Chapter 7: Policy Advocacy and Public Health

Climate change is not only an environmental crisis – it is a health crisis unfolding in slow motion. For Canadian health and social care providers, caring for patients in a warming world means looking beyond the clinic and into the community. This chapter explores how providers can use their trusted voices and positions to shape health systems and public policy for climate resilience, foster mental health awareness, and promote trauma-informed practices. The goal is to ensure that our health institutions and policies not only respond to climate-related threats, but also address underlying inequities that make certain groups more vulnerable. In short, effective care in the era of climate change extends from the bedside to the legislature.

Healthcare professionals in Canada have a proud history of advocacy – from campaigns against tobacco to efforts to reduce poverty. Today, the climate crisis calls for that same leadership. Providers are witnessing firsthand the impacts of extreme heat, wildfires, floods, and climate anxiety on patients’ well-being. With this insight comes an ethical responsibility to advocate for solutions. By engaging in advocacy through professional colleges, hospitals, unions, public health agencies, and community organizations, care providers can help drive policies that protect patients at a population level. Crucially, these efforts must be rooted in principles of justice, equity, decolonization, and inclusion, ensuring that those most affected by climate change are not left behind in our policy responses (1). The following sections discuss practical avenues for provider advocacy, strategies for public health outreach on climate-related mental health, and the intersections of climate policy and health policy in Canada – illustrated with real-world examples.

Engaging in Policy Advocacy as Care Providers

Individual care providers may sometimes feel that policy is outside their expertise. In reality, health professionals are uniquely positioned to influence policy through their roles in regulatory colleges, health institutions, unions, and professional associations. These bodies shape standards of care and public priorities – and they are increasingly recognizing climate change as core to their mandates. For example, in 2024 the Royal College of Physicians and Surgeons of Canada established a National Advisory Committee on Planetary Health to integrate climate action into medical training and accreditation. In its first initiatives, this committee helped the Royal College co-sign an open letter urging the federal government to treat climate change as a health emergency and protect people from extreme weather, explicitly linking fossil fuels to health harms (2). This shows how regulatory and certifying bodies can amplify providers’ voices at the highest levels of policy.

Within health institutions like hospitals, clinics, and public health units, providers can advocate for climate-resilient operations and policies. This might involve pushing for greener practices (reducing hospital emissions, improving energy efficiency) as well as better emergency preparedness (heatwave response plans, air filtration for wildfire smoke, etc.). Working from the inside, clinicians have helped some Canadian hospitals form “green teams” and influenced leadership to include climate risks in their strategic planning. Even small actions can snowball. Nursing leaders often quote “think globally, act locally” – a mantra that encourages health workers to take meaningful actions in their own organizations while keeping the bigger planetary health picture in mind. In fact, the Canadian Federation of Nurses Unions (CFNU) has outlined concrete steps nurses and their unions can take: working with employers to “green” workplaces, educating patients and the public, and calling for bold climate action by governments. By engaging colleagues and administrators, frontline providers can turn hospitals and clinics into role models of sustainability and preparedness.

Providers can also leverage unions and professional associations as platforms for advocacy. Unions represent thousands of healthcare workers and have political influence. The CFNU, for instance, has committed to advocate for a just transition to a sustainable economy and to build resilience within healthcare for the challenges ahead. Unions can bargain for protections that matter in a changing climate – such as policies on safe working conditions during heat waves or wildfire smoke episodes – and lobby governments for stronger environmental regulations. Professional associations, like the Canadian Medical Association (CMA) and Canadian Nurses Association (CNA), similarly play a key role by issuing policy statements and partnering with policymakers. These groups have emphasized that climate change is a public health emergency and have called for coordinated action. Health professionals can get involved by joining climate or environmental committees within their associations or supporting initiatives of advocacy organizations like the Canadian Association of Physicians for the Environment (CAPE). Such groups provide a collective voice that can influence legislation and public opinion. Indeed, health professionals are among the most trusted voices in society – nurses have repeatedly been ranked as the most trusted profession – and with that trust comes power. Harnessing it, nurses and doctors across Canada are helping communities transition to a cleaner future and urging policymakers to prioritize health in climate decisions. Whether it’s speaking at a city council meeting about air pollution or contributing to a national task force on climate and health, individual providers have many avenues to turn their expertise into advocacy.

Importantly, advocacy should also occur in collaboration with those most affected by climate impacts. Clinicians learn from patients’ stories of living with asthma aggravated by wildfire smoke or the anxiety of displacement after a flood. By bringing these real experiences to policy discussions, providers humanize the abstract concept of climate change. At the same time, working alongside Indigenous communities, disability advocates, youth activists, and other stakeholders ensures that proposed solutions truly meet the needs of all. Modern public health emphasizes community engagement and “Health in All Policies” – an approach recognizing that policies in housing, energy, transportation and beyond have health effects. Health workers can be the bridge between communities and policymakers, advocating for decisions in those sectors that yield healthier, more equitable outcomes. For example, by championing active transportation (like bike lanes and walkable neighborhoods) a provider advocates for climate mitigation and healthier lifestyles simultaneously. As Canada’s Chief Public Health Officer has noted, *putting health at the centre of climate action* creates win-win opportunities – cleaner air, more physical activity, and improved mental well-being, all while reducing emissions. In summary, whether through formal professional channels or grassroots community collaboration, Canadian care providers have numerous pathways to engage in policy advocacy. By doing so, they help align our societal response to climate change with the goals of improving health and equity.

Public Health Education and Trauma-Informed Outreach

One vital way health and social service professionals can lead is through public health education and outreach focused on climate change. As the climate crisis intensifies, so do its mental health impacts: anxiety about the future, grief over environmental losses, trauma from disasters, and stress on families and communities (3). Providers on the front lines see these challenges – a spike in depression after a community wildfire, or children expressing fear about a changing world – and they can act as educators and advocates to help communities cope. Public health education campaigns, workshops, and materials led by healthcare providers can improve mental health literacy around climate change, empowering people with knowledge and coping strategies. For instance, community nurses or social workers might organize information sessions on recognizing heat stroke and anxiety symptoms during heat waves, or pharmacists might distribute flyers on managing inhalers during wildfire season. Such outreach not only conveys practical health tips, but also sends a powerful message: you are not alone, and we can prepare together.

Crucially, climate-related outreach should be trauma-informed. A trauma-informed approach recognizes that many individuals – especially those who have survived floods, fires, or other disasters – may carry psychological trauma. Outreach must be sensitive, avoiding re-triggering distress and instead fostering safety, trust, and empowerment. Practically, this means health workers meeting people “where they’re at,” listening with empathy, and respecting cultural and personal coping mechanisms. Consider a community that has been through a catastrophic flood. A trauma-informed outreach program might involve mental health clinicians and community leaders co-hosting healing circles or group discussions where residents can share experiences and learn stress-management techniques in a supportive setting. It might include providing psychological first aid training to local volunteers, so that during future emergencies the community has built-in capacity to offer comfort and resources to those in shock. By explicitly acknowledging trauma and creating space for emotional recovery, providers help individuals build resilience. Indeed, resilience planning must involve health experts in developing trauma-informed disaster responses and ensuring mental health supports are accessible (4). In practice, this could be as simple as a family doctor advocating for cooling centers to have quiet spaces for those with anxiety, or as complex as a health authority setting up specialized counseling teams after a climate disaster.

Outreach is not only about responding after crises – it’s also about building psychological resilience before disasters strike. Many Canadians are feeling eco-anxiety and helplessness about climate change. Health professionals can alleviate some of this burden through community engagement that emphasizes preparedness and agency. For example, public health units can run workshops on emergency kits and extreme weather preparedness, coupled with discussions on managing fear and staying connected with neighbors during tough times. Such programs not only deliver practical knowledge (like how to sign up for local heat alerts) but also foster social cohesion, which is a protective factor for mental health. Community engagement that brings people together – a neighborhood planning meeting for climate adaptation or a youth-led tree planting event with a local nurse volunteering on-site – strengthens social networks. These networks prove invaluable when adversity comes; people who know their neighbors and have support systems fare better mentally and physically in disasters. Health providers, by virtue of their community standing, can catalyze these engagements. For instance, a family physician might partner with a school to educate students on climate change and coping skills, or a social worker might collaborate with an Indigenous community to incorporate traditional knowledge into climate health workshops, ensuring they are culturally safe and relevant.

Another emerging practice is integrating climate themes into existing public health outreach programs. Many public health initiatives – from chronic disease prevention to substance use harm reduction – can incorporate climate-related content. A smoking cessation program could discuss how reducing smoking and improving air quality (indoor and outdoor) builds resilience against the respiratory impacts of wildfire smoke. A youth mental health group could explore “eco-anxiety” as part of their anxiety coping curriculum, guided by a counselor who validates their climate concerns and channels them into positive actions (like starting a school garden or advocacy club). By weaving climate awareness into diverse health programs, providers help communities see the connections between planetary health and personal well-being. This integrated approach normalizes the conversation around climate change and mental health, reducing stigma and encouraging proactive coping. It aligns with what experts recommend: expanding communication, outreach, and preparedness activities to prevent climate-related mental health harms (3). When people are informed and engaged ahead of time, the psychological toll of climate events can be lessened.

Finally, it’s worth noting that outreach itself can be healing. Engaging in solutions – whether by attending a workshop or volunteering in a preparedness drill – gives individuals a sense of control and hope. Providers should strive to make their climate and health education hopeful and empowering rather than doom-and-gloom. The goal is to replace paralysis with preparedness. By highlighting stories of communities adapting and thriving, or the co-benefits of climate actions (like better health from active lifestyles), outreach can inspire optimism. For example, sharing a story of a community that successfully lobbied for a green space which reduced local heat effects and provided a gathering spot can motivate others to take initiative. As one Canadian climate advocacy group notes, sharing positive, concrete actions helps give people agency and combats despair (4). In summary, public health education and trauma-informed outreach are indispensable tools to reduce the mental health burden of climate change. Through culturally sensitive, inclusive, and empowering engagement, health providers can help communities not only withstand climate impacts but also strengthen their mental wellness and social ties in the process.

Climate Policy and Health Policy

Climate change and health are deeply interwoven, and nowhere is this more apparent than in policy. Climate policy is health policy. The quality of the air we breathe, the safety of the water we drink, the stability of our housing and infrastructure in the face of extremes – all are determined by policies that respond to climate risks and environmental conditions. In Canada, aligning climate policy with health objectives is increasingly seen as both a necessity and an opportunity to advance health equity. Many climate solutions yield immediate health benefits. For instance, phasing out coal-fired electricity (a climate mitigation measure) dramatically improved air quality in provinces like Ontario, preventing asthma attacks and heart and lung illnesses almost right away. On the adaptation side, investing in flood defenses and heat alert systems saves lives and reduces trauma. By highlighting these co-benefits, health advocates can build support for strong climate policies across society (5). Likewise, health policies – such as building new hospitals or expanding mental health services – must now account for climate realities. A new hospital wing, for example, should be designed to remain operational during heat waves and power outages; a public mental health strategy should consider climate anxiety among youth. The integration of climate considerations into health policy planning is not just prudent – it’s essential for a resilient and responsive health system (5).

Addressing environmental and health equity together is a central theme at this intersection. Climate change tends to magnify existing inequalities: seniors, people with disabilities, low-income and racialized communities, Indigenous Peoples, and those with pre-existing health conditions are often at greater risk from climate hazards (3). These same groups frequently have less influence over policy and fewer resources to adapt – a double injustice. Canadian policy responses are increasingly acknowledging this. Experts advising on Canada’s National Adaptation Strategy have stressed that adaptation measures must be planned with equity, justice, and anti-racism lenses to promote health equity and strengthen the determinants of health (1). In practice, this means policies like heat wave plans or evacuation protocols must prioritize those most vulnerable. It’s why some provinces are exploring programs to provide free air conditioners or clean air shelters for low-income seniors, and why municipal climate action plans often map neighborhoods with higher social vulnerability to target outreach. A recent federal bill, the Climate Change and Environmental Justice Act (Bill C-226), aims to develop a strategy to address environmental racism – recognizing that communities of color and Indigenous communities have faced disproportionate pollution and climate risks. Health professionals have voiced support for such legislation, noting that tackling environmental racism is integral to improving health outcomes. By advocating for climate policies that reduce inequities (like ensuring all communities have access to green space and clean air), providers champion both environmental and health justice.

Canadian health systems themselves are part of climate policy, both as emitters and as protectors of population health. Interestingly, Canada’s health care sector contributes notably to greenhouse gas emissions (among the highest per capita health-sector emissions in the world). This means health institutions have a responsibility to mitigate their climate impact – and doing so can serve health ends by reducing pollution. Forward-thinking policies are emerging: for example, some provincial health authorities (e.g., in British Columbia and Quebec) have developed climate action plans to lower their carbon footprint and report annually on health care emissions. At the national level, calls have been made for a dedicated climate-health secretariat to coordinate transforming Canada’s health system into one that is sustainable and climate-resilient. This kind of integrated approach echoes what other countries are doing. International best practices offer inspiration – the United Kingdom’s National Health Service, for instance, became the first in the world mandated by law to reach net-zero emissions, with the 2022 Health and Care Act obliging every NHS organization to consider climate change in its operations. That policy is driven by a recognition that a health system cannot protect public health if it contributes to climate instability or fails to withstand climate shocks. While Canada’s approach is still evolving, momentum is building: health professional associations have joined global initiatives (such as the WHO’s Alliance for Transformative Action on Climate and Health) to learn and share strategies.

Climate and health policy intersection also occurs at the provincial and local levels, given Canada’s federated structure for health care. Provinces like Ontario, Quebec, and B.C. have developed climate adaptation plans that include health chapters or companion reports on health impacts. These plans often emphasize surveillance for climate-sensitive infectious diseases, strengthening emergency management for extreme weather, and collaboration between health ministries and environment ministries. Local public health units are applying an equity lens to climate action: for example, Toronto Public Health’s climate and health strategy includes mapping heat-vulnerable populations and working with the city to open cooling centers and conduct door-to-door checks in high-risk areas during heat waves. This kind of health-informed climate policy saves lives – as seen in Montreal, where after a deadly 2010 heat event the public health department implemented a heat response plan focusing on isolated older adults, which likely reduced mortality in subsequent events. Community engagement in decision-making is key to procedural justice in these efforts (5). Public health agencies are learning to involve community members – including Indigenous elders, disability advocates, and youth – when designing climate resilience programs, to ensure interventions are culturally appropriate and actually reach those in need. One clear lesson is that solutions crafted with communities are more effective than those imposed on communities.

Health providers have an influential role in these policy processes. They can bring data – for example, illness and hospitalization rates during climate events – to justify stronger action, and they can personify the message that human lives are at stake. It’s one thing for an environmental scientist to talk about climate models; it’s another for an ER doctor to describe treating heat-stroke patients in an overcrowded hospital. Both are important, but the latter often hits home for policymakers and the public by translating abstract risk into tangible reality. Public health professionals in Canada are increasingly stepping up as policy leaders on climate. The Chief Public Health Officer’s 2022 report explicitly calls for public health to prioritize dedicated resources to climate action, lead by example with low-carbon health systems, and put health experts at climate decision-making tables (5). It outlines how core public health functions – disease surveillance, health promotion, emergency preparedness – must incorporate climate factors to protect Canadians (5). In other words, climate policy and health policy must merge to some extent, because the problems and solutions are intertwined.

Looking ahead, we see that bridging climate and health policy will involve not just government action but also shifts in professional practice and education. Medical and nursing schools in Canada are starting to include climate health in curricula, ensuring future providers see advocacy as part of their role. Regulatory bodies may update competency frameworks to include sustainability or disaster response skills. Hospitals might be required to have climate adaptation audits. These are policy decisions too, just at different levels. Each supports the ultimate vision of a climate-resilient, equitable health system. In summary, the intersection of climate and health policy in Canada is a dynamic space where care providers are key players. By advocating for policies that cut emissions, strengthen adaptive capacity, and address social determinants of health, providers help safeguard the well-being of communities now and for generations ahead.