Not on the Peds Conference Agenda: The State of the Planet
Originally published in the Sudbury Star, on May 1, 2021, as "Climate Change, Human Health, and the State of the Planet" https://www.thesudburystar.com/opinion/columnists/blacklock-climate-change-human-health-and-the-state-of-the-planet
Last week, I attended a 3 ½-day medical conference, hosted by one of Canada’s great pediatric hospitals. The event was, of course, virtual. Through my laptop screen, I had access to some of the world’s top experts in children’s health from the comfort of my home. No drive to Toronto. No expensive hotel for four nights. No meeting up with old friends. No dining out. No hitting the theatre district to finally see Hamilton. There are a few pros and a great many cons to the limited life we currently live.
The conference featured a myriad of topics, but if I had to pick out an overall theme, it just might be this: there’s not much new under the sun. The social determinants of health still rule. They still predict how healthy or unhealthy we are.
Take a journey back in time to the great influenza pandemic of 1918-19. In Chicago, deaths from influenza and pneumonia correlated strikingly with neighbourhood literacy rates. Now fast forward back to the present. Right here in Canada, in 2020/21, rates of COVID-19 infections, admissions to hospital, and deaths correlate not only with our age, but also with our postal codes, our incomes and ethnicities, our employment and access to paid sick leave, and of course our general state of physical and mental health. Which correlates with our housing and food security, our education levels, our internet access, our transportation options, our ability to access health care and childcare, and so much more.
Of course, these social determinants of health have always been with us. Social workers are all too familiar with them. Medical and nursing students continue to write essays about them. But lest we forget, and we tend to, COVID-19 has thrust them right back in front of our faces.
Now you may be wondering, is this not an environment and health column you are reading? Indeed, it is. So, here’s the link: think about the determinants of human health as a big pyramid with a big round bottom. At the narrow top is the health care system. The fat middle is stuffed with all the social determinants of health. And the broad bottom undergirds and cradles all health.
Or if you prefer, think about a bird’s nest. A sturdy frame built of sticks perched amidst the tree branches, enveloping and supporting the soft warm lining which shelters and protects the baby birds. Without the frame, nothing else thrives or grows. Everything falls apart.
In these analogies, the broad bottom of the pyramid, and the rigid structure of the nest, represent the ecologicaldeterminants of health: a stable climate with vibrant, functioning ecosystems, clean air and water, fertile soil, predictable temperatures, rainfall patterns, and sea levels, and the absence of poisons in the environment. This is the planet upon which we humans have created our civilizations, engineered the social determinants of our health, and built our health care systems.
The pediatric conference had record attendance this year, from all around the world. Alone together we cheered on the latest advances in medical care. We honed our skills in caring for some of the most challenging pediatric issues. We pondered the reality that in a country like Canada, one’s chances of dying from COVID-19 are melded to the colour of one’s skin. And yet, in three and a half days, there wasn’t a single mention of the other looming health threat of the 21st century: climate change and the critical state of the planet’s health.
So I’m going to mention it. Climate change is a health threat. And not just for polar bears. We humans had better stop covering our eyes with our masks and start paying attention to the ecological determinants of our health, lest they deteriorate irrevocably, right before our blinded eyes.
Sources:
Kyra H. Grantz et al. PNAS 2016;113:48:13839-13844