by Three years ago, I was offered an opportunity to focus on integrating climate change adaptation into two of BC’s largest health authorities. Fraser Health and Vancouver Coastal Health (VCH) had just received three years of funding from Health Canada to determine how these massive organizations could increase their own climate resilience, while contributing to similar efforts in the communities they serve.
To say the learning curve was steep would be an understatement. While I had been working in the climate adaptation sphere for a number of years, I entered this role with no previous experience in the health sector, and with only limited experience as a so-called practitioner. The field was so new that there was little guidance on how to approach such a project. Would it focus on protecting health in our communities using conventional frameworks for public and population health? Would it concentrate on the health system and maintaining service delivery?
Answering these questions took nearly two years and resulted in a Climate Change and Health Vulnerability Assessment, and a Climate Change and Health Adaptation Framework. What began as a funded position serving two health authorities has since turned into a full-time role with VCH, and I have been honoured to watch our team increase in both its size and impact (see video and website). I learned many valuable lessons throughout this time, some of which I’ll share below.
Overall, working in this sector really brought home that climate change is a wicked problem that requires creativity, collaboration, and strategic thinking alongside a commitment to equity and cultural humility. As a public health team within a large organization, it has been challenging to know how best to build strong relationships with partners like city governments and neighbourhood NGOs. Ten years ago it would have been almost unheard of for Canadian health authorities and local governments to be working together to manage climate risks, so many of these relationships had to be built from the ground up. Now, thanks to leadership and goodwill from multiple sectors, we see an adaptation landscape that is both collaborative and constantly maturing.
Second, the extreme weather events of 2021 in BC highlighted our susceptibility to heat, wildfires, flooding, and storms, and our resource insecurity across the province, all of which resulted in death and displacement. But these events also created an opportunity for the climate change and health adaptation field to create and improve approaches to governance, and to refine the roles and responsibilities of the multitude of actors in this space. There is more clarity now than there was two years ago. More people know what they are supposed to be doing, and there are more of them doing it.
For example, the 2021 “heat dome” was an event that caused unprecedented health impacts in communities across BC, including many deaths. However, it also led to the refinement of a provincial heat alert response system, informed by a committee that included leaders from the health and emergency management sectors. This system created a venue for the real-time coordination that will be essential in managing another heat emergency and would likely not be as advanced were it not for the extremely impactful heat in 2021.
Of course, the response is never perfect. But practitioners cannot let the perfect be the enemy of the good, especially in the context of a climate emergency. We need to broaden and hasten the impact of our work, which includes, for example, better considering the lived experience of various groups during extreme weather events. In times of uncertainty, it’s been helpful to have a guiding mission or touchstone that we and our partners can refer back to.
Ultimately, it’s been the focus on implementation generally, and the importance of the work specifically, that has been most exciting after over two years of learning and assessing. This experience has taught me that the transition from planning to implementation is essential and should be made as quickly as possible, but no sooner. The need to equitably implement projects should also remain top of mind, and practitioners need to find a way for equity concerns and commitments to inspire but not paralyze. A spirit of openness and continual striving and relying of our strengths has been essential for our team at VCH. Our journey to better understand the climate change and health equity space started with a single project, as many do, but has grown into a team that carefully considers who is involved in decision-making, and who benefits most from our projects and programs. Watching the climate change and health adaptation field in BC mature over the last three years has been heartening. It has also been instructive as a change-maker and instructor to be embedded in this process, to see such an immediate impact of my work, and to be inspired by a growing cadre of amazing colleagues.
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