Adaptation measures have the potential to greatly reduce many of the potential health impacts of climate change.

Canadians escape many climate-related extremes by using a wide range of physical and social adaptation measures. Seasonal changes in our clothing and lifestyles, the design of our buildings and other structures, and behavioural, social and economic adaptations have allowed us to remain generally healthy and comfortable except under the most extreme weather and climate conditions. Nevertheless, the possibility that future climate changes will force Canadians to deal with conditions beyond the range of historical experience suggests that there will be new stresses on the health sector and that additional adaptation will be necessary.

To address population health risks resulting from climate change, a two-step process, in which the risks are managed in a systematic and comprehensive manner, has been recommended.⁽⁷⁹⁾ First, there is a need to assess the vulnerabilities and adaptive capacities of different regions, communities and population groups. The next step would involve identification and selection of the most appropriate response strategies. The linkage between climate change mitigation and adaptation actions is particularly strong in the health sector because of the health benefits derived from reducing greenhouse gas emissions. Assessments must take into account not only the possible impacts of climate change on the health sector, but also the capacity to adapt to those impacts. This process is well suited to being examined as part of an integrated risk-management framework.⁽⁷⁹⁾

Work has also already started on developing vaccines against several viruses and protozoa responsible for emerging infectious diseases prevalent in the tropics, including malaria and West Nile virus.^{(80, 81)} These new vaccines may help to limit the future spread of emerging viral diseases. Monitoring for emerging diseases, and public education programs that provide information on reducing the risk of exposure and transmission, will also serve to limit the threat of infectious diseases. For example, satellite measurements could be used to determine linkages between environmental conditions and the spread of some pathogen vectors.⁽⁸²⁾

As noted previously, health impacts related to an increased frequency of extreme climate events and climate-related natural disasters are a key area of concern. Although many Canadian municipalities have emergency management plans in place, their emergency management capacity tends to vary widely. Communities prone to weather-related hazards, such as avalanches, floods, heat or cold waves, or storm surges, should generally be better prepared to cope with increased frequencies of such extreme events than communities that have rarely experienced them, although other factors are also important. This is exemplified by contrasting emergency response to the 1997 Red River flood in Manitoba, where disaster plans proved effective, with the 1998 ice storm in eastern Ontario and Quebec, where emergency power supplies, food distribution systems and emergency shelter provision were insufficient to deal with the crisis.⁽²⁵⁾ Measures have since been taken to strengthen emergency preparedness and response capacity in the region affected by the ice storm.⁽⁸³⁾

In addition to emergency management, another key component of responding to extreme climate events is the implementation of early warning systems.⁽¹⁶⁾ Such a strategy has been successfully introduced in Toronto to help reduce the health impacts of extreme heat and cold (see Box 5). Other important adaptive measures to reduce the health risks of climate change include land use regulations, such as limiting floodplain development, and upgrading water and wastewater treatment facilities (see Water Resources chapter).

BOX 5: Reducing mortality from temperature extremes⁽⁸⁴⁾

Several Canadian cities are promoting longer-term measures aimed at reducing the heat-island effect. Summer temperatures in urban areas tend to reach higher extremes than surrounding rural areas, in part due to the prevalence of infrastructure and surfaces, which act to absorb, rather than reflect, incoming solar radiation. In a Toronto-based study, researchers recommended promotion of cost- effective measures, such as the large-scale use of light-coloured, reflective 'cool' surfaces for roofs and pavements, and the strategic placement of vegetation to provide shade.⁽⁸⁴⁾ These measures are being promoted as 'win-win' adaptation options, as they also serve to reduce energy usage.

Other researchers, however, note that adaptation measures may themselves entail some health and safety risks. For example, green spaces harbour animals, birds and biting insects or ticks, which may serve as reservoirs for infectious diseases such as Lyme disease⁽⁸⁵⁾ and the West Nile virus. Therefore, careful planning and testing of proposed adaptation measures, as well as health surveillance after the introduction of adaptation measures, may be needed.

Facilitating Adaptation

A study of the health infrastructure in the Toronto-Niagara region revealed several barriers to effective adaptation to climate variability and change.⁽²⁴⁾ These barriers stem from knowledge gaps, insufficient organization and coordination, and inadequate understanding and communication of climate change and health issues within the health community. If adaptation measures are to be successful, these barriers must be overcome (see Box 6).

BOX 6: Overcoming barriers to adaptation⁽²⁴⁾

Successful adaptation will also depend on Canadians becoming more aware of, and actively engaged in, preparing for the potential health impacts of climate change. Several nongovernmental organizations have begun to draw the attention of their members and the public to the causes and effects of climate change, and to the need for both mitigation and adaptation measures. Among these are the Canadian Public Health Association⁽⁸⁶⁾ and the Canadian Institute of Child Health, which published its assessment of the implications of climate change for the health of Canadian children.⁽⁶⁹⁾

Some key recommendations stemming from these initiatives include:

• increasing the capacity of the health sector to manage the risk to human health and well-being from climate change, particularly for the most vulnerable population groups, including children, the elderly, and disabled persons; and
• managing population health risks in a systematic and comprehensive manner, so that climate change is integrated into existing frameworks, rather than being addressed as a separate issue.