The aim of building climate resilient and environmentally sustainable health care facilities is: (a) to enhance their capacity to protect and improve the health of their target communities in an unstable and changing climate; and (b) to empower them to optimize the use of resources and minimize the release of pollutants and waste into the environment. Such health care facilities contribute to high quality of care and accessibility of services and, by helping reduce facility costs, also ensure better affordability. They are an important component of universal health coverage. Action is needed in at least four areas which are fundamental requirements for providing safe and quality care: having adequate numbers of skilled human resources, with decent working conditions, empowered and informed to respond to these environmental challenges; sustainable and safe management of water, sanitation and health care waste; sustainable energy services; and appropriate infrastructure and technologies, including all the operations that allow for the efficient functioning of a health care facility. Importantly, this work contributes to promoting actions to ensure that health care facilities are constantly and increasingly strengthened and continue to be efficient and responsive to improve health and contribute to reducing inequities and vulnerability within their local settings. To this end, we propose a framework to respond to these challenges.

Climate change is increasing risks to the mental health of Canadians. Impacts from a changing climate may outstrip the ability of Canadians and their health-sustaining institutions to adapt effectively and could increase poor mental health outcomes, particularly amongst those most marginalized in society. A scoping review of literature published during 2000–2017 explored risks, impacts, and vulnerabilities related to climate change and mental health. In this commentary, the authors present a new assessment of evidence from this scoping review and highlight factors that influence the capacity to adapt to the mental health consequences of a changing climate. Findings from this assessment reveal eleven key factors that influence the capacity to adapt: social capital; sense of community; government assistance; access to resources; community preparedness; intersectoral/transdisciplinary collaboration; vulnerability and adaptation assessments; communication and outreach; mental health literacy; and culturally relevant resources. Attention to these factors by Canadian decision makers can support proactive and effective management of the mental health consequences of climate change.

Climate change impacts on the Canadian food system pose risks to human health. Little attention has been paid to the climate change, food security, and human health nexus, resulting in a number of knowledge gaps regarding food system components that are most vulnerable to climate change. The lack of understanding of key dynamics and possible future impacts challenges the ability of public health officials and partners in other sectors to prepare Canadians for future health risks. A series of literature reviews were conducted to establish the relationship between climate change, food security, and human health, and to identify vulnerabilities within the Canadian food system. Evidence suggests that key activities within the food system are vulnerable to climate change. The pathways in which climate change impacts travel through the food system and affect the critical dimensions of food security to influence human health outcomes are complex. Climate-related disruptions in the food system can indirectly impact human health by diminishing food security, which is a key determinant of health. Human health may also be directly affected by the physical effects of climate change on the food system, primarily related to the impacts on nutrition and foodborne illnesses. In this study, we propose a novel analytical framework to study and respond to the climate change, food security, and human health nexus. This work is intended to help public health officials, researchers, and relevant stakeholders investigate and understand current and future risks, and inform adaptation efforts to protect the health of Canadians.

Vulnerability and adaptation assessments can provide valuable input to foster climate-resilient health systems. However, these assessments often do not explore the potential health risks of climate change far outside the range of recent experience with extreme weather events and other climate-related hazards. Climate and health stress tests are designed to increase the capacity of health systems and related sectors to manage potentially disruptive climate-related shocks and stresses. Stress tests focus on hypothetical scenarios, during which it would be difficult for the health system to maintain its essential function of providing services to protect population health. The stress test explores approaches to effectively manage acute and chronic climate-related events and conditions that could directly impact health systems, and climate-related events in non-health sectors that can indirectly impact health outcomes and/or health system function. We provide detailed methods and guidance for conducting climate and health stress tests, centering on three primary activities: (1) preparing and scoping the stress test; (2) successfully conducting the stress test; and (3) communicating the results to key stakeholders to facilitate policy and programmatic reforms.

A climate change and health vulnerability and adaptation assessment was conducted in Dominica, a Caribbean small island developing state located in the Lesser Antilles. The assessment revealed that the country’s population is already experiencing many impacts on health and health systems from climate variability and change. Infectious diseases as well as food and waterborne diseases pose continued threats as climate change may exacerbate the related health risks. Threats to food security were also identified, with particular concern for food production systems. The findings of the assessment included near-term and long-term adaptation options that can inform actions of health sector decision-makers in addressing health vulnerabilities and building resilience to climate change. Key challenges include the need for enhanced financial and human resources to build awareness of key health risks and increase adaptive capacity. Other small island developing states interested in pursuing a vulnerability and adaptation assessment may find this assessment approach, key findings, analysis, and lessons learned useful.

Executive Summary Case studies contribute more focused analyses which, in the context of human loss and damage, demonstrate the effectiveness of response strategies and prevention measures and identify lessons about success in disaster risk reduction and climate change adaptation. The case studies were chosen to complement and be consistent with the information in the preceding chapters, and to demonstrate aspects of the key messages in the Summary for Policymakers and the Hyogo Framework for Action Priorities. The case studies were grouped to examine types of extreme events, vulnerable regions, and methodological approaches. For the extreme event examples, the first two case studies pertain to events of extreme temperature with moisture deficiencies in Europe and Australia and their impacts including on health. These are followed by case studies on drought in Syria and dzud, cold-dry conditions in Mongolia. Tropical cyclones in Bangladesh, Myanmar, and Mesoamerica, and then floods in Mozambique are discussed in the context of community actions. The last of the extreme events case studies is about disastrous epidemic disease, using the case of cholera in Zimbabwe, as the example. The case studies chosen to reflect vulnerable regions demonstrate how a changing climate provides significant concerns for people, societies, and their infrastructure. These are: Mumbai as an example of a coastal megacity; the Republic of the Marshall Islands, as an example of small island developing states with special challenges for adaptation; and Canada's northern regions as an example of cold climate vulnerabilities focusing on infrastructures.