The Engaged Citizen

Wildfire damage can be greatly reduced

Albertans are no strangers to the destruction of wildfires. Jasper, Fort McMurray, Slave Lake, and Sturgeon Lake Cree Nation are all communities devastated by wildfire in recent years. We empathize with those who lost their homes, their businesses or their jobs and bear witness to the challenges they face to rebuild their communities and their lives.

In 2023, wildfires burned 18.5 million hectares of land in Canada – three times the size of Nova Scotia. Two hundred thousand people were evacuated and the damages from insurable losses cost over $3 billion dollars. With 60% of Canadian communities being located near wildfire-prone areas, we can expect to face even more challenges in the future.

The risk of wildfire is increasing due to more residential and industrial development into forested and grassland areas, and due to accumulated vegetation from over one hundred years of fire suppression. Furthermore, climate change has increased the length of the annual fire season and created conditions for larger, hotter and faster-moving fires.

The economic, social and health impacts of the wildfires are far-reaching. Commercial activity and tourism decrease due to evacuations and structural damage. Businesses are forced to reduce operations and workers lose time at work. Loss of housing and disruptions to essential services such as electricity, drinking water, and communications put severe social stress on communities. Anxiety disorder and post-traumatic disorder are more common in those affected by wildfire damage and mental health issues can persist for many years after the event.

It is natural to feel helpless in the face of wildfire threat, but the reality is that there are many aspects we can control, both individually and collectively. As a society, we can make large-scale investments to ensure that our homes, businesses and communities can resist the destruction of wildfires.

Low risk vegetation in the immediate area surrounding homes was the single most important factor in differentiating homes that survived from those that burnt

Businesses, landlords and homeowners can reduce the risk of their buildings catching fire by up to 75 per cent through individual actions. Most structures at the edge of communities are not destroyed by direct contact with the fire, but by embers or burning fragments of vegetation showering on homes up to two kilometers ahead of the leading fire edge.

Relying on firebreaks and reduction of vegetation that can burn around communities is important to reduce direct contact with wildfire but is certainly not enough to protect homes from igniting due to embers. A study of the 2016 Fort McMurray fire found that low risk vegetation in the immediate area surrounding homes was the single most important factor in differentiating homes that survived from those that burnt, followed by uncluttered yards with few combustible objects and the use of firesafe building materials. These findings are consistent with the FireSmart guidelines for landscaping and building.

FireSmart is a national program designed to increase wildfire resilience of communities and it outlines several scientifically proven actions that can be taken to protect businesses, homes and neighbourhoods. FireSmart guidelines include avoiding planting shrubs and plants within 1.5m of buildings, removal of coniferous trees within 10 meters of buildings and relocating firewood and lumber stored within 10m of the house and under decks. The guidelines also recommend the use of fire-resistant roofing materials such as asphalt, metal or concrete; non-combustible siding (stucco, metal or fibre cement), and non-combustible materials for decks and porches. Following FireSmart guidelines reduces the chances of homes catching fire and helps firefighters defend structures if they do ignite.

But individual efforts can only go so far in preventing wildfire damage given what we know about how fire progresses. Vulnerable homes ignite first, then fire spreads to adjacent homes and when a critical mass of buildings catch fire, the fire coalesces and causes large scale destruction in the community. To protect our neighbours, neighbourhoods and communities, we all have to take action and view FireSmart implementation as a team sport.

Policymakers, government agencies and the private sector also have a role to play in reducing wildfire damage to communities. Fire protection and public safety agencies have to prioritize prevention initiatives and educate neighbourhoods and communities on how to prevent homes from catching fire due to embers. Housing developers and landscapers working in wildfire-prone areas should systematically follow FireSmart building and landscaping guidelines. Insurance companies need to help build back smarter after wildfire damage and support clients in rebuilding with fire resistant materials and design.

The federal government also has to take leadership and be responsible for creating nationally-accepted building standards to safeguard against wildfire damage. Provincial and national park agencies with jurisdiction over lands adjacent to communities must reinforce the efforts of property owners by ensuring that trees are thinned and pruned and accumulated vegetation and deadfall removed.

Municipalities need to protect communities by creating appropriate firebreaks and requiring greater separation of buildings in wildfire-prone areas to limit the spread of fire from one structure to another. Municipal governments in high-risk communities should consider making FireSmart measures mandatory in urban developments, and at the very least, make sure that municipally-owned buildings, social housing, and landscaping in urban parks and open spaces follow FireSmart guidelines.

Through effective leadership, collaboration between public and private sectors and community action we can learn to live with the threat of wildfire.

Climate change is a health crisis

As we cope with extreme heat waves and unpredictable wildfires this summer, it is hard to deny that climate change is a reality. With record setting high temperatures in many places in the West, this stretch of hot weather is a searing reminder of how human actions are affecting our planet. If global warming continues unabated, it is easy to imagine how life will become unbearable.

The health of humans and the health of our planet are inextricably linked. The effects of climate change on human health are already evident in Canada and so many other places in the world. Our northern latitude exaggerates the effect of climate change and disproportionately affects populations living in the Far North including many Inuit communities whose livelihoods are intertwined with the conditions of the land.

Climate change is the biggest public health threat of the 21^st century. The World Health Organization estimates that 5 million deaths will occur due to heat, malnutrition and diarrheal diseases attributable to climate change between 2030 and 2050. The scale and severity of the impact of global warming on human health can put health systems, economies and even global security at risk.

Climate change has both direct and indirect impacts on health. Heat waves, hurricanes and wildfires result in heat-related illness, trauma and death. Warmer temperatures increase the range of insect-borne diseases such as Lyme disease, malaria and West-Nile virus resulting in their spread to parts of the world they were not found in before. Climate change also has significant effects on mental health as extreme weather events can increase anxiety, post-traumatic stress disorder and suicide risk.

Fortunately, we have the technical and policy knowledge to avert climate disaster. What we need to do is create political will for immediate action and push our decision-makers to make use of the tools we have to keep us, and our planet, healthy.

“Carbon tax is about choice and freedom for individuals and businesses to decide how we want to reduce greenhouse gas emissions through the products we buy or sell.”

The carbon tax is the cheapest and most effective way of fighting climate change. But it suffers from a serious public relations problem. Due to poor communication by policymakers, many Canadians have an immediate and negative reaction to this highly efficient policy to fight climate change.

Carbon tax is about choice and freedom for individuals and businesses to decide how we want to reduce greenhouse gas emissions through the products we buy or sell. Unlike regulations, which force people to take certain actions, carbon taxes affect prices and create incentives for environmentally-friendly behaviours. We know very well that price affects consumer behaviour. Tax the sale of cigarettes, and the percentage of Canadians who smoke drops. Raise taxes on alcohol, and people choose to drink less.

Similarly, the carbon tax works by providing financial incentives for individuals to pollute less and encourages companies to offer products and services that result in fewer greenhouse gas emissions. It works by creating an economic incentive for reducing carbon reductions while maintaining a strong economy. This is why supporters of the carbon tax include Preston Manning, founder of the Reform Party; Elon Musk, investor and entrepreneur; and Steve Williams, former CEO of Suncor – Canada’s largest oil producer.

In British Columbia and California, where the carbon tax has been in place for many years, there is evidence that greenhouse gas emissions have been reduced while maintaining a strong economy and creating quality jobs. Not only does the carbon tax reduce present emissions, but it also affects future emissions as engineers and entrepreneurs innovate to develop technologies that reduce emissions even further, encouraged by strong cost incentives provided by rising carbon taxation.

Many Canadians believe that the carbon tax is taking money out of their pockets, but in reality, 8 out of 10 families in Canada receive more through the Canada Carbon Rebate – previously known more enigmatically as the Climate Action Incentive Plan – than they pay in carbon taxes. Recent polling shows that less than half of Canadians who are eligible for the rebates realize they are being getting back what they paid out and often more.

Pierre Poilievre and other “ax-the-tax” politicians are taking advantage of everyday Canadians’ knowledge gap about effective climate change policy and want us to believe that removing the carbon tax will save us money, and magically avert us from climate catastrophe at the same time.

Once we understand the economic principles behind the carbon tax, we will all join Preston, Elon and Steve in embracing the tax, and joyously visit the bank to retrieve our Carbon Tax Rebate.

By Vamini Selvanandan© 2024. This work is licensed under a Creative Commons CC BY 4.0 license. This article is an updated article and was published in various papers in July, 2024. Photo credit: Photo by Pixabay on Pexels.com

Avoiding low-value healthcare: sometimes less is more

You can’t get enough of a good thing. Or can you? In Canada, we use public funds to pay for diagnostic tests, surgeries and many medical treatments so it is natural to assume that more medical care is better. The more you get tested, diagnosed and treated, the healthier and longer your life will be. No, not necessarily! Some medical tests and treatments can be a waste of precious healthcare dollars and can result in harm to patients.

In the United States, it is estimated that around $100 billion per year is wasted on unnecessary medical care. This money could have been used to provide medical care that people really need. Furthermore, eliminating low-value diagnostic tests and treatments can reduce the healthcare sector’s carbon footprint and contributions to global warming.

Low-value care refers to tests and treatments that have no evidence of providing benefit to patients and may cause physical or psychological harm. They can take the form of blood tests, imaging, medications or surgical procedures. For example, getting x-rays or CT scans for low risk back pain within the first 6 weeks of symptoms will not change how the patient is treated, as most back pain will improve in this time frame, but exposes them to unnecessary radiation.

Antibiotics can save lives when used appropriately but can cause unwanted side-effects, serious complications or even death in some people. Antibiotics do not work against viruses, the cause of all colds and flu infections, almost all sinus infections, and most cases of bronchitis. So, the risks of antibiotics outweigh their benefits when used for most cases of nasal congestion, cough, or sinus pain.

Opioids are potent pain killers and can help in situations of severe pain like immediately after surgery or cancer pain. However, they are not the best option for chronic pain related to arthritis, low back pain or migraines. Opioids can lead to addictions, withdrawal symptoms and side effects like decreased alertness, nausea and constipation. Similarly, sleeping pills may be appropriate in acute situations of poor sleep for a few days, but when used over long-periods, lose their effectiveness and can cause falls and cognitive decline in seniors.

“The decision to have a screening program is based on the benefits of lives saved at the population level, but the risks may not be acceptable at an individual level.”

The media, the medical establishment, and not-for-profit cancer organizations have for years unequivocally broadcast the message that cancer screening saves lives. But the reality is more nuanced. A recently published paper analyzing 18 studies involving 2.1 million people and looking at six common cancer screening tests for breast, colon, lung and prostate cancer showed that only one test – sigmoidoscopy for colon cancer – increased overall lifespan, and that by only 110 days. The other cancer tests did not result in people receiving cancer screening living longer.

Patients, and even some doctors, assume that cancer screening tests are always beneficial and can cause no harm. But we know that all medical tests, procedures and treatments come with risks and benefits. Cancer screening can result in false positives requiring more invasive testing – like biopsies, with bleeding and infection as potential complications. Screening can also result in overdiagnosis and overtreatment – meaning providing unnecessary treatment for a condition that is not life-threatening or would never have caused symptoms. In fact, people participating in cancer screening are many times more likely to experience a false positive, overdiagnosis or overtreatment than having their lives saved by screening.

The decision to have a screening program is based on the benefits of lives saved at the population level, but the risks may not be acceptable at an individual level. For example, screening 1000 women aged 50-69 for breast cancer every two years with a mammogram for 7 years, saves one life, but results in 3 women treated unnecessarily for breast cancer because we don’t know which cancers once diagnosed will progress to cause serious illness or death.

Does this mean that one should never participate in cancer screening? No, because some individuals do benefit from early cancer detection and treatment. It may be your life that is saved. So shared decision-making needs to take place between individuals and their doctors to explore the risks and benefits of testing, the patient’s specific risk profile and their values and preferences.

To keep our healthcare system sustainable and accessible for effective and medically necessary care, we need to eliminate low-value care and transfer those resources to high-value health investments.

Investing in the health of children whether it be in early childhood education, prenatal nutrition, or childhood immunizations pays high dividends for lifetime population health. Similarly promoting healthy lifestyles and preventing diseases such as hypertension, diabetes and heart disease has big payoffs. Boosting the social determinants of health by providing adequate income, quality education and decent housing, improves health in ways that many low-value tests and treatments do not. Let’s choose wisely in how we spend our healthcare dollars.

Is our government working for Albertans?

This month marks a year since the United Conservative Party won the provincial elections under Danielle Smith. Affordability and health care were the top issues identified by Albertan voters in the lead-up to the election. Now a year later, Albertans continue to face high food prices, a lack of adequate and affordable housing and difficulty accessing health care. It is time to take stock of what this government has done in the past year to help improve the daily lives of Albertans.

The New and proposed legislation page of the Government of Alberta’s website inventories a list of what has kept our government busy in the legislature in recent months. This catalogue shockingly and painfully highlights the lack of work being done to improve food security, housing or access to health care for Albertans.

Instead, the website proudly lists several pieces of legislation that concentrate power in the hands of the government without regard for the struggles of average Albertans. The Public Health Amendment Act came into effect in December 2023 and strips the provincial Chief Medical Officer of Health of the ability to issue population-wide public health orders in future public health emergencies. Instead, it gives the authority to make final decisions “based on scientific and medical public health factors” to elected officials. Akin to seeking help from a local politician for treatment of a heart attack instead of rushing to a medical doctor with the knowledge, skills and tools to treat the medical condition, this new legislation puts Albertans at increased risk of suffering and death in the next public health emergency.

“It seems that our provincial government is more interested in consolidating and concentrating power into their own hands than governing for Albertans.”

Bill 17 introduced in April 2024, looks to establish a new crown corporation to build an abstinence-oriented system of care for people with substance use disorders. While treatment and recovery services for people struggling with addictions issues are necessary and welcome, they have to be a part of a continuum of services that can serve all people with substance use disorders no matter their stage in the course of illness. Just as cancer patients require a suite of options including surgery, chemotherapy, radiation and palliative care to treat their type and stage of cancer, those with substance use disorders require access to a full spectrum of services that include prevention, harm reduction, treatment and rehabilitation to meet them where they are at in their health journey.

Recently introduced Bills 18 and 20 will enshrine in legislation the current government’s refusal to work with other levels of government for the betterment of Albertans. Bill 18 requires municipalities, universities and colleges to obtain approval from the provincial government before accepting help from the federal government. This will result in layers of red tape, delays and a waste of taxpayer money.

With Bill 20 – and no small measure of irony – the UCP government is legislating provincial intervention into municipal governance, while at the same time touting Bill 18 as a pushback against federal overreach. Once enacted into law, Bill 20 will give the provincial cabinet power to remove councilors and mayors in any municipality and to repeal and amend any local bylaw – a clear affront to the democratic rights of municipal voters who have elected local politicians to create bylaws in the best interest of their community.

It seems that our provincial government is more interested in consolidating and concentrating power into their own hands than governing for Albertans. They have not shown an interest in addressing the issues that matter most to Albertans – food security, housing and quality health care. We need to express our displeasure with them and make it clear that they need to address the issues of importance to Albertans or at least get out of the way when other levels of government are providing solutions.

More than 1 in 4 Albertans lives in a household that is food insecure. In a province of abundant food production and availability, food insecurity is not about a lack of food but a mark of poverty. The Government of Alberta has three readily available policy levers to reduce food insecurity: increasing minimum wage, increasing welfare payments and lowering the income tax rate for the lowest income bracket. Each of these measures will independently reduce the risk of food insecurity for Albertans and all three lie completely within provincial jurisdiction.

The Alberta government also needs to take bold and decisive steps in health care reform. They must ensure that every Albertan has access to a primary care provider and a supporting health care team close to home. Alberta needs to build more quality publicly-funded long-term care homes to take care of aging Albertans and reduce the burden on acute care hospitals. Additionally, health care personnel and infrastructure in public health care facilities need to be bolstered to provide timely and high-quality acute, emergency and surgical services to Albertans.

Furthermore, our provincial government needs to take urgent action to address the housing crisis by collaborating with municipal and federal levels of government and making sure that all Albertans can realize their basic human right to housing. Immediate actions include using public lands for building social housing, establishing rent control to keep housing costs affordable, and protecting tenants from unfair and predatory practices by corporate landlords.

No matter how we voted in the last election, we need to hold this government accountable and working for Albertans. They have another three years to show they are worthy of governing for Albertans. If they fail, they will suffer the consequences in the next election.

By Vamini Selvanandan© 2024. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on May 27, 2024. Photo credit: Joshua Woroniecki on Pexels.com

Housing is a human right

With asylum seekers dying waiting for shelter space in Mississauga and single mothers denied rental housing in Halifax, Canada’s lack of affordable housing is becoming a frank violation of human rights.

Housing, like the need for food and water, is a basic human need. International law recognizes the social right to housing in the Universal Declaration of Human Rights and the International Covenant on Economic, Social, and Cultural Rights and Canada has ratified several international treaties on the right to adequate housing.

But according to the 2021 Census, more than 1 in 10 households in Canada live in core housing need, meaning they live in housing that is unsuitable (overcrowded), inadequate (in need of major repairs) or unaffordable (costs more than 30% of pre-tax income).

Housing is an important determinant of health. Overcrowded living conditions increase the spread of infectious diseases and people living in damp, moldy conditions have higher rates of asthma and allergies. Extreme indoor heat or cold is associated with increased cardiovascular disease, and poor living conditions can increase psychological stress in adults and children.

Having decent housing is important to living a healthy life. We also know that affordable housing is key to a strong economy. It creates more disposable income, GDP growth, higher productivity and job retention and more tax revenue for governments.

So, when the benefits of decent, affordable housing are so clear, why do we find ourselves in a nationwide housing crisis? This predicament did not arise overnight. It is the result of over 30 years of disinvestment in affordable housing by the federal government as well as the insidious financialization of housing.

In the decades post-World War II, the federal government invested heavily in building affordable housing, creating up to 20,000 new units a year until the late 1980s. But in 1993, the federal government cancelled its housing program and social housing dropped from 20% of annually built housing stock to 1 to 2% by 1996.

“We need to emphasize that towns and cities are for people living and working there, and disincentivize second homes, real estate speculation and short-term rentals.”

Around the same time, the financialization of housing began creating a significant barrier to realizing people’s right to affordable and decent housing. Financial instruments such as mortgage-backed securities and Real Estate Investment Trusts (REITs) have transformed housing from a basic need into a vehicle for investment. Investors look at housing as a commodity and a way of extracting wealth from the basic human need for shelter.

The securitization of mortgages (pooling mortgages to create a financial instrument sold on the stock market for profit) has created large amounts of debt for Canadian homeowners and delinked house prices from income. Purchase of rental housing by REITs has led to systemic practices of rent increases, higher rates of eviction, reduced on-site services, and poor investments in maintenance and repair of housing units to maximize shareholder profits.

In 2017, the federal government created the National Housing Strategy, and, in 2019, passed the National Housing Strategy Act, marking a return to the housing arena after decades of absence. Now they have a lot of catching up to do – the Canada Mortgage and Housing Corporation (CMHC) estimates that Canada needs to build 5.8 million new homes by 2030.

It may seem like a large number, but we know it is possible to achieve this goal. Canada built over 1 million Homes for Heroes between 1943 and 1960 – the equivalent of 6 million homes today. All levels of government, the private sector and civic organizations will have to pitch in to get the job done.

To ensure housing for all, we need to let go of the North American dream of a single-family home and instead embrace density and community by creating an adequate supply of housing close to workplaces, schools and other important amenities and services. We need to emphasize that towns and cities are for people living and working there, and disincentivize second homes, real estate speculation and short-term rentals.

The only way to counter financialization of housing is for the public to claim back a sizeable share of the housing market. France has legislated 20% of total housing stock in each municipality as public housing and in Vienna about 60% of the population lives in social or co-op housing.

We too can set and meet targets to keep housing a public good. The federal government has to invest far more money than it has so far to build housing, and vacant public lands need to be provided to municipal governments and non-profit housing providers free of charge for building affordable housing.

Provincial governments can protect existing housing stock by creating first right of refusal for municipalities to purchase affordable housing at risk of being bought by REITs. Municipal governments can retain control or transfer ownership to not-for-profits, co-ops or land trusts to administer below-market housing programs.

Municipal governments, with their smaller tax base, need to be creative in raising money to build housing. Progressive property taxes levy higher rates for more expensive properties and can be a way to create an affordable housing fund. Vacancy tax for homes that are unused create another revenue stream and encourage absent homeowners to sell or rent their homes to those who live in the area.

When we understand housing as a human right, we acknowledge that decent, affordable housing is the responsibility of all levels of government and civil actors in society. Everyone deserves to live in dignity and security and have a place to call home.

We are sick of sick notes

There is one thing doctors and patients can readily agree upon: we both hate sick notes. Patients loathe waiting long hours in overcrowded waiting rooms to request a note and doctors detest the added burden on the healthcare system in providing one.

Sick note policies increase use of scarce healthcare resources as employees are forced to visit the emergency room or their family physician’s office for the sole purpose of getting a sick note. Sitting unnecessarily in waiting rooms with minor viral illnesses, they put other vulnerable patients – like the frail elderly, pregnant or immunocompromised – at risk of serious complications.

Having to obtain a sick note also creates a strain on the worker, and does not respect a person’s right to rest when they are sick. The World Health Organization and the Public Health Agency of Canada advise people with the flu to stay home to recover and prevent infecting others. Common colds and gastroenteritis are also self-limiting illnesses which get better without medical treatment.

So why do employers insist on sick notes? It appears that some feel it as an effective way of policing employee absenteeism. Either by having a doctor verify illness in an employee or by creating a barrier for employees to taking days off when they are sick, they feel that it will improve employee attendance and ultimately, business productivity and profit.

“Not surprisingly, several physician organizations are pushing back against sick note policies.“

But this logic does not bear out. Doctors do not verify minor illnesses in patients through testing or other objective means before providing sick notes. They simply listen to the patient and believe the symptoms that patients report. Trust is central to the doctor-patient relationship and doctors do not take on the role of policing or disciplining truant employees. Such responsibilities lie squarely with the employer or their human resources department.

Creating barriers to employees staying home when sick can also backfire. A recent study showed that 82% of Canadians would rather go to work sick than get a sick note. Slower recovery and increased infections of customers and co-workers can lead to workplace outbreaks of disease and seriously affect a business’s bottom-line. When a critical number of employees get sick, businesses temporarily shut down operations or reduce their hours or services.

Not surprisingly, several physician organizations are pushing back against sick note policies. The Canadian Association of Emergency physicians is advocating for a ban on sick note requirements by employers and schools through federal or provincial legislation. The Canadian Medical Association and the Ontario Medical Association are also taking a stand against sick notes. In 2023, Doctors Nova Scotia succeeded in getting provincial legislation to limit employers to asking for a sick note only if an employee has been absent more than 5 days or absent twice within the previous year.

Paid sick leave is an alternative policy to requiring sick notes and has benefits for workers, employers, and society. Most Organization for Economic Co-operation and Development (OECD) countries have national permanent paid sick leave policies, but Canada is a laggard by comparison. In 2020, fifty-eight percent of Canadian workers reported not having paid sick leave, and this number increases to seventy-five percent among those making less than $25,000 per year. Workers in precarious jobs at hotels, restaurants, and grocery stores are less likely to have paid sick leave than those in secure office jobs.

Paid sick leave increases income security for workers, protects public health, and helps business continuity by reducing disease transmission in the workplace. It is also an effective strategy for recruitment and retention of employees, making them feel valued and less likely to turnover. Paid sick leave reduces costs of training for rehires and saves money in the long run for businesses. Research shows that concerns of abuse of sick leave policies are unfounded: 45% of workers with paid sick leave did not take even a single paid day off work in the previous year.

We may not be directly affected by sick note policies or already have paid sick days ourselves, but we all have a stake in this matter. If we want to ensure a sustainable healthcare system with timely access for all those who have medical needs, we need to make our opposition to sick notes heard in workplaces and ask our provincial government to ban sick note requests by employers.

If we want to remain healthy and safe as customers and clients, we need to advocate for paid sick leaves for workers so they may stay home and not spread infections. If we want to increase productivity and profit as business owners, we must build healthy relationships with our workers and show that we value and trust them by providing paid sick leave and not requiring sick notes.

Businesses, healthcare workers and governments should work together to ensure a quick and painless demise of the sick note.

By Vamini Selvanandan© 2024. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on February 21, 2024. Photo credit: Andrea Piacquadio on Pexels.com

We only have one planet

We live in a time of multiple environmental crises: global warming, natural resource depletion, pollution and biodiversity loss. Far from being unrelated, these environmental disasters share the same root cause. Overconsumption has surpassed population growth on our planet as the driver of environmental degradation.

Put simply, overconsumption refers to taking more than what we need from the planet, and doing so at a rate faster than the planet’s ability to regenerate. In 2019, the United Nations Environment Program reported that our natural resource consumption has increased more than three times between 1970 and 2010. Rich countries like Canada consume on average 10 times as much as the poorest countries. If everyone in the world consumed as the average Canadian does, we will need five planets to feed our ravenous consumer appetites.

Canadians have not always consumed as we do now. In the 1950s, our lifestyles were consistent with one-planet living. But since the turn of the millennium, our consumption rates of everything from materials goods, to fossil fuels, to the use of rare earth metals have soared. All this consumption has not increased our well-being. If anything, quite the opposite. The pressure to consume has increased levels of anxiety and depression and decreased life satisfaction and levels of happiness.

Inequality is one of the great drivers of consumption. There is immense social pressure for conspicuous consumption in our society, as we use the display of our possessions and wealth to maintain position in society and assert social status. This pursuit of materialistic goals means we spend so much of our time earning and spending money that we have less time for things like close relationships and time spent in nature that increase our well-being.

Climate change is the most pressing health emergency of our time and overconsumption is driving climate change by pumping greenhouse gases into the atmosphere at alarming rates. If we are to keep global warming to 1.5⁰C, and maintain a habitable planet, we will have to limit our consumption.

Impactful actions we can take as individuals is to limit airline flights, and travel by car, train or bus instead. During holidays, we can opt to explore an interesting area close to home or take one longer vacation instead of several shorter ones that require distant travel.

“We must not fool ourselves into thinking that simply purchasing green technology is good for the environment”

We can also buy less things, especially avoiding big-ticket items like personal vehicles and holiday homes (the latter also contribute to the current housing crisis). When deciding to buy something, we can consider if it is really needed and if so, we can buy used items; well-made, longer-lasting items; or rent, borrow or share things used only occasionally.

Greener options are preferable for an item that is needed, or to replace one that is near the end of its lifecycle, but we must not fool ourselves into thinking that simply purchasing green technology is good for the environment. Our total consumption determines how much damage we cause the environment and it is only through reducing consumption across all products, green or otherwise, that we can have a smaller footprint.

Solving our converging environmental crises is going to take more than lifestyle changes, it will require system change. We have to let our politicians know that we want to see policies to reduce overconsumption. We need federal, provincial and municipal governments to set policy on supporting investment in high-quality, long-lasting, net-zero infrastructure whether they be homes, office buildings or public facilities.

Asking our governments to address inequality will ensure that people do not have to consume conspicuously to maintain their status in society. A decrease in consumption will inevitably cause an economic slowdown and job loss unless countered by a rethinking of our current economic model. Fair taxation for wealth redistribution, four-day work weeks and universal basic incomes are components of an economic system that will see prosperity for all in a setting of lower consumption.

The private sector has an important role in addressing overconsumption, too. Companies should once again take pride in manufacturing high-quality, long-lasting products. They can make their products repairable and grow their operations to include departments to repair, refurbish and recycle their products.

Where there is a lack of voluntary initiative in the business sector, governments need to step in with right to repair policies, regulations prohibiting planned obsolescence of products, and mandatory recycling of components. Governments also need to regulate advertising to ensure that people are not coerced to spend frivolously on items that will cost them their health and that of the planet.

None of us wants to hear that we cannot take as many vacations to exotic places as we want or buy all the things we can afford (or at least get on credit). But we have to admit that our current five-planet living amounts to stealing resources from future generations to enrich ourselves. Overconsumption is not something that politicians, corporations or individuals want to talk about. However, if we want to maintain a planet habitable by humans, the time to curb overconsumption is now.

Destabilizing Alberta’s Healthcare System

If you were already worried about our province’s health care system, you now have far more cause for concern. And if you weren’t worried before, it is time to feel alarmed.

On November 8, 2023, the UCP government announced a major restructuring of the health care system in Alberta. They announced plans to create four new provincial organizations to administer health care services in Alberta divided into the categories of Acute Care, Primary Care, Continuing Care and Mental Health and Addiction.

While health systems in other provinces are moving towards integration, our province is taking a huge step backwards by increasing fragmentation. With the creation of Alberta Health Services (AHS) in 2008, Ed Stelmach’s Progressive Conservative government introduced Canada’s first integrated health system. This approach reduced duplication in the system, closed gaps and increased access to services for rural and remote populations. Operating with a single governing body, it created administrative efficiencies, reduced costs and cut bureaucracy.

Alberta currently has the lowest health administrative costs of all provinces in Canada. Creating four entities to replace one in this restructuring plan will only increase expenses and bureaucracy. The budgeted $85 million dollars is a gross underestimation, and Albertan taxpayers will be paying a lot more for this futile exercise.

“Clearly, the intended outcome of restructuring AHS is to concentrate power in the hands of the health minister and premier.”

There is no doubt that our health care system is in crisis and that AHS needs to address serious issues related to capacity and timely access to care. But, the current proposal for restructuring does not address these issues and will likely make things worse. No plan or funding for recruitment and retention of healthcare workers have been announced. Bringing chaos and instability to the health system takes away from quality patient care as overburdened staff learn new systems and processes. At a time when other provinces, like Ontario and British Columbia, are putting their resources into making working conditions more attractive for health care workers, destabilizing the health care system seriously disadvantages Alberta in recruiting and retaining staff to provide care for Albertans.

Alberta is Canada’s richest province and we can afford adequate investments in healthcare. Instead of policies to subsidize fossil fuel corporations and provide tax breaks for the wealthy, Albertan politicians can use our collective wealth to build more public operating rooms, improve care in nursing homes and invest in health promotion and disease prevention to meet the needs of all Albertans. In this land of abundance, Albertans do not have to live in a constant state of health care scarcity.

Clearly, the intended outcome of restructuring AHS is to concentrate power in the hands of the health minister and premier. The government is poised to take over health care decisions and control over health care workers from AHS. As an agency operating at arm’s length from the government, AHS currently makes decisions that are not politically motivated. But restructuring leaves the health system vulnerable to decisions based on cold calculations of politics and power rather on what is best for the health of Albertans.

There is however some promise in the proposed changes. In the current state, acute care is prioritized while primary care, continuing care and mental health and addictions services get less attention. Having new organizations dedicated to each of these can lift their profile and should be accompanied by adequate resources for these critical components of health care.

Also, Danielle Smith’s promise that every Albertan will have access to a family doctor or nurse practitioner is one that we can embrace and hold her accountable for delivering upon. Her pledge needs to be backed up by action that supports team-based care, provides financial viability for primary care clinics (who operate as small businesses), and allows primary care providers to use their time and energy on patient care rather than paperwork.

We are living in a time of multiple health care crises: ambulance shortages, lengthy emergency room wait times, inadequate staffing and poor work conditions for health care workers and now the destructive restructuring of AHS. These health care crises are not inevitable but a result of political choices, interference and micromanagement. Albertans suffer from a crumbling health care system while politicians making selfish choices, profit and consolidate power.

Regardless of who we voted for, we have a responsibility to hold the current government accountable for providing high quality health care that is accessible, timely and maximizes the value of taxpayer money. We have to demand that health care decisions remain focused on what is best for the health of patients and populations and not on power and political gain.

We have to insist that Albertans experience health care that is seamless and not risk falling through the cracks of a fragmented system. We need to hold the government accountable for recruiting health care workers and treating them with respect so that they continue to provide excellent care right here in our province. We need to tell our government it is time to stop shuffling the chairs on the deck of a sinking ship and start correcting course.

Why a living wage matters

With soaring food prices, unaffordable housing costs and rising energy bills, a living wage becomes ever more relevant for Albertans. Referring to the hourly wage a full-time worker needs to make to pay for basic expenses while maintaining a modest standard of living, a living wage is about ensuring dignity for all those who work and contribute to our economy.

It is not a way of offloading affordability challenges onto employers, but a way for governments, businesses and civic organizations to take collective responsibility for creating livable communities. Living wage calculations are made for specific communities and take into account municipal, provincial and federal tax deductions, financial supports and social services.

Shelter, childcare and food are some of the biggest costs in the calculation of a living wage, and such basic expenses can be significantly higher than what minimum wage can provide. In Alberta, the $15 per hour minimum wage has not increased in the last five years and is not indexed to inflation. So, for Albertans, minimum wage effectively decreases year over year eroding their purchasing power for goods and services.

Figures recently released by the Alberta Living Wage Network show that living wage in several towns and cities in our province is much higher than minimum wage and calculated to be $23.70 in Calgary, $22.25 in Edmonton, and the highest in Canmore at $38.80.

Ensuring that people earn a living wage has benefits for both individuals and society. People who live in adequate housing and can afford to buy healthy food for themselves and their children enjoy better physical and mental health, and raise healthy children. This in turn reduces the burden on our healthcare, social service and justice systems. Additionally, a living wage allows workers to spend money in their communities, supporting local businesses and boosting economic activity.

For employers, paying a living wage is about more than “doing the right thing”, it is about making the right business decision. Savvy employers who pay living wages reap the rewards of their investment. In today’s climate of labour shortages, a living wage not only serves to attract workers during recruitment but also helps retain employees, thus decreasing the costs of rehiring and training. Living wages contribute to employee job satisfaction and overall health, and in doing so increase productivity. With loyal, happy and engaged staff, customers have a quality experience and keep returning.

“But ensuring a living wage is not the sole responsibility of employers.”

Over a hundred employers, from small family-owned businesses to multinational corporations, have joined the Alberta Living Wage Network and committed to paying the living wage. Being certified as a living wage employer gives businesses a leg-up on their competition, signaling to customers that they care about their employees, and want to build sustainable communities with strong local economies.

But ensuring a living wage is not the sole responsibility of employers. Governments need to contribute to reducing the living wage through programs that make housing, childcare, transit and healthcare more affordable.

The Alberta government needs to raise minimum wage to better reflect what it costs to live a decent life in our province. They need to establish better labour standards, guaranteeing paid sick leave to workers and protecting us from the insecurity of precarious work. In collaboration with the federal government, the provincial government needs to provide universally accessible child care and improve access to health services through pharmacare and dental care programs.

Both provincial and federal governments need to make sure that income tax structures support a dignified standard of living. This means a more progressive taxation structure that requires low-income earners to pay very little tax, and high-income earners who can afford it, to contribute more.

Municipal governments can work with other levels of government to further reduce the living wage in their communities. They can support affordable housing projects, expand or create public transit that is affordable, accessible or even free, and provide services that increase food security for residents in their area.

When communities invest the time and energy in calculating a living wage, they are able to provide context to the affordability concerns of their residents. They create an instrument to use in advocating with employers to pay a living wage, and with governments at all levels to provide programs, services and tax breaks to effectively reduce the living wage.

As thoughtful and caring residents in a community, we too have a role to play in patronizing businesses that are certified living wage employers and using our influence with other businesses we frequent to ensure they become certified. Through voting in elections, writing letters to our elected officials and other civic actions, we can call on governments at all levels to strengthen affordability programs.

We must all take responsibility for creating and maintaining communities that are livable and where people and families can thrive. The living wage takes a systems approach to show how businesses, governments and civic organizations can work together to make sure that we can all live a life of dignity and fully participate in our community.

Cleaning up our act in healthcare

The healthcare system is tasked with saving lives and improving the health of populations and individuals. But what if it is contributing to environmental degradation and global warming, and making us sicker in the process?

The healthcare system is the fifth largest producer of greenhouse gas emissions globally and contributes 4.6% to all greenhouse gas emissions in Canada. Comprised of hospitals, community clinics, pharmaceutical manufacturers and public health, the healthcare system is also a major contributor to waste production.

Greenhouse gases are emitted all along the supply chain of pharmaceuticals and medical equipment from manufacturing and transportation to consumption and disposal. Heating, cooling, ventilation and hot water systems of healthcare facilities further contribute to the carbon footprint of the industry.

Anesthetic gases such as desflurane emitted into the atmosphere from hospital rooftops have 20 times the climate warming effects of other greenhouse gases – using one bottle of desflurane is the equivalent of burning 440kg of coal.

With respect to solid waste, a study of 110 hospitals done in 2019 in Canada found they generated 87,000 tons annually. Plastic syringes, single-use surgical equipment, containers and packaging are sent to landfills or end up scattered on the land or in rivers and oceans.

Fifteen percent of healthcare waste is biohazardous – either toxic or infectious – and must be incinerated. In addition to greenhouse gases, incineration releases dioxins and furans which are carcinogenic to humans. Heavy metals emitted into the environment during incineration contribute to air pollution and increase the risk of heart attacks, strokes and death from cardiorespiratory causes.

Healthcare systems exist to prevent unnecessary deaths and treat illnesses, yet the way they operate can damage the health of our planet and our population. With direction from leaders and decision-makers and encouragement from consumers, healthcare systems can pivot to operating in ways that maintain the health of the planet and the people they serve.

Representing approximately 12% of Canada’s gross domestic product (GDP), the healthcare industry has immense purchasing power and can put pressure on suppliers to use sustainable practices in the manufacture of their products including reducing packaging, eliminating environmentally unfriendly chemicals in the manufacturing process and reducing the weight of items while maintaining quality.

The federal government can establish minimum environmental standards and practices for provinces and territories in healthcare provision as a condition of the Canada Health Transfer and hold provinces accountable for reducing healthcare-related waste and carbon emissions.

Provinces have set up health authorities to operate healthcare facilities, with Alberta Health Services being the single health authority in our province. The provincial government can stipulate that, in fulfilling its mandate, Alberta Health Services must follow environmental standards and practices that enhance the health of Albertans; that they must act to reduce greenhouse gas emissions, reduce waste and reduce the release of toxic and carcinogenic materials into the air we breathe.

We can change our own behaviour to reduce medical waste and decrease stresses on our overburdened healthcare system.

Operating rooms produce more than 30% of waste in healthcare facilities and use five times more energy per square foot than other parts of the hospital. Hospitals providing surgical services can reduce their environmental impact by reducing use of anesthetic gases (particularly desflurane), sterilizing and reusing all surgical instruments and using washable bed linen and gowns. Furthermore, sterilizing biohazardous waste prior to disposal in the landfill will have less environmental impact than incineration.

Ten to fifteen percent of hospital waste is food waste and buying policies that minimize waste, as well as composting and donation of excess food to rescue programs, can work to reduce the amount of food wasted.

Health clinics in the community, whether they provide primary or specialist care, dental care or physiotherapy, can do their part by reducing, reusing and recycling wherever possible including encouraging patients to return reusable products such as crutches and orthopedic boots, buying items in bulk to reduce packaging waste and sourcing products from ecofriendly manufacturers.

As clients of the healthcare system, we too have a part in reducing medical waste and we can make our concerns for personal and planetary health known to our healthcare providers and encourage the hospitals and clinics we visit to implement greener measures.

We can change our own behaviour to reduce medical waste and decrease stresses on our overburdened healthcare system. We can take care of minor self-limiting illnesses like colds at home and reduce waste by not asking for unnecessary medications such as antibiotics for viral illnesses.

We are all consumers of healthcare, starting most often with birth in a hospital setting and ending with needing health resources to deal with sudden disease, injury or prolonged illness at the end of life. Dedicated to improving the health of individuals and populations, the healthcare industry is also a contributor to negative environmental and human health effects. We need to acknowledge that human and planetary health are inextricably linked and work together to protect both. It is time to clean up our act.