Below are some helpful resources related to the content in this chapter:
The World Health Organization’s overview of climate change as a health issue, including key facts, latest evidence, and recommended actions for policymakers and health professionals.
The Lancet Countdown on Health and Climate Change is an annual international report tracking the connections between climate change and public health. Each year’s Lancet Countdown provides updated data on health impacts (e.g. heat deaths, disease spread), as well as progress (or setbacks) in the health sector’s response. The reports are a valuable, evidence-based tool for understanding trends and making the case for action.
Climate Change Toolkit for Health Professionals is a Canadian resource produced by the Canadian Association of Physicians for the Environment. This toolkit (available in modules) offers practical guidance on climate science, health impacts across Canada, and solutions – from greening healthcare facilities to communicating with patients. It’s a hands-on guide to help clinicians integrate climate action into their practice and advocacy.
Chapter 1. The Role of Health and Social Care Providers
Climate change is no longer a distant environmental issue – it is here and now, affecting the health of our patients and communities in profound ways. Around the world and in Canada, doctors, nurses, social workers, and other care providers are already witnessing climate-related illnesses and emergencies. From heat exhaustion in the midst of record-breaking heatwaves to respiratory problems during severe wildfire smoke events, the impacts of climate change are increasingly present in clinic waiting rooms and hospital ERs. Leading health authorities now recognize climate change as an urgent health crisis: the World Health Organization calls it “the single biggest health threat facing humanity” (1), and it has been described as the greatest public health threat of the 21st century (2). In short, climate change is fundamentally a health issue – and front-line providers are on the front lines of the response.
Why is climate change such a critical issue for healthcare providers? For one, the health consequences of a changing climate are wide-ranging and already underway. More frequent extreme weather events – heatwaves, wildfires, floods, and storms – are triggering acute health emergencies and humanitarian crises (1). For example, an unprecedented “heat dome” over western Canada in 2021 led to 619 heat-related deaths in British Columbia alone (3), overwhelming emergency services and highlighting the lethal risk that extreme heat poses to vulnerable patients. Worsening wildfire seasons are creating hazardous smoke conditions; on June 7, 2023, New York City’s air quality (impacted by smoke from Canadian wildfires) briefly became the worst in the world, illustrating how one region’s climate disaster can send ripples of health effects across a continent. Less dramatically but just as worryingly, gradual climate shifts are intensifying allergies, expanding the range of insect-borne diseases, threatening food and water security, and undermining mental health and well-being. These impacts touch every aspect of medicine and public health – from cardiology (as heat stress strains the heart) to infectious disease, maternal-child health, nutrition, and mental healthcare. As caregivers devoted to healing and prevention, we must confront this new reality. Climate change is effectively a “threat multiplier” that undermines decades of progress in public health (4). If we fail to respond, the health gains we’ve achieved – whether cleaner air in our cities or lower infectious disease rates – could be rolled back by the cascading effects of a warming planet.
Roles of Health and Social Care Providers in the Climate Crisis
Healthcare and social service providers have a unique and crucial role in addressing climate change. We are trusted professionals who witness the human toll of this crisis firsthand, and this positions us to act as both healers and advocates. In fact, health professionals are among the most trusted voices in society (2), and we carry a dual mandate: to care for individuals affected by climate change and to help lead broader changes that protect communities. Broadly, our roles can be thought of in three domains – mitigation, adaptation, and prevention – which align with the goals of reducing climate change, coping with its effects, and preventing harm to patients.
Mitigation
Health and social care providers have a critical role in climate change mitigation by influencing both individual behaviors and broader social norms. Through everyday patient interactions, providers can initiate conversations that connect personal health improvements with environmental benefits, promoting choices like active transportation, plant-rich diets, and reduced reliance on high-carbon consumption. These dialogues are powerful because they not only lower patients' individual climate footprints but also advance primary prevention goals—improving chronic disease outcomes, air quality, and mental well-being. Beyond personal counseling, providers can model sustainable behaviors within their professional practice and advocate for healthier, low-carbon communities, reinforcing that climate action is part of caring for both current and future health. By normalizing conversations about the links between climate, lifestyle, and health, healthcare leaders strengthen the cultural shift toward a healthier, more sustainable future.
Adaptation
As trusted figures in times of uncertainty, healthcare providers are indispensable in helping patients prepare for and respond to the health effects of a changing climate. Through anticipatory guidance and personalized health planning, providers can assist patients in developing practical strategies—such as heatwave safety plans, asthma management during wildfire seasons, and mental health care following climate-related trauma. Engaging patients in these conversations strengthens self-efficacy and preparedness, particularly for those most at risk. Providers also exercise leadership by contributing frontline insights to public health adaptation strategies and participating in community-level resilience planning, such as identifying vulnerable patients for outreach during extreme weather events. In the clinical encounter and beyond, every discussion about readiness and risk management becomes a small but vital act of climate adaptation, safeguarding patients against foreseeable harms.
Prevention and Health Promotion
Healthcare providers are uniquely positioned to cultivate resilience by addressing both the immediate and structural factors that influence patient vulnerability to climate-related stresses. Through clinical care, providers can strengthen individual resilience by teaching coping skills, promoting mental health support, and connecting patients with community resources that buffer environmental shocks. Yet resilience-building also calls for leadership beyond the clinic: providers can advocate for systemic changes that address social determinants of health—such as housing, food security, and equitable healthcare access—that are foundational to climate resilience. Meaningful conversations with patients about emotional well-being, collective action, and community ties help reinforce that resilience is not solely about personal grit but also about solidarity and support networks. By championing resilience at both the personal and societal level, healthcare and social care providers reaffirm their role as stewards of health in an increasingly volatile climate.
The 2021 BC Heat Dome – A Deadly Intersection of Climate and Health
In late June 2021, British Columbia was gripped by an extreme heatwave unlike anything the province had experienced. Over a few days, temperatures in normally mild Vancouver soared past 30°C, and interior towns like Lytton hit an astonishing 49.6°C – the highest temperature ever recorded in Canada. The health care system was pushed to its brink. Emergency calls spiked to unprecedented levels. In fact, 9-1-1 operators saw call volumes about double the usual daily average during the worst of the heat (2). Ambulances were so overwhelmed that responders could not keep up – in dozens of cases, it took 30 minutes or more for paramedics to arrive, and some callers were placed on hold because no ambulances were available (18) (2). Emergency physicians in Metro Vancouver reported waiting rooms filled with patients suffering from heat exhaustion, dehydration, and heat stroke. Many were older adults found collapsed at home. This even highlighted the profound and acute health impacts that climate change can have and why doctors need to be engaged.
Indeed, as we would all come to learn hundreds of people did not survive this heat event. The BC Coroners Service later confirmed 619 heat-related deaths in that week (2). One striking finding was that those with serious mental health conditions were disproportionately among the victims. An analysis showed people with schizophrenia, for example, were three times more likely to die in the heat dome compared to average (3). This was a wake-up call: conditions like schizophrenia can impair judgment or the ability to seek help, and some psychiatric medications make it harder for the body to regulate temperature (3). Many such individuals lived alone in SRO (single-room occupancy) hotels or social housing without air conditioning. One Vancouver outreach worker recalled checking on a client with schizophrenia during the heat emergency: “He was disoriented and hadn’t been drinking water. He didn’t understand how dangerous it was in his tiny room.”
Furthermore, providers on the front lines faced their own trauma. Paramedics later recounted harrowing stories of finding people deceased in their apartments because help arrived too late. “We were breaking down in tears, soaked in sweat, and sick from the heat,” one first responder told a local news outlet. “It felt like the whole system was collapsing.” These experiences took a mental toll on the responders. In the weeks after, many paramedics and dispatchers sought counselling for critical incident stress. The heat dome also spurred a lot of soul-searching in the health system: How could this have been handled better? What about all those who slipped through the cracks?
In the aftermath, B.C. officials launched an Extreme Heat Alert system and invested in cooling centers and programs to distribute air conditioners to vulnerable people. Health authorities updated their emergency plans to include proactive outreach – for example, using lists of at-risk patients (like those on certain medications or living alone) to have community health workers check on them early in a heat wave. Culturally specific approaches were included as well, recognizing that some Indigenous elders or people in remote areas might not access mainstream services. Perhaps the biggest lesson for providers was the importance of viewing heat waves as a medical emergency. Just as we prepare for pandemic flu or mass casualty events, climate-driven heat emergencies require preparation, triage plans, and collaboration across services. The 2021 heat dome was a dark moment in B.C.’s history, but it has driven home the message: climate change can be deadly, and we ignore the health risks at our peril. Both the physical and mental health impacts of such events must be part of our preparedness going forward.
Chapter Highlights
Climate change is already affecting the health and well-being of patients and communities, placing health and social care providers on the front lines of the response.
Health and social care providers contribute to mitigation by engaging patients in conversations that link healthier lifestyles with climate action, modeling sustainable practices, and advocating for low-carbon, health-promoting environments.
Providers strengthen adaptation by preparing patients for climate-related health risks through personalized guidance, supporting community resilience planning, and ensuring clinical care anticipates new climate threats.
Building resilience means helping patients develop coping skills, connecting them to supportive community resources, and addressing social determinants of health that shape vulnerability to climate shocks.
Find the content of this chapter helpful?
Use the posts above to share key insights from this chapter with your network!