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A new Health Canada report suggests public health officials should be openly advocating for the toppling of capitalism, Western society and even the very concept of “liberty and individualism.”
“Fundamental changes in our socioeconomic structures are needed to rebuild our relationships with each other and with our planet,” reads the conclusion of the April 17 report prepared for chief public health officer Dr. Theresa Tam.
The paper — written by three authors who “identify as white settlers” — also recommended that Canadian public health actions should focus on “decolonization, justice and equity” above all.
The 72-page report, What We Heard: Perspectives on Climate Change and Public Health in Canada, was commissioned to detail the “impacts of climate change on the health and well-being of people living in Canada.” The authors surveyed 30 academics and public health experts for their input.
There are indeed a number of emerging public health issues spurred by a warming climate. One example is an expansion of the ranges for disease-carrying mosquitoes, vastly increasing the number of people potentially exposed to malaria, dengue fever and West Nile virus.
But the Health Canada report is careful not to get into specifics: There is no explicit mention of a condition or infectious illness that is expected to become worse in Canada as a result of climate change.
Rather, the report features Canadian public health professionals explaining how they should focus on “less tangible determinants,” such as “legal, colonial and racist factors.”
“If we don’t address capitalism, if we don’t address colonialism, racism, the patriarchy, et cetera, we’re going to tread water for a long time until we eventually drown,” reads one expert quoted in the report.
“It’s really about the foundations of our society, the capitalist system, the culture of extraction — and we need to change that. How do we do that?” said another.
One respondent delivered a lengthy explanation of why the “core values” of Western society stood in their way, most notably the concept of “liberty and individualism.”
“It advances the individual over the collective, it says ‘as long as I get what I want, bugger you,’ and it leads to a huge number of problems, and it undermines the collective process,” they said.
The report distills the views of 30 Canadian public health officials and academics deemed to “have some understanding of the role of public health systems.”
This includes many already at top levels in the Canadian public health establishment, as well as three Canada Research chairs. Among them are Sandra Allison, formerly chief medical health officer for Northern B.C., and Cristin Muecke, regional medical officer of health for the Northern Region of Nova Scotia.
Also solicited were Trevor Hancock, the first leader of the Green Party of Canada, and Melissa Lem, a Vancouver family physician who pioneered the idea of prescribing nature to patients.
All 30 were asked, either in focus groups or in one-on-one interviews, “what roles should the public health system play and why?”
Ultimately, the report concludes that climate change and poor public health are caused by many of the same things: “White supremacy, capitalism, colonialism and racism.”
The report is clear that its content comes from “uninvited land occupiers.” Yet, the authors say they are sensitive to Indigenous perspectives.
“Collectively, we have a deep appreciation for Indigenous Peoples’ close and continuing relationship to the land and waters that we live upon and we are committed to a lifelong learning journey toward becoming good guests here,” reads an opening statement.
Another theme was that public health officials should be more “courageous” in pushing for policy typically considered outside their purview.
This included promoting “low meat” diets, designing housing policy, and advocating against the extraction and use of fossil fuels.
“Practically speaking, a lot of public health people want to be making the connections, but they are literally not given the mandate or the permission to because it’s not seen to be within their box,” said one.
The report acknowledges that there may be public or official pushback to this kind of “speaking out” from health agencies, and recommends these bodies be insulated against the usual avenues of accountability.
“Health systems should be independently governed or at least arm’s length from government structures to be free of fear of repercussions,” it reads.
Recent polls show that Canadians’ trust in public health agencies remains high in the wake of the COVID-19 pandemic, even as public trust in politicians has fallen. Polls have also shown that up to 90 per cent of Canadians agree that climate change is occurring, with as much as 70 per cent supporting a move to lower carbon usage.
Nevertheless, one respondent to the report said they believed the exact opposite was occurring on both points.
“Public health is under attack in some provinces … and there’s this climate change denial that we all know is being fuelled by the fossil fuel sector. So, my worry is that with public health that we won’t actually be able to get out there and do what we need to do,” they said.
The report also contained the near-unanimous pronouncement that public health agencies should receive more funding, even at the expense of the primary health care system. The reasoning behind that is if public heath has more money to improve society and fight climate change, fewer people will be going to the hospital.
“Not only would the primary health-care system require less funding but staff would be less overwhelmed in their duties, especially as health issues related to climate change intensify,” it reads.
