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Technical Case Study from Health Canada

Approach:

  • The Climate Change and Health Adaptation Capacity Building Porgram (HealthADAPT) in Canada is an example of a national capacity building intervention for health
  • The overall approach to implement such a program includes:
    • Developing a tailored approach to address regional and local needs
    • Engaging stakeholders and local communities
    • Networking to facilitate shared learning
    • Integrating health equity considerations
    • Securing foundational resources and data for informed decision-making at regional and local levels across the country 

1. Why take action?

Canada is a geographically diverse country, with provinces and territories experiencing different climate change risks and impacts. In the western province of British Columbia, wildfires have become more frequent and intense due to warmer and drier conditions, leading to poorer air quality, and increased respiratory problems in residents. In the Prairies, in the middle of the country, droughts and heatwaves are threatening agriculture and livestock, affecting the livelihood of farmers and ranchers. In the North, above 60 degrees latitude, melting permafrost and changing weather patterns are causing infrastructure damage and loss of traditional foods, which can lead to food insecurity and impact the physical and mental health of Indigenous communities. Changing weather patterns and warmer temperatures associated with climate change are also creating conditions that are more favorable to the transmission of vector-borne diseases, including the spread of ticks that carry Lyme disease. These conditions are also fueling the occurrence of deadly heat waves which put immense strain on local healthcare systems. The escalating impacts of climate change on public health underscore the critical need for adaptive measures to reduce vulnerability to climate hazards. 

Implementing targeted capacity building and support programs is crucial: such programs can ensure that building resilience to climate change will adequately consider the unique challenges faced by different regions. Using this approach, the HealthADAPT program in Canada has aimed to increase the capacity of the health sector to anticipate, prepare for, and respond to the impacts of climate change on human health. 

The pilot program (2018-2022) provided technical and financial support to 10 health authorities across Canada at local, regional, and provincial and territorial scales. The goals of the HealthADAPT program are to: 

  • Increase the understanding of climate change impacts on health systems and the health of Canadians; 

  • Identify communities or people who are more at risk of experiencing negative health effects of climate change; 

  • Support the developing, testing, and carrying out of local and regional climate change and health adaptation plans with partners; 

  • Monitor and evaluate the effectiveness of climate change health adaptation plans. 

 

Despite some projects encountering delays due to the global COVID-19 pandemic, the program nonetheless yielded invaluable insights into discerning, supporting, and addressing the unique adaptation needs of diverse communities. The program has not only expanded the capacity of regional authorities, but has also acted as a catalyst for increasing the understanding and implementation of elements that contribute to building climate resilience and adaptation in the health sector. The work initiated in the pilot program can serve as a blueprint for capacity building on climate resilience in other health authorities nation-wide and globally.  

 

KEY MESSAGES:

  • National-level capacity building and adaptation programs play a crucial role in enhancing climate resilience within the health sector and can support countries in responding to various climate and health challenges. 

  • The HealthADAPT program in Canada is an example of a national capacity building intervention that can support climate adaptation in health systems and communities across the country.  

  • The program has allowed to equipped health authorities across the country with the necessary tools and guidance to address the health challenges posed by a changing climate. Key outcomes of the pilot program include: 

    • Enhanced understanding of regional vulnerabilities to climate change. 

    • Reduced Bridging regional disparities by addressing local climate risks and population health needs.  

    • Enhanced community engagement in climate adaptation for health. 

    • Strengthened stakeholder collaboration and information sharing on climate adaptation for health.  

    • Shared learning and continuous improvement of climate change and health adaptation work by health authorities at all levels. 

 

2. How to get started  

Capacity development is one of the first steps that national health authorities can take to start working towards a climate resilient health system. The experience of the HealthADAPT pilot program in Canada has allowed to identify key learnings that can be helpful for national health authorities to consider when developing and implementing a national capacity building program on climate change adaptation.  

 

2.1. Key learning: Building on existing frameworks and evidence 

The HealthADAPT program approach is based on the US CDC Building Resilience Against Climate Effects (BRACE) Framework. The program has also been informed by the 2008 and 2014 national health assessments in Canada; a 2016 Health Canada stakeholder workshop to discuss the development of a pan-Canadian climate change and health surveillance system; local-level assessments such as an assessment done in London-Middlesex; as well as the WHO 2013 V&A assessment guidance. The development of the program thereby focused on the importance of V&As towards developing targeted strategies to adapt and build resilience through evidence-based planning and prioritizing actions to address the most pressing challenges posed by climate change.  

 

2.2. Key learning: Building regional and local capacity  

Building local capacity is essential to ensuring the sustainability of V&A efforts. This can include training of staff on areas such as V&A methodologies, stakeholder engagement, and data analysis. Funding recipients in the pilot program affirmed that the V&A assessment process contributed to a deeper understanding of health equity, climate change, and the impacts of climate change on community health, promoting the need for sustained efforts and local capacity building to navigate these complex dynamics successfully. In the context of Canada’s diverse geographical and social contexts, the project-based support provided by HealthADAPT allowed health authorities to develop targeted climate and health adaptation interventions to address localized climate risks and population health needs.   

 

2.3. Key learning: Providing a framework for assessing vulnerability to climate change 

As part of its capacity building work, Health Canada published the Climate change and health vulnerability and adaptation assessments: Workbook for the Canadian health sector to guide health authorities in assessing vulnerabilities and adapting to the health impacts of climate change.  This Workbook provides step-by-step information on how to conduct a climate change and health vulnerability and adaptation (V&A) assessment, through detailing six steps of the assessment process. This Workbook is intended for use by health officials to develop vulnerability assessments and adaptation plans through participatory processes that engage partners from multiple sectors and organizations. The six steps outlined in the workbook are:  

  1. Frame and scope the assessment;  
  2. Describe current risks, vulnerabilities, and capacities;  
  3. Project future health risks;  
  4. Identify and prioritize policies and programs to increase climate-resilience of health systems;  
  5. Establish an iterative process for managing and monitoring health risks; and  
  6. Examine the potential health co-benefits and co-harms of adaptation and greenhouse gas mitigation options implemented in other sectors.  
Source : Institut national de santé publique du Québec

This framework for V&A assessments has helped many health authorities across Canada identify key vulnerabilities that exist within their health regions and develop strategies to adapt to them. The framework accounted for a range of factors, including climate projections, demographic data, and health outcomes, to assess vulnerability and provide targeted recommendations for adaptation strategies.  

 

2.4. Key learning: Engaging stakeholders and local communities 

Engaging with stakeholders such as local communities, academic institutions, and government agencies is critical to ensure their knowledge, concerns, and needs are reflected throughout the climate change vulnerability assessment process and in adaptation planning. At the community level, engagement can increase local awareness and preparedness for climate change risks and ownership to adaptation efforts, but it can also be difficult to engage, or initiate engagement, with at-risk populations and communities. Throughout the Health ADAPT pilot program, funding recipients were encouraged to engage with targeted stakeholders at many stages, including to outline the potential scope of their projects and V&As. The 10 health authorities funded through the HealthADAPT pilot program reported an increase in community engagement during the V&A process, particularly in the planning and implementation stages of adaptation strategies.  HealthADAPT funding recipients made use of numerous strategies to engage communities, including utilizing external consultants who were members of the at-risk communities, or had close working relationships with such communities; engaging with community leaders, and working through a more community-based, participatory research model. Many funding recipients found that building strong relationships and partnerships, both internally and externally, played a vital role in the success and implementation of their projects. However, it should be noted that all communities are diverse, and there is no one-size-fits-all strategy to engagement. 

Source : Institut national de santé publique du Québec
Source : Institut national de santé publique du Québec

2.5. Key learning: Enabling knowledge sharing and collaboration

Knowledge sharing can help identify vulnerabilities and risks faced by different communities, sectors, and regions. Knowledge sharing builds partnerships between different stakeholders and supports the development of stronger and more effective adaptation options. Many funding recipients underscored the value of synthesizing and sharing knowledge through resources, tools, and information related to climate change and health. The HealthADAPT pilot program included several knowledge sharing and translation actions. These enabled a broader engagement in climate change and health adaptation initiatives and encouraged a wider uptake of adaptation activities. For instance, outcomes and lessons from the program led to the development of several communication products, including the Digital Case Stories, which were created to showcase the HealthADAPT projects for the 10 funded health authorities.   

The HealthADAPT program also facilitated collaboration and information sharing through its Community of Practice (CoP), a national network where health authorities across Canada can access and share resources, tools, and best practices on climate change and health. The CoP connects experts from different sectors and disciplines to share their knowledge and expertise and continues to provide health authorities and other health partners opportunities to engage in ongoing dialogue and exchange of ideas. Throughout the pilot program, recurring meetings among the CoP served as a platform for members to discuss ongoing challenges, exchange helpful practices, and share solutions with fellow CoP members and the program team to strengthen climate adaptation efforts across the country. The ongoing exchange of resources and tools within the CoP remains valuable for regional health authorities, even with the culmination of the pilot program. 

Credits: Sabrine Dinia, Climate Change and Innovation Bureau

2.6. Key learning: Supporting a multi-disciplinary approach 

It is critical to take a multi-disciplinary approach when conducting V&As, which considers the various linkages of climate change and adaptation planning across diverse fields. During the pilot program, recruiting a multidisciplinary team with expertise in areas such as climate science, epidemiology, statistical analysis, public health, and stakeholder communications and engagement, enhanced team capacity in addressing climate change and health issues by encouraging a multidimensional approach. 

 

2.7. Key learning: Developing access to local data and information 

The availability of reliable data and information on climate change and health impacts and underlying vulnerabilities is essential. It is important that the data and information used in the assessment is as reliable, up-to-date, and relevant to the local context as possible. During the pilot program, some funding recipients noted limitations in accessing local-level data for V&As, emphasizing the need for more developed data and tools, particularly tailored to different regional settings and environments.  

 

2.8. Key learning: Integrating health equity considerations 

During the pilot program, funding recipients identified how community-based and participatory research and engagement helped ensure that health equity considerations inform climate and health adaptation planning and decision-making. This illustrates the need to ensure that the assessment process and adaptation strategies meaningfully incorporate health equity considerations, namely the differential climate change and health impacts on at-risk and marginalized populations, such as low-income communities, Indigenous populations, and people with chronic health conditions. A targeted and equity-based approach allowed the pilot Health ADAPT program to successfully build capacity across diverse areas, extending support to Indigenous communities, and addressing the unique needs of urban, rural, remote, and coastal areas. 

 

3. Tracking progress  

The first iteration of the HealthADAPT program supported 10 partners across Canada to address climate-driven health risks unique to their jurisdiction. Funding recipients represented Canada’s diversity, including Indigenous people, urban, rural and coastal communities, and both official languages, who each developed a unique set of indicators tailored to their local settings. Funding recipients reported progress for their respective projects through mid-point and final evaluation reports that highlighted successes, challenges, and overall lessons learned. Many key deliverables and knowledge sharing resources developed from HealthADAPT are publicly available on funding recipient websites.  

Since the conclusion of the pilot program, several lessons for climate change and health adaptation work have been identified, including the significance of having clear objectives, diverse engagement, integrating lessons from other health emergencies, and a focus on preparation and prevention in adaptation measures. These takeaways will be helpful to optimize future program iterations, and broadly affirms the need for additional support, resources, and guidance for health authorities who are undertaking climate change and health adaptation work.  

As the HealthADAPT program moves into its next cycle, Health Canada will continue to support capacity building across the health sector to prepare for and respond to the health impacts of climate change. Through its community of practice, HealthADAPT regularly engages organizations in knowledge sharing and engagement opportunities. This community of practice aids Health Canada in actively monitoring the progress of climate change and health adaptation work across the country. The program will continue to grow and support partners as it moves into its next iteration, whilst incorporating key lessons learned and maintaining monitoring and evaluation as a critical component.  

 

4. In practice  

The HealthADAPT program has provided health authorities with financial and technical support to advance their efforts in addressing climate-driven health risks. By identifying specific vulnerabilities that exist in different regions of the country, health authorities are better able to develop targeted adaptation strategies that enhance climate-resilience within their communities. This includes actions such as seasonal readiness planning, the development of air quality monitoring programs, community-based monitoring programs, and increased public engagement. 

 

5. Key resources 

Further information about the HealthADAPT program and projects can be found on the following webpages: HealthADAPT, Map of Adaptation Actions, and Digital Case Stories. 

More information 
For more information, please contact the HealthADAPT team at climate.health.adaptation-adaptation.climat.sante@hc-sc.gc.ca.   

 

6. References 

 

 

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