The Right to a Healthy Environment: Becoming law in Canada and the imperative of environments and health research
The right to a healthy environment is recognized in law by more than 80% of the United Nations Member States. In June 2023, amendments to the Canadian Environmental Protection Act (CEPA) that relate to a right to a healthy environment were established with Bill S-5 receiving Royal Assent in Parliament (CEPA2023). Drawing on learnings from the Canadian Institutes for Health Research’s (CIHR) $35M, 5+ year Environments and Health Signature Initiative (EHSI), we reflect on how new investments in research are essential in achieving the ambitions of CEPA2023.
In April 2023 the Canadian Urban Environmental Health Research Consortium (CANUE), with support and guidance from the National Collaborating Centre for Environmental Health (NCCEH) and Health Canada (HC), hosted a national Environments and Health Summit representing the EHSI’s capstone knowledge translation event, wrapping up the CIHR initiative. This milestone event culminated in a Summit report that is now available. Across the 18 EHSI projects much was learned on an incredible diversity of topics drawing from multiple disciplines and establishing strong intersectoral partnerships. These are described in the report; additionally, there are pre-Summit webinars and videos of many Summit sessions.
The Summit provided the opportunity to discuss different overarching and motivating perspectives that future research and knowledge mobilization (R&D) will need to integrate. Major thematic areas include:
- One Health
- Planetary Health
- The Exposome
- Indigenous Ways of Knowing
Advancing in all these areas is necessary to halt and reverse damage to health and biodiversity due to adverse environmental conditions, to strengthen preventative approaches to improving and protecting the health of Canadians and to move forward sustainably at the planetary scale. Canada has a critical mass of expertise and public systems to be a leader in this effort; the success of the EHSI offers proof.
Five main recommendations from the Summit need to be highlighted:
- Hold future targeted Environments and Health Summits to build connections across One Health, Planetary Health and Exposome Science while achieving substantive integration of Indigenous Knowledge.
- Launch efforts to scale what was learned in the EHSI in terms of novel measurement methods and community engagement processes.
- Improve coordination to document and direct interdisciplinary environments and health research across all sectors.
- Develop flexible funding mechanisms.
- Enhance focus on children’s health in Canada.
These recommendations are broad and may seem rather logical. They are expanded upon in the Summit report, but require much attention to turn them into actions that lead to R&D and implementation throughout the highest levels of Canada’s science and environmental policy, if not beyond. Canada’s environments and health science community is motivated and prepared to help, but the end of the EHSI and the gaps discussed during the Summit and beyond are real and severely limit the progress needed.
The conditions are ripe to motivate a properly funded Canadian Environments and Health research strategy. By design, the EHSI was a one-time only program. Despite a widely recognized need for ongoing investment, made even more apparent given the ambition of CEPA2023, momentum is not being sustained. This comes at a time when a coordinated, comprehensive, and adequately funded long term environments, health, and societal well-being initiative is needed to accelerate R&D in Canada.
Alongside the implementation of CEPA2023 and the Summit, other organizations are recognizing the urgent need for action. The Association of Faculties of Medicine of Canada released their Declaration on Planetary Health declaring the health of the planet a “Code Red emergency, and calling for immediate implementation of planetary health education and research, and the transition to climate-resilient and low-carbon health systems in order to build a healthy, sustainable, and just future for all.” In October 2023, over 200 health journals called on the UN, political leaders, and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe stating that, “This overall environmental crisis is now so severe as to be a global health emergency”.
The enduring wildfire season of 2023 that was seen across Canada should be a cogent reminder of the stakes. There are some challenging questions that demand answers without further delay. What do the Right to a Healthy Environment, Intergenerational Equity, Environmental Justice, and maintenance of Canada’s current levels of protection (“non-Regression”), principles now formally recognized in CEPA2023, mean with the health risks from smoke exposure and the trauma of mass evacuations only increasing inside our own borders, or the ubiquity of plastics and forever chemicals in our lives, our environments and in our bodies? How should CEPA2023’s statements that the above are “subject to reasonable limits” be fairly interpreted? Your thoughts on these and other questions Environment and Climate Change Canada and HC have posed in their Discussion Document need to be heard.
Work under the EHSI has relevance to these challenges, but much more is needed. CIHR’s recognition of the complexity of such issues and the structure of the EHSI around cross-cutting research themes and emphasis on building intersectoral partnerships were impressive strengths that evolved over several years of planning and consultation. We can learn and build from this ground-breaking perspective. Clearly, CIHR cannot be solely responsible for advancing future Canadian initiatives. This is a whole of society effort and without substantial investment in science and adoption of the knowledge from today and the future, the vision of CEPA2023 cannot be realized.
The environments we live in have a profound effect on our overall well-being and more-broadly, who we are. The ways that this comes about are complex, operating on all scales inside and outside our body, and are bi-directional whereby the environment continually shapes us, and we continually shape the environment. The impacts are felt individually and accumulate over populations such that well-being requires knowledge and action in consideration of both perspectives.
While subtle, the use of the phrase environments and health, which CIHR used for the EHSI, vs. environmental health is important. Perhaps the former helps ground us less towards anthropocentric thinking and more towards an understanding that above all, environments (and ecosystems) must be healthy for humans and humanity to realize long-term well-being; humans are (one) part of the whole.
The research undertaken across the EHSI covered this whole environments and health spectrum admirably. Each in their own way, the projects embraced the inherent complexity of the systems they were studying thereby significantly advancing knowledge.
Looking ahead and beyond the five recommendations above, we know what we need to do and there is no time to delay actions. While the EHSI made significant progress on some critical hurdles, there is much work to be done to build on that progress:
- Implementing and evaluating currently known or newly discovered healthy city solutions in a complex social environment.
- Extending the mission of personalized medicine towards personalized environmental health.
- Informing government and the public on evolving science to assist in the creation and maintenance of optimal environmental conditions.
- Embracing both Indigenous and western knowledge towards minimizing impacts and preparing for the implications of environmental/societal change, such as water scarcity, wildfires, extreme weather and energy and economic transitions.
Science-based perspectives from environments and health research, past and present, are a critical part of the process in development of the CEPA2023’s Implementation Plan and to lay the foundation for future R&D, as well as effective policy decisions. Public commenting on the initial CEPA2023 blueprint is open until Apr. 8, 2024. All stakeholders should consider sharing their perspectives to help ensure it is clear, ambitious, and actionable thus serving to create change for short and long term.
About the Author
Dr. Jeff Brook is CANUE’s Scientific Director and Associate Professor in the Dalla Lana School of Public Health at the University of Toronto. He was the chair of last year’s Environments and Health Research Summit. Jeff was previously a senior research scientist in the Air Quality Research Division at Environment and Climate Change Canada. CANUE’s main goal is to increase scientific understanding of the interactions among the physical features of the urban environment, individually and in combination, their effect on health and how they can be modified to improve health. CANUE is also making environmental equity data and maps widely available across Canada through HealthyPlan.City.