposed to view”; others have noted the importance of colour in affecting our mood and behavior.

There is now an interesting evidence-based process to assess and certify buildingfeatures that “support and advance human health and wellness”. Launched in 2014, the WELL Building Standard, in its recently updated version, assesses 10 components of a building that are related to health and wellbeing: Air, water, nourishment, light, movement, thermal comfort, sound, materials, mind and community.

In the ‘mind’ component, the design requirement is for both direct and indirect access to nature, with the former focused on using plants, water, light and views and the latter involving the use of natural materials, patterns, colors or images. Both indoor and outdoor ‘restorative spaces’ – often involving nature – are also part of the mind standard, using access to spaces that allow for contemplation and relaxation; in our homes, that might be the bedroom or a living room or nook. Another standard, but one that would clearly overlap with this, is controlling both internal and external noise.

It is good to see that architects are turning their attention do these issues, now they must apply the lessons learned in workplace design to the places where we spend most of our time – our homes.

© Trevor Hancock, 2018

Healthy homes – The basics and beyond

Healthy homes – The basics and beyond

Dr. Trevor Hancock

30 July 2018

700 words

As I noted previously, in Canada we spend about 90 percent of our time indoors, and according to a 1996 study, 65 percent of our time is indoors at home and a further 10 percent indoors at school or work. Thus the environment of our buildings, and especially our homes, is enormously important for us. As Sir Winston Churchil remarked, “First we shape our buildings, then they shape us”.

So if we want healthy people, it would be a big help if we had healthy homes. Which raises the question – what is a healthy home? And an even more interesting question – how well are we doing at creating healthy homes? Let’s start with that first question.

There are some basic health functions a home needs to fulfil. In 1989 the World Health Organization (WHO) published a set of principles for healthy housing. It needs to protect us from the elements, keep us warm, dry and safe, and should keep out pests and noise. Also, it must not fall down or catch fire easily and must be well drained. It must have a proper water supply and provisions for sewage and solid waste removal, and “adequate provision for storing food, to protect it against spoilage and contamination”. Indoor air quality is also important (remember, 90 percent of the time we are breathing indoor, not outdoor air), as are issues of overcrowding. These and other basic safety and health functions are the reason we have building codes.

Here we might stop and reflect on the extent to which housing that meets these basic health needs is not the case in Canada today. As Bernie Pauly and Katrina Barber noted two weeks ago in these pages, we have signed several international covenants, such as the International Declaration on Human Rights, which enshrine the right to shelter. One would think such shelter would need to meet the WHO’s basic principles.

But those living on the streets or in tent cities do not have these basic amenities. Indeed, when the Medical Health Officer in Nanaimo recently used the Public Health Act to order the City of Nanaimo  to provide clean water and sanitation to the tent city there, he was initially and  deplorably met with outrage by some, including the Mayor, who called the idea ludicrous.

Indigenous people in Canada are another group that lacks many of these basic housing needs. Statistics Canada reported last year that the 2016 census found that “One in five Aboriginal people lived in a dwelling that was in need of major repairs”; for First Nations and Inuit people, it was one in four people.‘Major repairs’ meant the housing had “defective plumbing or electrical wiring, (or) needing structural repairs to walls, floors or ceilings”. The only good news was that the rate was down by 2 – 3.6 percentage points (depending on the group) since 2011.

These high rates among Indigenous people are the legacy of 150 years of Canadian government neglect and colonialist policies. For comparison, 6.5 percent of dwellings overall in Canada needed major repairs, a bit less among owners, a bit more among renters. The rates for BC are much the same and are about one percentage point less in all categories in the Victoria region.

At the very least, a country as wealthy as Canada must ensure that everyone’s basic housing needs are met, that we all live in safe and healthy homes. But surely we should aspire to more than having housing that is not a threat to basic health? What is a health-enhancing home, one that improves our overall physical, mental and social wellbeing?

There are several aspects to this question. First, what  – beyond the basics – makes a home physically healthy? What makes it mentally and socially healthy – the latter implying that a home does not stand alone, so how does it – and how do we – relate to other homes and people in our neighbourhood. And finally, given our concern for the state of the environment, how environmentally friendly are our homes – and how might they be better for the environment as well as for us?

Next week, I will  go deeper into some of the leading edge ideas for creating healthier homes.

© Trevor Hancock, 2018

 

Tools for healthier built environments

Two BC tools for healthier built environments

Dr. Trevor Hancock

24 July 2018

699 words

We are lucky in BC to have two useful initiatives to help us create healthier built environments. The first, which I described briefly last week, is the Healthy Built Environment Linkages Toolkit. The second is a BC Ministry of Health funded initiative, PlanH, which “facilitates local government learning, partnership development and planning for healthier communities”. I will describe them both here. (Full disclosure: PlanH was developed and is implemented on behalf of the Ministry by the non-profit BC Healthy Communities Society, of which I am Vice-Chair of the Board.)

For each of the five key elements of the built environment that the Toolkit considers – neighbourhood design, transportation networks, natural environments, food systems and housing –it provides a chart showing the impact on the built environment and the strongest research correlations found in evidence reviews. I briefly covered the first two elements last week, so here I want to examine the others.

For the natural environment element, the focus is on preserving and connecting environmentally sensitive areas, expanding natural elements across the landscape and maximising the opportunity for everyone to access these natural environments. By doing so, we can increase the tree canopy, reduce urban air pollution and create cooler urban areas. (For a great discussion of the health benefits of trees and urban forests see the book Planet Heart by Dr. Francois Reeves, an interventionist cardiologist in Montreal.)

Among the health benefits identified in the Toolkit for which there is strong evidence are reduced deaths from heart and urban heat events; improved mental health and social wellbeing; increased physical activity and improved respiratory health. Other benefits include reduced health care costs, energy savings, reduced pollution control costs and increased recreation and tourism.

Turning to food systems, the Toolkit focuses on increasing equitable access to affordable and healthy food options, protecting agricultural land, increasing the capacity of local food systems and supporting community-based food programs such as community gardens and community kitchens.

The health-related impacts of these approaches include improved diet quality and social wellbeing. Evidence suggests community kitchens, such as the Shelbourne Community Kitchen in Saanich, are particularly useful. This small NGO provides small-group cooking, pantry, and gardening programs which help participants from low-income families acquire food skills and learn to access nutritious food affordably, while at the same time building community.

Finally, the Toolkit looks at four approaches to creating healthy housing, particularly through prioritizing affordable quality housing options, especially for marginalised groups. The evidence supports the need for diverse housing forms and tenure types, located so as to avoid environmental hazards. There are multiple health benefits, including improved overall health and social wellbeing and reduced domestic abuse, crime and violence. (I will return to the topic of healthy housing in a future column.)

While the Toolkit provides evidence and is intended primarily for planners, PlanH is more concerned with how to bring the health implications of decisions to the attention of municipal governments and citizens to support “leading-edge practices for collaborative local action”. It focuses on three key interconnected themes: Healthy people, a healthy society and healthy environments.

In considering healthy people, PlanH emphasises that our health behaviours and choices are shaped by local social and environmental conditions; we need to create “vibrant places and spaces [that] cultivate belonging, inclusion, connectedness and engagement” in the context of “well-planned built environments and sustainable natural environments”.

To do so, PlanH helps local governments and their citizens learn about these issues and provides action guides and other practical resources and tools. It helps them connect and build relationships with community partners in other sectors (including regional health authorities) and with other local governments. And it helps them innovate with a funding program to support action, and by sharing success stories from around BC and beyond.

Together, these two initiatives give municipal governments, urban planners and citizens powerful support to help them make decisions that will improve the health and wellbeing of their citizens, which is surely one of their most important roles. So if you want healthier built environments in which to lead your life, raise a family and grow old, you may want to talk to your local government, community association and neighbours about the Toolkit and PlanH.

© Trevor Hancock, 2018

 

We can create healthy built environments

We can create healthy built environments

Dr. Trevor Hancock

17 July 2018

698 words

The BC Healthy Built Environment Alliance was established by the Provincial Health Services Authority in 2007 to provide leadership and action for healthier, more livable communities. The key purpose of the Alliance is to foster the partnership between urban planning and public health, which I wrote about last week. Members are drawn from the health, planning, NGO, municipal and academic sectors as well as from Ministries working in this area.

One of the problems with cross-disciplinary work such as this is that we all have our own language, so getting urban planners and public health professionals to understand each other and recognise each other’s skills and areas of focus and concern is key to taking joint action. Accordingly, one of the first things the Alliance did was to organise ‘Planning 101’ workshops for public health professionals, so they could develop a better understanding of urban planning. This was followed by ‘Health 201’, a guide, toolkit and self-assessment tool for the design professions.

Ongoing discussions both at the Alliance and through its network of members help keep this interaction and shared learning alive. This work is supported by the publication of case studies and best practices that highlight good examples across Canada of public health and urban planning collaborating alongside municipalities and communities to create healthier built environments.

But one of the most important things the Alliance has done has been to create a Healthy Built Environment Linkages Toolkit that makes clear the links between design, planning and health. While it is designed primarily for public health professionals, its clear, simple design and graphics means it can be used by anyone – including the development industry and the general public – who is interested in creating healthier built environments (and it’s easy to find – just Google the title).

The Toolkit is intended to provide all the participants in the planning process with evidence of the health implications of different aspects of planning and design. Its earlier version has been used by healthy built environment specialists in health authorities – yes, there are such beasts in some health authorities – and other public health staff to work with local municipalities on official plans, helping them to consider the health impacts and benefits of their policies and planning decisions.

But there is no reason why the Toolkit could not be used by community associations and other citizen groups to argue for better, more health-conscious planning decisions in their own neighbourhoods, or by private sector planners and developers to create healthier communities that would be more attractive to potential purchasers.

The Toolkit examines five key elements of the built environment that affect our health: Neighbourhood design, transportation networks, natural environments, food systems and housing. For each of them, the Toolkit provides evidence of the key health benefits that can result from applying the principles and measures that are included. So what are some of the key features of healthy built environments?

The Toolkit states that “healthy neighbourhood design is facilitated by land use decisions which prioritize complete, compact and connected communities”. By ‘complete’ they mean having a mix of residential, commercial, institutional and workplace sites so you can live, learn, work, shop and play largely in your own community. These mixed-use neighbourhoods are also more compact, which makes it easier to meet the need for transportation networks that prioritize and support active transportation such as walking, biking and public transit. In fact, neighbourhood design and transportation – and indeed all the key components of healthy design – are complementary and often positively reinforce each other.

We can also achieve significant health and well-being impacts, the Toolkit states, by preserving and connecting the surrounding natural environment; ensuring the “accessibility and affordability of healthy foods”, which – interestingly – “can be supported through land use planning and design”, and developing quality, affordable housing options for everyone, especially including marginalised people.

Interestingly, many of these are also features of sustainable community design, reinforcing the general principle that if we design for people and the planet, we are likely to build better communities – more pleasant, atttractive and livable as well as healthier and more sustainable.

Next week, I will delve in more detail into some of the key characteristics of healthy community design.

© Trevor Hancock, 2018

 

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

 

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