Color & Control:

Why is climate change an ageing issue 

A Q&A with Dr. Samantha Green, President-Elect of the Canadian Association of Physicians for the Environment

Q) To start with, can you give us a brief recap of what the changing climate will mean for conditions here in Canada?

A) So right now we’re sitting at about 1.2 degrees of warming above pre-industrial levels, and in the coming decades we will hit 1.5 degrees, and at current rates it’s projected that we’ll actually hit more than 3 degrees of warming by the end of the century. Here in Canada, we’re warming at twice the global rate. What that means is we’re going to be seeing more erratic weather, more extreme weather events, including extreme heat. We’ll also see an increase in wildfires. We’ll see more flooding, more drought, an increase in hurricanes.  

And then there are also changing infectious disease patterns. So, for example, Lyme disease has been creeping northward. And climate change is also a driver for pandemics—as the climate warms, we will see a destruction in biodiversity, and we’ll see humans and animal vectors coming closer together. So likely we’ll see future pandemics related to the changing climate. 

We’ll also see changes in food security as a result of global drought and flooding, and we’ll see migration. And that’ll be global migration, but also within Canada—there may be communities who will be forced to relocate, especially Indigenous communities.

Q) When you speak about some of these issues, especially around heat and extreme climate, what are the risks of those changes to older adults?

A) In southern Ontario, the lower mainland of British Columbia and many other communities along the U.S. border, we expect a doubling to tripling of extreme heat days in the coming decades. As we get older, our body’s ability to regulate temperature changes, and we’re less able to cope with extremes in temperature. That’s also true of people with chronic conditions, and older adults are more likely to experience chronic conditions, like respiratory conditions, cardiovascular disease, diabetes. 

People who take certain medications are also at increased risk, and older adults are more likely to take medications. Antidepressants, blood pressure pills, allergy medications, anti-psychotic medications—those all interfere with the body’s ability to regulate temperature and put people more at risk of heat exhaustion and heat stroke. Heat can also exacerbate those chronic diseases. So we’re more likely to see, say, a heart attack during an extreme heat event because the heat can exacerbate underlying heart disease. 

When our body is less able to cope with changes in temperature, we’re more vulnerable to heat-related illness, like heat exhaustion and heat stroke. And heat stroke is deadly—the mortality rate from a true case of heat stroke is about 50 per cent, and we know that older adults are more vulnerable to that. In the B.C. heat dome event of 2021, about 600 people died, and the vast majority of those were over age 70, isolated seniors. Lack of air conditioning, lack of green space—neighbourhoods that had less tree cover had more people die, because those indoor spaces get really hot without adequate tree cover.

Q) What about in terms of climate-related natural disasters?

A) People who are older are just more vulnerable because often they’re more isolated. People may also have difficulty ambulating, or leaving a place that’s unsafe, and are more likely to suffer from conditions that put them more at risk. So people with asthma, with heart disease, with diabetes are more at risk of those conditions becoming exacerbated when they’re exposed to wildfire smoke, for example. 

Hurricanes and floods can also limit someone’s ability to even access health care. We saw that with the example of Merritt, B.C., also in 2021. All roads leading into the community flooded and that meant that people living there were cut off from accessing health services, and many people ran out of medications.

Q) Are there differences in how this would affect people at different socioeconomic levels?

A) Yes. People who are living in poverty are among those who are most at risk of climate-related illness, especially heat-related illness. People who are living in poverty may have less access to air conditioning, and also tend to live in communities that have less tree cover or less green space. And we know that places without adequate tree cover experience the “urban heat island” effect. It can be up to 12 degrees hotter than surrounding areas that have adequate green space. So, yeah, racialized communities, people living in poverty are much more at risk. So are people experiencing homelessness—and we’re actually seeing a growing population of older adults experiencing homelessness—who are directly exposed to the heat, to the storms, to wildfire smoke.

There is also a risk to many people living in long-term care facilities and unregulated retirement homes. Many long-term care facilities in Ontario still do not have air conditioning. So people living in these spaces may not have control over the cooling systems that they have access to. 

Q) From a policy perspective, are there things that we should be doing to help prevent some of these issues?

A) Yes, of course. First off, it’s not too late to mitigate climate disaster. We need to stop extracting and burning fossil fuels—that’s number one, and the latest Intergovernmental Panel on Climate Change synthesis report is very clear about that. That means no more extraction. We need to very quickly transition our economy away from burning fossil fuels.

And there’s also a lot that can be done to improve our resilience. I think there are a few things that can protect, especially more vulnerable older adults who are living in poverty. For example, currently, most communities have a minimum temperature bylaw—so tenants have a right to live in an apartment that is above a certain temperature. We also need maximum temperature bylaws. There doesn’t necessarily need to be air conditioning if the space is naturally cool. And, in fact, that’s what we need to be building—buildings that are naturally cool. But having a maximum temperature bylaw, I think, could really protect vulnerable residents, especially in tower communities, who don’t have access to air conditioning. 

And then, partnering with local community agencies that really know where those vulnerable, isolated seniors are. For example, there’s been a program in France—after there was a really deadly heat wave in 2003, they instituted a program with their postal workers to have them keep track of seniors who are isolated. 

And an increase in green space—it’s just such a good solution. It will directly cool the environment. Access to nature improves well-being, so seeing more trees is good for everyone. And at the same time, it’s directly sinking carbon into the ground. So planting trees is actually a great intervention for us, especially if you can target it to marginalized communities and racialized communities that we know don’t have enough green space.

Q) Is there anything else that individuals should be doing?

A) We need to be prepared for an increase in climate-related disasters, including extreme heat. So think about your neighbours, your family, your wider community, and really think about who is at risk and think about reaching out to them during an extreme weather event and seeing whether they’re OK. And let your politicians know that climate change is the biggest threat to health we face, and we need to immediately transition our lives away from fossil fuels while protecting the vulnerable.

Dr. Samantha Green is a family physician at Unity Health Toronto, Assistant Professor In the University of Toronto’s Department of Family & Community Medicine, and president-elect of the Canadian Association of Physicians for the Environment. 

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