Background

The climate crisis is a global health and biodiversity emergency. Global temperatures have risen by 1.3°C since preindustrial times, mainly due to human burning of fossil fuels. ¹ Consequently, the increasingly frequent and intense heat waves, pollution from forest fires and extreme weather events fuel the unabated rise in adverse health impacts on Canadians. ^{Reference Romanello2} Despite this uptick in health consequences, public awareness of these risks remains low, especially compared to awareness of the biophysical impacts of climate change. ^{Reference Perrotta3} Associated with these changes are declines in mental health and threats to economic and social stability. Strong action across all sectors of society is imperative and necessary to both limit the crisis and respond to its adverse impacts. The provision of healthcare is, itself, a leading contributor to global heating and environmental degradation, responsible for approximately 5% of greenhouse gas emissions in Canada.

The Canadian Stroke Consortium (CSC) is an organization of healthcare professionals involved in stroke clinical care and research; as such, the implementation and development of health sustainability policies in Canadian stroke care is of particular interest. Climate change and the loss of planetary biodiversity are particularly concerning to us due to the exacerbating effects of climate change on stroke risk and outcomes. In addition, heat waves lead to increased morbidity and mortality from cardiovascular events, including stroke, ⁴ while other consequences of our high-carbon lifestyle, such as air pollution and obesity, also significantly increase stroke risk. In this document, we present a position statement and sustainability policy on behalf of the CSC to guide our future operations and activities and to ensure that we not only advance stroke medicine but also mitigate and adapt to the effects of climate breakdown.

The Canadian Stroke Consortium’s (CSC) Position Statement on Health

The CSC strives toward sustainable healthcare, recognizing that planetary health is inextricably linked to patient outcomes. We are committed to sustainability through preventative and carbon-minimizing approaches to health, moving beyond late-stage reactive care. Sustainable healthcare promotes high-quality healthcare delivery now without compromising the ability of future generations to meet their health needs, balancing optimal patient outcomes with minimal environmental, social and financial impacts. ^{Reference Mortimer, Isherwood, Wilkinson and Vaux5}

We affirm that a foundational understanding of planetary health is necessary to achieve sustainable health. Current healthcare provision drives extensive environmental damage, including greenhouse gas emissions, resource depletion and clinical, chemical and plastic waste. Pharmaceuticals, medical equipment and other supply chains are healthcare’s largest carbon hot spots. Further, the stroke care pathway is associated with considerable energy use, waste and resource utilization. Evidently, healthcare professionals and the public are increasingly concerned about and aware of the need for concrete approaches to address sustainability across all healthcare activities and decisions. ^{Reference Perrotta3}

Given that stroke is the third leading cause of death and a leading cause of adult disability in Canada, it is reasonable to expect a significant contribution of stroke care to the Canadian healthcare system’s carbon footprint. To advance stroke medicine, we have a duty to minimize our contribution to the climate crisis and broader planetary health issues. Indeed, given the damaging effects of climate change and related to the burning of fossil fuels on the health of people at risk of stroke and those who have already suffered a stroke, along with the health co-benefits to be gained from a move toward sustainable health and lifestyles, the CSC commits to actively addressing the climate crisis (see Table 1).

Table 1.

The Canadian Stroke Consortium’s (CSC) climate action and sustainability strategy

Role of Sustainability Lead in the CSC

The CSC will appoint a Climate Policy Officer (CPO) to the group’s Policy and Advocacy Committee to ensure that sustainability remains a core principle and is integrated into all CSC operations. This will be a permanent role in the PAC, where the occupant’s responsibilities will entail advocating for our sustainable health through monitoring and minimizing the environmental impact of the CSC’s own activity, maintaining awareness of the climate and biodiversity crisis among CSC members and developing strategies to promote resource-efficient guidelines and practices for sustainable stroke care.

Furthermore, the CSC’s CPO will engage with the Canadian Public Health Association and the Canadian Medical Association, who have each provided important policy statements on sustainable health and climate change. In doing so, the CPO will work to align the CSC’s policies with broader public health goals, leading to a more sustainable Canadian health system.

The Commitments of the CSC in Reducing Its Own Carbon Footprint (Figure 1)

Embedding sustainability in governance, structure and culture

Without good governance and leadership, an organization is likely to fail to implement its sustainability health policy. Thus, the CSC aims to cultivate a sustainability-oriented organizational alignment among CSC members and within its governance framework. Environmental considerations will be reflected in all decision-making, policy development and action-planning endeavors. In addition, we encourage all members to collaborate and actively engage in developing community-informed solutions to improve the sustainability of daily professional operations.

Figure 1.

The Canadian Stroke Consortium’s (CSC) pillars and climate action strategy.