Plant-rich: the Win-Win Diet

Originally published in the Sudbury Star on Feb. 5, 2022

When it comes to their eating habits, you’d never know my two kids were raised in the same home. Kid #1 is a committed vegan and amateur chef, who loves her beans and lentils. Kid #2 (to his pediatrician-mom’s dismay) subsists on red meat, eats no vegetables except raw carrots, and can barely rehydrate noodles.

Over the last few decades, we’ve been fed so much contradictory advice about food, we hardly know what to eat any more. Even the meaning of the word “diet” itself has been transmogrified: the purpose of a diet isn’t to nourish our bodies. It’s all about shrinking them.

There are so many “diets” out there, we can’t even keep them straight. Paleo. Keto. Low-carb. Low-fat. Atkins (which is low everything), The Zone. Gluten-free. Vegetarian. Flexitarian. Vegan. We’re so busy cutting out this and supplementing that, we’ve lost track of what food is. And thanks to the food industry, it’s questionable whether much of what’s to be found in our supermarkets and fast food outlets even qualifies for consideration. (My own personal view: if it isn’t capable of rotting quickly, it probably isn’t food.)

Despite our mixed-up relationship with nourishment and our preoccupation with losing weight, obesity and its complications have become a global pandemic.[1] Around the world, some 1.9 billion adults are overweight or obese. The rates are particularly high in countries like Canada and the USA. Our messed-up eating habits and inactive lifestyles result in a high risk of diabetes, high blood pressure, heart disease, and many forms of cancer. In 2021, about 15,000 Canadians tragically died of COVID-19, but  almost 80,000 died from heart disease, stroke, or complications of diabetes.[2]

When I was born in 1959, the world’s population was about 3 billion. We’re now approaching 8 billion, and although birthrates are falling, we will likely hit 10 billion in the 2050s. Producing enough food for everyone is one of humanity’s greatest challenges and achievements. Through the development of higher-yield crops, the use of synthetic chemicals and fertilizers, and the industrialization of agriculture, we’ve managed to increase global food production dramatically. Around the world, a great many people have access to far more food than is good for them; famine and malnutrition have become less common. That said, hundreds of millions of our fellow humans still go to bed hungry.

While our capacity to expand food production might seem like a triumph of human ingenuity, it has come at an enormous environmental cost. Here are just a few examples: Globally, about 25 percent of greenhouse gases originate from agriculture. Heavy use of chemical fertilizers has dramatically altered the planet’s nitrogen and phosphorus cycles, with serious consequences like massive aquatic dead zones in the Gulf of Mexico. The use of pesticides is killing off wildlife, and contributing to biodiversity loss. Large swaths of critically important ecosystems like the Amazon rainforest have been been cleared to make way for agriculture. All these costs have been inflated by our modern love affair with animal-derived foods, and especially beef.

The good news is this: there’s a way of eating that’s good for both people and planet. A win-win diet. A diet characterized not by restrictions, but by abundance. It’s called the Plant-Rich diet. It’s not really a “diet”; it’s a way of life. There’s nothing you can’t eat on the plant-rich diet. But when you intentionally fill up your dinner plate and your stomach with plant-sourced foods like vegetables and fruits, whole grains, beans, lentils, nuts, and seeds, there will simply be less room for meat, cheese, eggs, and chicken. You will be eating a diet that’s higher in fibre, and lower in sugar, salt, and unhealthy fats.  

And finally, here’s the biggest surprise: the plant-rich diet bears a remarkable resemblance to the latest version of Canada’s Food Guide![3]

Sources:

[1] https://worldpopulationreview.com/country-rankings/obesity-rates-by-country

[2] https://www.statista.com/topics/8039/death-in-canada/#dossierKeyfigures

[3] https://food-guide.canada.ca/en/

Climate Action in the Time of Omicron 2

Two weeks ago, I opined on the challenge of sustaining action directed at the 21st century’s greatest health threat (climate change and other environmental issues) while mired in a dreary, endless pandemic that has sickened and killed people we know and love. It’s rather like forgetting about chemotherapy while seeking help for acute chest pain. Or neglecting to take the insulin one’s life depends on, while fleeing a grizzly bear.

Such lapses of attention are understandable, in the short term. But what happens when the acute threat drags on for months or years, stealing our mental and physical energy? If we can’t learn to deal with both threats at once, we’ll end up dying of the cancer or diabetes we sidelined while trying to survive the heart or bear attack.

COVID-19 has been both an acute threat and a global tragedy. In 2020, the virus killed some 15,000 Canadians. A similar number died in 2021.[1] The toll on our physical and mental health has been incalculable, and it’s not at all clear if or when the danger will be over.

Meanwhile, in the backdrop, the climate crisis escalates like a nasty case of neglected diabetes or cancer, rearing its ugly head in the form of unprecedented and lethal heat waves, droughts, wildfires and smoke, tornados, rainfall, landslides, and floods. Air pollution brings the lives of some 15,000 Canadians to a premature end each year,[2] and has been doing so since long before we’d ever heard of COVID-19.

So how do we deal with a chronic and looming climate-health emergency, while simultaneously enduring yet another wave of lockdowns, exhausted nurses, and over-run ICUs? It’s tough. But almost two years have passed since the novel coronavirus entered our lives, and global emissions are not coming down. Carbon dioxide levels in the atmosphere continue to rise; the glaciers, polar ice sheets, and Arctic permafrost keep melting; and the weather gets more unpredictable and life-threatening with each passing year.

I’ve been writing this climate-health column for a year now, to help keep the climate crisis in the minds of readers, especially health professionals. So it’s discouraging to observe that in 2021, what got people riled up and out protesting was not government inaction on the climate crisis. Instead, it was anger at the legitimate public health precautions and vaccine mandates put in place to keep us safe from the virus that’s still holding us hostage.

The 2020s are a critical decade. Either we re-engineer the way we live on this planet, or we blunder into climate-health catastrophe. There is no time left for incremental change. We need mega-activism and action at all levels. So, to stimulate your imagination, here are some things I’ll be doing in 2022:

• Personal: Stay vaccinated and wear a mask. Eat a plant-rich diet; use my feet and my electric bike whenever possible for transportation; enjoy the beauty of the lakes and forests and trails of Northeastern Ontario.

• Professional: teach every medical learner and health professional colleague I meet about the climate-health emergency; publish articles at every possible opportunity; write this column; continue work on my book; strategize with health professionals around the world; foment a massive uprising! Supporting the work of CAPE: The Canadian Association of Physicians for the Environment.

• Political: lobby (with Citizens Climate Lobby) before, during, and after the provincial election, for vigorous climate action in Ontario; work to ensure that every MP and MPP in every riding in Canada is hearing regularly from their health professionals about the climate health emergency. Support our Fridays for Future Youth climate activists. Sign petitions. Write Op-Eds. Protest. Give speeches. VOTE!

Climate action is the very best diversion from this boring pandemic, and it’s also the best antidote to climate anxiety. So please, do your own mental health a favour and take audacious climate action in 2022.

Sources:

[1] https://health-infobase.canada.ca/covid-19/?stat=num&measure=total#a2

[2] https://www.canada.ca/en/health-canada/services/publications/healthy-living/2021-health-effects-indoor-air-pollution.html#a1

Originally published in the Sudbury Star on Jan. 22, 2022

https://www.thesudburystar.com/opinion/columnists/blacklock-climate-action-in-the-time-of-omicron-part-2 

Climate action in the time of Omicron: 1

Originally published in the Sudbury Star Jan. 7, 2022

This COVID-19 pandemic is getting to be a bit much. Like, serious bandwidth overload. We were still grappling with the delta variant and had barely managed to reopen the Canada-US border when omicron appeared on the scene in South Africa. Borders slammed shut again, too late to make a difference. Within days, the new variant was turning up everywhere, like a malignancy long since spread. Once again, (or perhaps still,) we are faced with overwhelmed hospitals and health care workers, canceled surgeries, limits to our testing capacity, long waits for vaccine boosters, and of course, a significant minority of the population who persistently refuse to protect themselves. Theatres, restaurants, and gyms are closed again. Flights are being cancelled; travel plans put on hold. And school is back on-line, for the third year in a row.

As a sixty-something woman whose children are grown and whose parents have passed, I can only imagine what it must be like to be a single mom or dad, or worse, a member of the sandwich generation, worried sick about elders and simultaneously scrambling to provide childcare, school supervision, and parenting, while also holding down a job and paying the bills.

My nursing and medical colleagues, especially those working in Public Health, Emergency Departments, and Critical Care Units, are tired, overwhelmed, and often burnt out. And no wonder. Our health care system was struggling to keep up before the pandemic even started, and our country is short some 20,000 nurses.

Although COVID-19 has been relatively merciful to pediatricians and their young patients, with the advent of omicron, increasing numbers of infants and children are requiring hospital care; some of them are gravely ill. A few have died.

It will probably be years before we fully appreciate the impact of the pandemic on our mental health. But already, it’s more than apparent, in the Emergency Department, at mental health clinics, at the offices of family doctors, pediatricians, and psychiatrists, and at my Eating Disorders clinic. There’s also a serious risk that vulnerable students will be permanently left behind amidst the chaos and unpredictability of their school experience.

If there was an end in sight, a clear path back to what used to be “normal life”, it would be easier to sustain ourselves. But the whole situation just drags on and on, with surge after surge, and who knows what the next COVID variant of concern may impose on our already frayed psyches.

Unfortunately, a pandemic doesn’t make other issues go away. Despite the economic consequences of lockdowns and border closures, there’s been no lasting reduction in global greenhouse gas emissions. Air pollution continues to kill millions each year. The destruction of rainforest and other critical ecosystems continues apace, and more species go extinct.

Last year’s string of catastrophic weather-related disasters in British Columbia brought home to many Canadians the folly of continuing along our current fossil fuel-burning path. But many people simply lack the mental energy to engage with what will ultimately be this century’s greatest threat to human health: climate change and all the other derangements we humans have inflicted on the planet, and ultimately on ourselves.

It’s unfortunate. The 2020s are a critical decade. Either we choose to re-engineer the way we live on this planet, or we continue to blunder along, choosing our future by default. It’s pretty clear that without a massive and sustained public outcry, our political leaders are unlikely to respond to the climate crisis with the drastic action required after three-plus decades of dallying around.

But how, in the midst of a pandemic that drags on and on, do we generate that public outcry? How do we find the bandwidth to engage, the energy to act with vigour, when we’re feeling exhausted and demoralized by a virus? These are questions I will ponder in my next column.

We expect drinking water . . . why not breathing air?

 Originally published in The Sudbury Star on Dec. 11, 2021 as "When Faced With Polluted Air, Our Choices are Limited"  

  Everyone knows what’s meant by the term drinking water. Here in Northern Ontario, there are lakes everywhere, but for various reasons, whether microbial or chemical, most of the water isn’t safe to drink without treatment. Drinking water has to meet stringent public health standards, to ensure it won’t make us sick.

      In lower income countries, reliable supplies of drinking water are not universally available. Water-borne diseases like cholera, typhoid fever, Hepatitis A, Giardia, and dysentery/diarrhea are all too common. Travellers can get sick even from water that’s safe for the locals. When I visit West Africa, I guzzle many a 750 ml bottle of “pamplemouse”, a locally-made grapefruit-flavoured pop. I assume it’s made with drinking water, and so far I’ve managed to stay well. 

      In higher income countries, people expect the water coming out of their taps to be drinking water. And for the most part it is, although some indigenous communities in northern Canada are still waiting for the permanent end of boil water advisories. During the November 2021 flooding disasters in British Columbia, the entire town of Merritt had to be evacuated due to failure of their sewage and water treatment facilities. The town was unable to provide citizens with safe drinking water. Four weeks later, many people are still unable to return home, and a boil water advisory remains in place for the foreseeable future. Under such circumstances, it’s possible to truck in limited supplies of drinking water as a temporary measure, assuming the roads aren’t blocked by mudslides or washed out by flooding rivers. Water is transportable.

      Not so with air. The air we must breath is the air in the immediate vicinity of our mouths and noses at any given moment. If we are lucky, that air might be breathing air, clean enough most of the time. But many people are forced to breath chronically filthy air, within their homes on account of antiquated cooking technologies and dirty fuels, and/or outside thanks to industrial emissions, fossil fuel burning, and wildfires. Sometimes the sources are far away, the other side of an ocean or continent. When we are faced with polluted air, our choices are limited. It’s not like we can hold our breath and wait a few days for the air to clear. And it’s not like clean air can be gathered up from the mountain ranges and trucked into towns and cities that lack it. Affluent people may choose to stay indoors with their AC cranked up or climb into their air-conditioned cars and travel to less-polluted locales. But most people have no options, and precious little recourse. They just have to keep breathing.

      The research coming in on air pollution is scary. It’s killing and sickening way more of us than was previously thought, even at very low levels. It’s increasing rates of prematurity and low birth weight; impacting the growth and development of babies before they’re even born; causing or aggravating pneumonias, asthma, and chronic lung disease; and raising our risk of heart attacks, strokes, and dementia.

      But what gives? We all know about drinking water. Why doesn’t English have a term like breathing air? There were lawsuits over the lead contamination in Flint Michigan’s drinking water. Where are the lawsuits arising from the sickness and death inflicted on us by air pollution? How much suffering and death could be prevented, and how many health care dollars saved, by ensuring that everyone on the planet has access to breathing air?

      And finally, how much headway could be made on reducing our greenhouse gas emissions by setting and achieving the goal of breathing air for everyone on the planet?

Air pollution and climate change: It’s about your health!

Originally published in The Sudbury Star on Nov. 27, 2021

Ella Adoo-Kissi-Debrah was a precocious and talented young girl. At the age of nine, she could play the cornet, the drums, the guitar, and the piano. She loved to read, sing, and dance. From a young age, she excelled at numerous sports, and was in demand as a soccer player despite the chronic ill health that plagued her from age seven. Ella died at the ripe old age of nine, a victim of her final and fatal asthma attack. 

Ella’s asthma tended to flare up during the winter. Over two years, fits of coughing, wheezing and shortness of breath took her to hospital 28 times. 

Ella and her family lived a mere 25 metres from South Circular Road, one of London’s busiest thoroughfares. Due to the heavy traffic in Ella’s neighbourhood, levels of the air pollutant nitrogen dioxide (NO2) almost always exceeded the UK’s legal limits, especially during the winter. In the days before Ella’s death, pollution levels really spiked. Ella’s mother didn’t know any of this at the time.   

Still, like many parents who lose a child, Rosamund Kissi-Debrah sought to make something good come out of her daughter’s passing. She started a charity to advocate for children with asthma. Someone suggested that air pollution might have been a factor in Ella’s illness. A human rights lawyer got involved, and a medical report was commissioned. The report demonstrated a clear association between Ella’s attacks of asthma and levels of air pollution in her neighbourhood. Ultimately, a second inquest was held, and on Dec. 16, 2020, Ella made posthumous history, becoming the first person in the UK (and possibly the world) to have air pollution officially listed on her death certificate as a cause of death. She is not, however, the first person to die a premature air pollution-related death.

It’s estimated that 40,000 deaths in the UK, and about 15,000 a year in Canada, can be attributed to air pollutants like NO2 and PM2.5. Very recent research concluded that in the year 2018, the PM2.5 generated just from burning fossil fuels was responsible for about 8 million premature deaths globally. As with the health impacts of climate change, the poor and people of colour everywhere bear much or the burden. 

The battle for clean air was very evident at the recent COP26 meetings in Glasgow. There were the pediatric health professionals who cycled from London to Glasgow, bringing attention to the twin health threats of climate change and air pollution. Warrior Moms were there from Delhi, India, one of the most polluted cities in the world. (As I write this column, Delhi’s Air Quality Index is in the hazardous range.) Choked Up, a group of self-described “black and brown teenagers from South London,” were there, helping plan future international collaboration. And of course, Kissi-Debrah herself was there, ardent and eloquent as always, and concerned that many people feel like COP and climate change have nothing to do with them.

For Kissi-Debra, air pollution and climate change are not two separate issues. Both problems arise largely from our human fondness for burning things, especially fossil fuels. “This is a public health crisis,” she said. “Every time people mention climate change, they need to mention the health crisis . . . This is about you and your health.” Recent events in B.C. and elsewhere are starting to bring that lesson home to Canadians.

Sources:

1. https://www.canada.ca/en/health-canada/services/publications/healthy-living/2021-health-effects-indoor-air-pollution.html

2. Royal College of Physicians. 2016. “Every Breath We Take: the lifelong impact of air pollution.” This report can be downloaded at: https://www.rcplondon.ac.uk/projects/outputs/every-breath-we-take-lifelong-impact-air-pollution

3. Vohra K et al. 2021. “Global mortality from outdoor fine particle pollution generated by fossil fuel combustion.” Envir Research 2021 Apr;195. doi: 10.1016/j.envres.2021.110754

1. http://ellaroberta.org/ella-roberta-family-foundation/ Accessed Nov. 24, 2021.

Kids can’t be healthy on a sick planet

Originally published in The Sudbury Star on Nov. 13, 2021   

On a hot July day in the summer of 2015, an older pediatrician was out on the street chatting with a couple of neighbours. During a lull in the conversation, she was heard to say: “I’m really worried about climate change, but I don’t know what I could do that would make a difference.” She sounded pretty lame, especially to herself.

As luck would have it, one of her neighbours was the National Director of Citizen’s Climate Lobby Canada. So obviously Blacklock wasn’t allowed to get away with her verbal flailing. To her credit, she got busy, read a great many books, started writing letters to the editor, and became a lobbyist for the very system of greenhouse gas pollution pricing now in place across Canada.

As mentioned, Blacklock was indeed getting older. Silver threads amongst the gold, as the (very) old song goes. She’d finished her pediatric training in 1989, before most current medical students were born. After a two-year stint in West Africa, she’d returned to Canada and done her best to serve, at the hospital and the office, for close to thirty years. And as those years flew by, Blacklock found herself thinking some troubling thoughts. In this regard she was not unique. It’s a common theme for older health professionals, who’ve worked long hours, year after year, doing their very best for whatever patient is before them. They start to recognize anew something they may (or may not) have been taught in medical school: Access to a good health care system is important, but for the most part what really keeps people healthy are the so-called social determinants of health: access to clean air and water, healthy food, green spaces, housing, and the internet; educational and vocational opportunities; political stability and safety; stable family and social networks; vaccination and other public health measures . . . the list goes on and on.

But as Blacklock studied, and listened, and even started writing a book, she found herself coming face to face with an even deeper reality: all those social determinants of health, and indeed our health care systems themselves, depend upon the health of the planet. And all the babies and kids and teens and families she’d cared for over the years (not to mention her own offspring) were heading out to live their lives on a planet that’s increasingly unhealthy. A planet that’s in fact seriously ill. A planet in the midst of multiple man-made crises: air pollution, deforestation, and a changing climate. Drastic destruction of ecosystems. A great dying off of plant, animal, and insect species. Oceans chock-a-block full of plastic and dead zones. Bleaching coral reefs. Way too much phosphate, nitrogen, and carbon in all the wrong places. And a rapidly rising population of humans who are consuming resources and excreting garbage at levels well beyond the support capacities of the planet.

In the face of these realities, Blacklock contemplated how best to spend her latter years, and came to the conclusion that she would become a “chronically retiring” pediatrician, devoting the majority of her time to fighting for the most fundamental determinant of health: a healthy, thriving planet. Some days, it’s an overwhelming task. A mere pediatrician has only so much power and influence. COPs come and go. Change is slow and incremental. But of this Blacklock remains certain: there’s no better way to care for her patients (and her own children) than to fight for their health on Planet Earth. Because ultimately, no kid will be healthy on a sick planet.

Climate Inaction: an assault on the mental health of our kids

Originally published in The Sudbury Star on Oct. 16, 2021

“If you are a Baby Boomer . . . do you remember how frightened you were about being nuked? . . . Remember how they scared the hell out of us? . . . Now they’ve transferred that to global warming, except it isn’t real.”  That’s Rush Limbaugh on his radio show in 2014. The “they” he’s referring to presumably includes climate scientists, climate activists, and any politician who proposes actual climate action. Apparently, it’s all fearmongering. It’s upsetting people and causing mental health problems. Of course, Rush dismissed the dangers of smoking too, and now he’s dead of lung cancer. Perhaps a bit more anxiety would have done him some good.

In some circles, it’s fashionable to blame the climate angst of young people like Greta Thunberg on environmental education and the constant deluge of dire warnings about imminent climate catastrophe, destruction of ecosystems, and extinction of species. There’s no doubt our children and youth are anxious. Many of them are angry, too. However, in the face of the very real environmental threats we face, feelings of alarm, anxiety, and anger seem like appropriate responses, not signs of mental illness. In fact, as one young adult commented in a 2013 study, “My worries are rational, climate change is not.”

Derogatory terms like “mass neurosis” and “global warming hysteria” are propagated by people like Rush, who don’t “believe” in climate science (or apparently tobacco science either.) The rest of us know there’s a serious problem, and yeah we’re worried about it. Many of us are even alarmed. And when that worry is united with a sense of agency and focused on problem solving and solutions, it can be a highly constructive feeling, leading us to engage with the issue and take action. Research suggests that taking action in the company of like-minded people can be one of the best strategies for dealing with climate anxiety.

The situation is particularly perilous for the mental health of our youth. They are not just little adults. They are still growing and developing. And if adults feel unsure about how to change what’s happening to the planet, imagine how disempowered young people must feel. They can’t even vote. They are stuck with relying on adults and governments to respond, on their behalf, with an appropriate level of science-based action, which we have manifestly failed to do. Is it any wonder young people feel abandoned and betrayed? That their climate angst has the colour of anger? The flavour of moral injury?

In 2009, Litz and colleagues suggested that potentially morally injurious events might arise from “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.” On a day-to-day basis, children and youth are learning about and bearing witness to the ongoing destruction of the planet by adults who are perpetrating, or failing to prevent, the wreckage. We risk inflicting what Shay described in 2014 as a “character wound that stems from a betrayal of justice by [persons] of authority in a high stakes situation.” It’s worth pondering what might be the long-term impact of such a wound on today’s young people, if we adults keep failing to tackle the multiple environmental crises we’ve created.

Perhaps that’s why parents worry that soon enough, young people we love will ask us what we did to prevent climate change or mass extinctions. Will we have answers, or will their questions overwhelm us with guilt and shame?

People like Rush Limbaugh would have us protect kids from climate anxiety by stopping the “fear mongering”. I say the better way to protect our kids from anxiety, anger, and moral injury is to act. Young people need to see adults, the businesses and corporations they’ve created, and the governments they’ve elected, stepping up to the plate, and making the needed action happen. This decade. This year. Next month at COP26 in Glasgow.

Sources:

https://live-rush-limbaugh.pantheonsite.io/daily/2014/05/06/podesta_helps_obama_play_dictator/

VerPlanken B and Roy D (2013). “My worries are rational; climate change is not”: Habitual ecological worrying is an adaptive response. PLoS ONE 8(9): e74708. https://doi.org/10.1371/journal.pone.0074708

Lancet Preprint: Hickman C et al (2021). Young people’s voices on climate anxiety, government betrayal and moral injury: a global phenomenon. Electronic copy available at https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3918955

Litz B et al (2009). Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clin. Psych. Review 29:695-706. DOI: 10.1016/j.cpr.2009.07.003

Shay J (2009). Moral injury. Psychoanalytic Psychology 31:182-191. https://doi.org/10.1080/00377310903130332 

Griffin B et al (2019). Moral injury: an integrative review. J Trauma Stress. 32(3):350-362.https://doi.org/10.1002/jts.22362   

Clayton S (2020). Climate anxiety: Psychological responses to climate change. J Anxiety Dis 74:102263.https://doi.org/10.1016/j.janxdis.2020.102263

#Ride for Their Lives - UK Peds Docs Cycle to COP 26

Originally published in The Sudbury Star on Oct. 30, 2021

Great Ormond Street Hospital, in the heart of London, is affectionately known as GOSH. On the morning of Oct. 24, its excited team of riders gathered out front, mounted their bicycles, and headed for Granary Square to join health professionals (and a few former patients) from pediatric hospitals all over the UK on a cycling trip to Glasgow. Their purpose: to deliver some very critical documents to the world’s leaders at COP26 on behalf of the global health community.

Those same documents had already survived an 860 km bicycle trek from WHO headquarters in Geneva Switzerland, carefully protected from wind, rain, and sweat by “occasional cyclist” Dr. Diarmid Campbell-Lendrum, head of the WHO’s Climate and Health Program.

With some relief, @DiarmidCL handed over the burden of responsibility to Dr. Finella Craig, a children’s palliative care specialist at GOSH, the UK’s equivalent of Sick Kids, and the second half of their journey began.

So what are these documents? The first is a copy of the WHO’s new report called “The Health Argument for Climate Action”, prepared in consultation with the international health community. The second is the Prescription for a Healthy Climate, addressed to world leaders soon to gather at COP26, and signed by groups representing 45 million health professionals from around the world. The team of riders will also deliver a copy of the latest Lancet Countdown report and a recent editorial published in 220 medical journals calling for emergency action on climate change for the sake of human health.

As the cyclists made their final preparations, Dr. Craig spoke of the twin threats of climate change and air pollution: “Our feeling is that as children’s health professionals, we’ve got a duty to protect children’s health, and my personal feeling is that if I ignore the issue, or say nothing about the issue, it means that I don’t care, or I don’t think it matters. And actually . . . it really, really does matter . . . so we have to do something. And I’m not alone in that everyone who’s cycling with me . . . and millions of children’s health professionals across the world . . . we’re all really concerned!”

An 840 km cycling trip requires both mental and physical preparation. “Green Machine” Dr. Ewan Wallace, a Glasgow specialist in pediatric anesthesia and chronic pain, began training by cycling to work, and getting in as many miles as possible on the weekends.

Pediatrician “Alex” found personal motivation in the knowledge that air pollution affects the health of children before they are even born. Alex gave birth to her first child in a city with some of the dirtiest air in the world.

@DrMarkHayden from GOSH gathered energy from conviction: “As an intensivist, I know that when someone’s really sick, just like the planet, it’s no good sitting around talking about it. It’s no good making promises for the future, you need to take immediate action.”

@SustainaPhil, a charismatic sustainability officer from Sheffield, recruited members of his fabulous family to prepare refreshment pitstops along the way.

Children’s psychiatrist Dr. Catriona Mellor wrote a thought-provoking blog-post for the British Medical Journal, called “The Climate Crisis: How do we show we care?

@DrMikeMcKean, a children’s cardiac care doc from Newcastle on Tyne in the north of England, booked a ticket to London, and tweeted a photo of his bicycle securely strapped to the train’s bike rack.

#RideForTheirLives participants are scheduled to arrive in Glasgow on October 31st, the opening day of COP26, to deliver their documents and demand action, on behalf of the world’s children.

Their trip has raised awareness of the impacts of climate change and air pollution on children’s health and demonstrated that the UK’s pediatric health professionals care. Each kilometer they’ve ridden is also a demonstration of the dramatic health benefits of emissions-free active transportation. We can only hope world leaders are watching and listening.

Climate Change and the Political Levers of Change

Originally published in the Sudbury Star on Sept. 18, 2021

There’s a joke of sorts out there about smoking. “It’s easy to quit; I’ve done it many times!” It’s not easy though, because smoking is both an addiction to nicotine, and a powerful social habit. Despite the wide array of smoking cessation therapies available, would-be non-smokers relapse at a high rate. Nonetheless, smoking rates in Canada have plummeted, from 50 percent in 1965 to 13 percent in 2021.

This drastic decline was facilitated by the wise implementation of levers and forcing mechanisms. Pricing, for starters. Through targeted taxes, the price of a pack of cigarettes came to reflect not just manufacturing and retail costs, but also the additional expense of providing health care to smokers. Municipal regulations also made the frequent need for a smoke inconvenient and uncomfortable. There are just so few places a person can light up these days.

The Greek mathematician Archimedes once said, “Give me a place to stand and with a lever I will move the whole world.” Large scale change requires big levers and powerful forcing mechanisms, and large-scale change is exactly what’s required to address the climate emergency we’re facing.

Fossil fuels are a powerful societal and economic addiction. It is simply not enough for motivated individuals to switch to LED bulbs, recycle, eat less meat, drive a hybrid, or quit flying. Nor are Canada’s national emissions reduction targets anywhere near enough to keep global heating within a range that’s safe and healthy for humans. And let me be clear: when I use the word “enough”, I’m not referring to what environmentalists would prefer; I’m talking about what science and physics and human health demand.

Over the Labour Day weekend, more than 220 of the world’s medical journals simultaneously published an editorial entitled:

“Call for Emergency Action to Limit Global Temperature Increases,

Restore Biodiversity, and Protect Health”

The planet’s climate stability, its biodiversity, and the health and safety of its humans are in serious peril. We are desperately in need of powerful levers and forcing mechanisms to produce an urgent and massive transition in our societies and our economies, both nationally and globally.

Perhaps the greatest lever available to us is the pricing of greenhouse gas pollution. (aka carbon pricing, carbon tax, carbon fee and dividend, etc.) Greenhouse gases (GHGs) are causing expensive harm to the planet and to human health and safety. As with cigarettes, we can no longer ignore this reality. Prices must start to accurately reflect the true costs of our addiction. Here in Canada, we have managed (barely) to put a system of GHG pricing in place, complete with rebates. What we need now is policy persistence. We need to stick with the plan, consistently raise that price, and lobby hard for similar action at a global level. Meanwhile, we have options like border carbon adjustments, to protect our economy from unfair competition.

Back in 2008, the UK passed a law binding itself to constrain its GHG emissions. Three-year carbon budgets are proposed by an independent, science-based committee, and once agreed upon, they are legally binding. This is an example of a forcing mechanism, and thus far, it’s been quite effective.

Meanwhile, here in Canada, we pay lawyers to squabble over carbon taxes, and set far-too-meagre emissions reduction targets for years down the road. At least one of our political parties would regress those targets at a time when more ambition is what’s desperately needed.

Big change is hard. It took far too long to bring smoking rates down and give nonsmokers the right to clean, breathable air. It is taking way too many decades to end our destructive addiction to fossil fuels and ensure ourselves, and especially our youth, the right to a livable planet.

There’s an election on Monday. At this point in history, the climate action we need is political action.

A Canadian Carbon Election Parable

Originally published in The Sudbury Star on Sept. 4, 2021

There was a man named Jack, a self-employed, hard-working fellow with Type 2 diabetes, who lived in a fake town called Carbon City.

Now Carbon City was a peculiar place, where planning for retirement was straightforward. Every citizen knew precisely how long they would live, and how much each year of living would cost. In Carbon City, banks didn’t offer interest. People had to manage on what they’d saved, but with care, life could be wound down gracefully.

After 40 years of toil, Jack had managed to save $1 million. He decided his time had come. With 20 more years to live, at a cost of $40,000 a year, he would have $200,000 left for unexpected costs and a wee bit of fun. His financial advisor gave him a 50-66% chance of having enough money to see himself through.

During his first year of freedom, Jack decided he deserved a real vacation.  His doctor had warned him about the potential complications of diabetes and Jack wanted to enjoy a cruise while he still had both legs. He blew $8000 and had a blast. His advisor wasn’t so happy.

The next year, Jack’s old Honda Civic called it quits, so he bought himself a brand-new souped-up Ford truck.  For some reason, his advisor wasn’t interested in taking it for a spin. He just shook his head and walked away.

As year three rolled around, a pandemic struck, and Jack was stuck at home. What with the diabetes, he always felt too hot or too cold, so he invested in AC and got a two-for-one deal on gas fireplaces. His financial advisor accused him of flouting his advice and threatened to quit if Jack didn’t stop spending so much money.

But on it went. By year ten, Jack’s diabetes was out of control. His legs were a weird bluish-purply-grey colour, and he would soon be a double amputee. Life just wasn’t much fun anymore. Unexpected bills were piling up on his countertops. His “extra” $200,000 was gone, and Jack was dipping into his cost-of-living money to keep his creditors at bay. With ten more years of life to pay for, he started buying lottery tickets.

In year eleven . . . well, need we go further? Jack was in poor health, and in serious financial trouble. He had repeatedly failed to stay within his budget and plan for the unexpected. But instead of taking responsibility for his actions, Jack blamed his financial advisor. Why had the guy ever suggested that a 50-66% chance of having enough money was good enough odds? Life was going to be tough on the streets for a guy with no legs.

Readers may ask what this parable means, so I will offer an interpretation. Carbon City is our fossil-fuel-based global economy. Jack represents all of humanity, but especially those who inhabit the industrialized world. Jack’s $1 million is the fixed budget of greenhouse gases we have left, if we are to avoid global warming of more than 1.5-2.0C. This budget has been ordained by the laws of physics and can’t be changed.  When it’s gone, it’s gone. Jack’s financial advisor represents the verdict of science and the best advice and warnings of the world’s climate scientists. Jack’s odds of having enough money (50-66%) are the same odds many of the currently recommended actions are based on.

Jack’s overspending and poor financial management represent our ongoing failure to seriously curtail our emissions and wind down our fossil fuel economy gracefully within the years allotted to us. Jack’s deteriorating health and loss of his legs represent the increasing near-term impact of climate change so evident in the news these days, and the devastation to come if we don’t change direction immediately. 

As Jesus used to say, “He who has ears to hear, let him hear.”