Global Problems with Local Impacts: Exploring the Health Impacts of Climate Change and Air Pollution in Older Adults and Immigrants Living in Canada
Creators: Tilstra, McKenzie H
Publisher: name: University of Alberta Library
Year: 2022

<p>As human actions continue to drive global climate change and increase air pollution, these two closely related environmental phenomena pose a significant threat to public health. Because of Canada’s geographical location, it is warming at twice the rate of the global average, which is expected to amplify adverse health impacts via direct and indirect pathways. The cyclical relationship between climate change and air pollution can, in some cases, compound and intensify morbidity and mortality even where there are low levels of ambient air pollution. While all populations will be impacted, some populations, such as older adults and immigrant communities, may bear a disproportionate amount of the health risk. With estimates of life expectancy continually increasing, an aging baby-boom generation, and rising levels of immigration to metropolitan centers, these groups are vulnerable. Since health impacts are heavily influenced by local environmental and socioeconomic contexts, the aim of this research is to explore drivers of health risk and resilience associated with climate and air pollution in older adults and immigrants living in Canada. Insights generated through this work will help fill an existing knowledge gap in Alberta and help inform community-level planning activities for effective adaptation measures targeted at protecting health.<br>
A scoping review methodology was used in Chapter 2 to identify peer-reviewed articles published from 2010 to June 2020 focused on the health of older adults and immigrants living in Canada, where the primary exposures were related to climate or air pollution. Following abstract and full-text screening by two independent reviewers, data from the 52 included articles on setting, exposures, health outcomes, and other sociodemographic and environmental contextual factors were extracted. While older people in Canada experience health risks due to climate and air pollution exposures, the extent of the risk depends on multiple factors. There was little published information about the climate and air pollution-related health impacts experienced by immigrant communities. Future work is needed to investigate what promotes or reduces resiliency to the health impacts of climate- and air pollution-related hazards in Canada’s older adults and immigrant communities. Of the 52 included articles, most considered populations in Ontario (n=25) and Quebec (n=20). Due to the expansive and diverse geography of Canada, future research should also consider understudied rural and urban areas, Prairie Provinces, and those in the North. <br>
In Chapter 3, the Intergovernmental Panel on Climate Change Fifth Assessment Report risk framework was used to guide an ecological correlation study focused on older adult and immigrant communities in Edmonton, AB in. Prevalence rate ratios (PRR) from negative binomial regressions were used to estimate the effects of exposure to climate change and air pollution hazards on the rate of adverse cardiovascular, injury, mental, and respiratory health events at the dissemination area (DA) level between 2015-18 within the context of a community-level vulnerability (sensitivity, adaptive capacity). Higher proportions of older adults associated with increased rates of cardiovascular, injury, mental, and respiratory health events (PRR [95%CI] = 1.051 [1.044, 1.058]; 1.041 [1.037, 1.045]; 1.027 [1.021, 1.033]; 1.022 [1.018, 1.027]). Rates of injuries and respiratory events increased with increasing proportions of refugees (PRR [95%CI] = 1.007 [1.001, 1.013]; 1.017 [1.011, 1.024]). Higher proportions of economic immigrants demonstrated protective effects for cardiovascular, injury, and mental health events (PRR=0.990 [0.985, 0.996]; 0.993 [0.989, 0.996]; 0.984 [0.979, 0.989]). Associations between climate change and air pollution hazards were dependent upon the type of health event. The effects of certain hazards depended on the proportions of immigrants and older adults in a DA (heat effect on injury rates: PRR [95%CI] = 0.865 [0.809, 0.925] at 5% ≥65 years; 1.110 [1.011, 1.219] at 25% ≥65 years). Findings from this thesis can be incorporated into community-level planning and adaptive strategies to effectively reduce disproportionate impacts and protect health.</p>