Healthy Planet, Healthy People | Courtney Howard | TEDxMontrealWomen

Healthy Planet, Healthy People  | Courtney Howard | TEDxMontrealWomen

[Applause] I'm an emergency physician I live in Yellowknife in Canada's Northwest Territories I spend about half of my time in the emerg and about half of my time working on the world's biggest health emergency climate change it's easy to stay motivated we're kind of melting in Yellowknife scenes every summer we get new dips in the roads that the permafrost kind of melts down and then you hit the money wait at the hospital you're like whoa and does wake you up which is good I came north as a newly minted emerg doc and I hadn't thought about climate change in the environment since I was in about grade five and then one day I was in the Edmonton Airport and I picked up a book and I was like okay why should I learn something about this read it as we went through Yellowknife and up to Inuvik and by the time I got to Inuvik I was like oh my god thing badness so like any good emergency physician I consulted dr. Google and it turned out that six months earlier The Lancet the world's most prestigious medical journal had called climate change the biggest global health threat of the 21st century I was like I just finished emergency school thing is bad how do you miss the biggest problem anyhow I started asking around a new Vic and it turned out it's already three degrees Celsius warmer than it was at baseline in the 1950s just according to the temperature gauge records from the airport now three degrees Celsius is a big deal when you're talking about the difference between solid water and liquid water I took this picture on a flight between Inuvik and a little nursing station in Aklavik this is the Mackenzie River when it freezes it becomes a highway for people it's how they cheaply transport groceries and building supplies it's how they visit their friends and family it's also a road for the caribou which is a traditional food and very significant protein source for the Aboriginal communities who live here so you can imagine when the ice gets more sketchy it makes for decreased safety of ice base travel dropping caribou herds less successful hunts and less food for people to share with their families the rapid landscape change also can lead to a feeling called solastalgia which means feeling homesick when you're still at home so those are a little bit of how climate change is impacting health where I live how is it impacting health in the rest of the world this slide was drawn from a 2012 McMichael it al report in the British Medical Journal it has a little bit of what's 2015 and 2017 from the Lancet and a tiny bit of Sam Meyers thrown in so climate change is going to lead to immediate and direct risks to health indirect risks and risks associated with climate conflict and environmental refugee flows the immediate risk those are the things we see on the news right now so heat waves make it tough to cope and to work can lead to heat stress heat stroke deaths droughts decreases access to water can make wildfires more likely which have been horrible in Canada in the u.s. in the last few years leading to burns deaths evacuations sending big clouds of smoke up that can travel for hundreds of kilometres and lead to asthma exacerbations and breathing problems now we've seen storms down in Puerto Rico and Florida they can lead to injuries death pollute water sources and any of these tragedies can lead to post-traumatic stress disorder or anxiety now we haven't even talked about the critters that can bite us and make us itchy and make us sick and sometimes kill us vector borne disease is changing Lyme disease is moving across Canada and dengue fever is increasing worldwide now more intense pollen seasons make it tough for people with allergies and increasing temperatures result in increased conversion of ground-level ozone into air pollution that makes it tough for us and we can get cancer from that heart disease stroke lower respiratory disease now much of this is being driven by increasing co2 levels mostly from the burning of fossil fuels and as co2 goes up in the air it actually also seeps into water bodies underneath and when it's in the water it acts like an acid so that's no good for the fish and it's also no good for the people who rely on fish for protein and that's about a billion people worldwide now all the weird weather does weird things to crop yields and undernutrition is actually expected to be the major health consequence of climate change in the 21st century it's already associated with almost half of pediatric deaths worldwide now the impact of malnutrition was made very real to me when I spent six months working on a pediatric malnutrition project with medicine sulfonyl TL Doctors Without Borders in the Horn of Africa in a slum in a tent ICU before going I had never had a child die under my care the first time it happened I wanted to disappear through the crust of the earth could I have been faster could I have done something differently I swore in front of all my staff in English and I hope they didn't understand and then I got back to work because I still had 50 other kids to see the most humbling thing was that almost every time the mom after the child died would come and take my hand and she would say thank you thank you for caring for my child can you imagine having a mother thank you after their child has just died under your care during one of those moments I had a white-hot full-body wave of rage that children died of malnutrition at all and I said to myself that when I got back to Canada I would do everything I could to prevent further similar deaths and it turns out that means working on climate change so you can imagine if your kid didn't have any food you'd go almost anywhere to find them food so that means you might leave your home go to someone else's home and they might not like it that you came population displacement can lead to conflict this is one of the problems that were worried about as we get warmer so there's information and studies coming out of Syria already that show that a five-year long climate related drought and famine led to population displacement which meant that when the spark of the Arab Spring arrived there was already an unstable population just one factor contributing to the conflict now the thought has been that to avoid the worst health impacts the climate change we need to keep global surface temperature warming to below two degrees Celsius aim for one-and-a-half unfortunately our emissions trajectory currently has us heading to between two point six to four point eight degrees Celsius now because of these kinds of factors those temperatures are expected to leave the badness increase sea level rise stress displacement potentially culminating and systemic and economic collapse you guys are so glad you came here today so you know four degrees Celsius is not considered consistent with global organized civilization now in a fact this is a difficult diagnosis for all of us when you think about if somebody gets a diagnosis of cancer when I'm in the emerge and I see something in a chest x-ray and I have to say hey I saw something worrisome you know we need to come up with a treatment plan nobody likes to hear that it doesn't make them happy some people have lots of questions they want to know everything some people get really quiet some people kind of want to avoid the issue we all have different reactions and what I think is important is that we start to develop insight into our emotional reactions to the diagnosis of climate change because then we can work on becoming as centered as we can and that's gonna help our judgment and our action going forwards I've been here I have been there around my six month old now it's important to remember that it could be worse right you could have a raging urinary tract infection a horrible dental pain you know it's important every day to try to do things that are helpful to you you know whether that's spending time with friends and family time outside time without your phone you may need to access mental health services to get you out of that really stressed out place but what I'd like people to know is that it's possible and the most interesting thing to me has been that action feels better than anxiety I don't worry anymore I just do the work so we're at a point of transition what is the best-case treatment scenario for us right now we're pretty lucky because we've come up with a lot of the technology we need at the right prices right at the right time because renewables are dropping in price we're often told to do things like change our lightbulbs hang to dry avoid too much plane travel but basically that's not enough we need to change the system so it's just easier and to live in a low-carbon way than a high carbon way my friend Nick Watts was producing a giant climate change in Health Report for The Lancet with a multidisciplinary team of doctors engineers ecologists economists financial planners urban planners and when they looked at it all it turns out that they concluded that achieving a decarbonized global economy and securing the public health benefits that it offers is no longer primarily a technical or an economic question it's just a matter of getting it done so what do we do what I learned in Djibouti is that if you work quickly if you do the right thing quickly in a timely way sometimes you can pull someone out of a near death spiral and come in the next day and instead of having a little-person kind of all won in their mom's arms you've got a little sprite sitting up and reaching for your stethoscope what if planets are the same way what if we step up as a generation and we're able to say to our kids look we moved we pulled this thing out of the spiral is not perfect but we could cope with what we've got now who leads this is a slide of who people trust now if you'll notice the politicians are at the very bottom so how about will you not leave the whole saving the world thing all up to them nurses are at the top that is very promising doctors are second you may notice hairdressers do pretty well in fact man and woman on the street do well way better than ministers so we all have pull and we need to use it I decided to start with the doctors I want you to Canadian physicians to send a really clear message that climate change is an urgent health threat and that a low-carbon transition is needed as treatment it took us five years but the Northwest Territories Medical Association and I got the Canadian Medical Association to divest from fossil fuels and invest in renewable energy this transition is happening the 2017 Lancet countdown report showed that in 2016 there are more people employed a renewable energy worldwide than there are in fossil fuel extraction and Canadian Physicians think it's really important that we anticipate where we're going see whose livelihoods are going to be impacted and proactively retrain and help them resettle so that this is a just transition now this is happening worldwide to the point that a new discipline is emerging called planetary health and we're looking for places where we can have a big impact on both the health of people and the planet one of the biggest places isn't supporting women to have education and access the family planning that they tell us that they want it turns out that this reduces their vulnerability to natural disasters improves the yields on their farms reducing potential for malnutrition and makes for smaller and healthier families and in in addition to all of that goodness it also is one of the cheapest ways of decreasing carbon emissions because a smaller family for Humanity means less carbon emitters and less carbon emissions now I've had 25 years of education and 20 years on contraceptives and I have no clue what my life would be like without that incredibly though given all of this goodness there's still a giant funding gap we need to fund this another place where we can really improve health by climate action is in improving healthy energy so these are the top five ways you could die in Canada of chronic disease there's another way also that's in the top five it's some accidents stats in the US are very similar so how do we decrease these and improve health for the climate the biggest target is to make a whole bunch of healthy energy and phase out coal coal is responsible for 44% of global co2 emissions and almost a million air pollution related deaths every single year one of the best case studies is here in Canada in Ontario a group of health professionals convinced the Ontario government to phase out coal and we've seen a 30 Megaton per year reduction in greenhouse gas emissions and hundreds less deaths or hundreds less emergency visits for a spire Tory related disease so we make clean energy the additional benefit is we don't have to extract coal and we don't have to frack for natural gas both of which put our water resources at risk we can't afford to screw up our water in our climate at the same time so that's the first step in decreasing area nations enough to stay below 2 degrees Celsius the other two things we really need to think about in the next couple decades are maximizing energy efficiency and electrifying end-uses like heating and transport so in this low-carbon world they'll be getting around in electric cars and trains and vehicles and also on our own two feet because it turns out the commuting on foot or by bike actually reduces your chances of dying of heart disease as well as exercise decreases anxiety and depression and greenhouse gas emissions and all of the prices associated with dealing with all of those hospital visits for the chronic diseases so this is a huge opportunity cycling additionally reduces all-cause mortality as well as our chance of dying from cancer now if we fuel these commutes with a plant rich low-carbon diet will be even healthier this reduces cardiovascular disease risk your risk of getting colorectal cancer and diabetes as well as having a 20 to 30 percent reduction in your footprint associated with carbon emissions land use and water this is huge we need to make sure that we welcome our newcomers because we will have refugees coming to our shores and we need to be good at treating them well so these win wins for health and the planet are why The Lancet says that tackling climate change is the biggest health opportunity of our time of the 20th century I don't know about you but I like working where the opportunities are working on this I've met so many cool people who have taught me so many amazing things you'd be amazed what can be accomplished and a potluck or recurring teleconferences now I am lucky to live in a majority of Rober gional territory and it shown me what's possible when an entire culture takes planetary health into account when my daughter brought home her first report card last year the categories were communication skills literacy numeracy connection to the land if kindergarten can start to take planetary health into account I'm sure the rest of us can too now I still love being an emergency doctor every once in a while I get a chance to save a life working on planetary health though we all have a chance to help the earth state us thank you [Applause]


  1. Excellent. Climate change is not simply an environmental threat – it's a threat to health, well-being, and all that makes life worth living

  2. Nurses know and responsible for so little that it's hard to lie. Politicians know even less but they lie to cling to power. This chart is irrelevant to climate actions. And maybe we have enough scientific facts and technology to save Earth, it won't happen in the current economy that must be replaced with the computer model of resources balance.

  3. Amazing. It's important that not only those who are working in the environmental field talk about climate change. Thank you for having highlighted it is a health problem too.

  4. Courtney! Beautiful presentation. The personal story is so impactful . . The only addition I would make is including the 2015 Lancet statement: “The single most powerful strategic instrument to inoculate human health against the risks of climate change would be for governments to introduce strong and sustained carbon pricing, in ways pledged to strengthen over time until the problem is brought under control.” (2015 Lancet Commission on Climate and Health pg. 45). Please consider joining the Citizens' Climate Lobby ( Health Action Team as we work to get a price on carbon!

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