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Integrating Environmental Health into the Federal Sustainable

Development Strategy

Francis Santiago, MPA candidate School of Public Administration

University of Victoria July 2014

Client: Nishu Gulati

Sustainable Development Office, Environment Canada

Supervisor: Dr. Lynda Gagné

School of Public Administration, University of Victoria

Second Reader: Dr. Kimberly Speers

School of Public Administration, University of Victoria

Chair: Dr. Rebecca Warburton

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! ! ! ! To!the!professors!who!have!nurtured!my!curiosity,!to!the!colleagues!at!the!Sustainable! Development!Office!whose!wisdom!and!patience!have!guided!me,!and!to!the!MPA!friends! with!whom!I!shared!laughter!and!memories:! ! Thank&you.&

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Executive Summary

Purpose

The objective of this report is to identify different ways to improve the integration of environmental health issues into the future cycles of the Federal Sustainable Development Strategy (FSDS). Specifically, the report [1] explores how the environment affects health and identifies the type of health content and approaches that can potentially be included in the next FSDS; and [2] identifies alternative ways to incorporate this information into the FSDS

architecture Methods

A review of international and Quebec sources was conducted to provide an overview of other strategies related to health and the environment, and identify the gaps in the FSDS. The report also examines existing federal legislation and programs to determine how the Government of Canada is addressing environmental health issues. Finally, the report includes a discussion of the results of a focus group session with Environment Canada policy analysts to obtain feedback on the identified gaps, discuss key strategic considerations, and propose ideas for integrating health into the FSDS.

Key Findings

The results of the research are as follows:

• Environmental health is an internationally recognized concept that refers to the physical, chemical, and biological factors that can potentially affect human health. The review of international experiences revealed that these factors include: climate change and air quality, water quality and access, chemicals and waste, disasters and emergencies, food safety and security, and occupational health and safety. These environmental factors have health impacts, affecting the incidence of diseases and illnesses.

• Many national strategies that address environmental health issues involve enhancing health emergency and disaster response preparedness and capacity. Additionally, many countries reduce environmental health threats by improving regulations, legislations, and risk assessment tools.

• The comparison of the FSDS to international experiences revealed that most

environmental health issues addressed in other jurisdictions are covered in the Strategy. In particular, both climate change and air quality and water quality and access have their own dedicated themes. Chemicals and waste, and disasters and emergencies both have their own targets under the nature theme. However, despite this expansive coverage, the FSDS does not always draw direct links to human health.

• The research also uncovered several gaps in the Strategy’s coverage of environmental health issues. For example, food safety and security and occupational health and safety issues are not present in the FSDS, though the latter is due to provincial jurisdiction.

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Furthermore, diseases and illnesses received little attention. The Strategy could better integrate these environmental health issues.

• A review of federal legislation and programs revealed that environmental health policy is well-developed in the Federal Government. Adding specific targets, actions, and

indicators on food safety and security and diseases and illnesses would be consistent with existing environmental policy, would further accountability, and would strengthen the environmental health components of the FSDS.

• The focus group research explored two key considerations for the integration of

environmental health into the FSDS. First, stakeholders may expect other socio-economic issues to receive similar treatment as health in the Strategy. Consequently, the FSDS runs the risk of becoming too large and ineffective. Second, the focus group expressed

concerns about the about the 2015 federal election, which could disrupt the Strategy’s development process.

Options to Consider

Four options were developed to address the environmental health gaps in the FSDS. Some of these options can be combined:

1. Strengthen the links between health and environmental sustainability in the introductory and indicator sections of each FSDS theme. This expanded health narrative can contain an explanation of the desired health outcomes of current

environmental programming in the federal government. It can also provide a summary of non-FSDS federal activities that align or connect with health-related FSDS priorities. Finally, this option can list or tag all implementation strategies related to the protection or promotion of human health.

2. Expand Theme III, specifically on protecting Canadians, to include more targets, indicators, and implementation strategies related to human health and nature. In particular, a new target on food safety and security can be added or expanded in existing targets on sustainable fisheries (5.1), aquaculture (5.2), and agriculture (5.4). Similarly, a new target on diseases that could arise from the environment can be created and can contain federal programs related to surveillance, assessments, and disease prevention and control.

3. Expand Themes I, II, and III to include more targets, indicators, and

implementation strategies related to environmental health. In addition to Option 2, this alternative proposes to add new environmental health-related targets, indicators, and implementation strategies in Themes I, II, and III of the FSDS. These other issues can include population dynamics, namely in addressing the effects that a growing population, migrations, and urbanization will have on air, water, and nature. This option can also include public transportation and the related air quality issues.

4. Create a separate, standalone theme to support goals, targets, indicators, and implementation strategies that have a strong link to human health. This option can

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either move existing FSDS targets to or create new targets in a separate health theme or both. This is the most comprehensive option and will provide the highest profile for health-related sustainable development issues in the FSDS.

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Table of Contents

Executive Summary ... iii

List of Acronyms ... viii

1 Introduction ... 1

1.1 Objective ... 1

1.2 Sustainable Development ... 1

1.2.1 History ... 1

1.2.2 Sustainable Development in Canada ... 2

1.3 Federal Sustainable Development Strategy ... 3

1.4 Three Pillars of Sustainable Development ... 4

1.5 Health ... 5

1.6 Organization of the Report ... 5

2 Methodology ... 6

2.1 Document and Legislative Review ... 6

2.2 Focus Group ... 7

2.3 Limitations ... 8

3 Conceptual Framework ... 9

3.1 Environmental Health Scope ... 9

3.2 Defining Environmental Health ... 9

3.3 Integrating Environment and Health ... 11

3.3.1 Environmental Health Challenges ... 11

3.3.2 Environmental Health Principles and Guidelines ... 14

4 International Experiences ... 16

4.1 Environmental Health Issues and Challenges ... 16

4.1.1 Climate Change and Air Quality ... 16

4.1.2 Water Quality and Access ... 17

4.1.3 Chemicals and Waste ... 18

4.1.4 Disasters and Emergencies ... 19

4.1.5 Food Safety and Security ... 20

4.1.6 Diseases and Illnesses ... 20

4.2 Comparison to the FSDS ... 21

5 Federal Legislation and Programs ... 25

5.1 Federal Legislation ... 26

5.2 Federal Programs ... 26

5.3 Conclusion ... 28

6 Focus Group Results ... 29

6.1 Conclusion ... 30

7 Discussion ... 31

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7.1.1 Food Safety and Security ... 31

7.1.2 Diseases and Illnesses ... 32

7.2 Considerations ... 32 7.3 Conclusion ... 33 8 Options ... 34 8.1 Option 1 ... 34 8.2 Option 2 ... 35 8.3 Option 3 ... 35 8.4 Option 4 ... 36 9 Conclusion ... 38 References ... 39 Annex I ... 44 Annex II ... 47

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List of Acronyms

Organizations

International

OECD – Organization for Economic Co-operation and Development PAHO – Pan-American Health Organization

UNEP – United Nations Environment Programme WHO – World Health Organization

National

AAFC – Agriculture and Agri-Food Canada

AANDC – Aboriginal Affairs and Northern Development Canada CBSA – Canada Border Services Agency

CESD – Commissioner of the Environment and Sustainable Development CFIA – Canadian Food Inspection Agency

EC – Environment Canada

ESDC – Employment and Social Development Canada

DFATD – Department of Foreign Affairs, Trade and Development DFO – Department of Fisheries and Oceans

DND – Department of National Defence EC – Environment Canada

FIN – Finance Canada HC – Health Canada IC – Industry Canada

NRCan – Natural Resources Canada PC – Parks Canada

PHAC – Public Health Agency of Canada

PWGSC – Public Works and Government Services Canada SDO – Sustainable Development Office

TC – Transport Canada

Documents

International

MDGs – Millennium Development Goals

NSDS(s) – National Sustainable Development Strategy (ies) SDGs – Sustainable Development Goals

National

DPRs – Departmental Performance Reports

DSDS(s) – Departmental Sustainable Development Strategy (ies) FSDA – Federal Sustainable Development Act, 2008

FSDS – Federal Sustainable Development Strategy RPPs – Reports on Plans and Priorities

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1

Introduction

1.1 Objective

The objective of this report is to identify different ways to improve the integration of environmental health issues into the future cycles of the Federal Sustainable Development Strategy (FSDS). Specifically, the report [1] explores how the environment affects health and identifies the type of health content and approaches that can potentially be included in the next FSDS; and [2] identifies alternative ways to incorporate this information into the FSDS

architecture.

The current FSDS covers the 2013-2016 period and the focus has now shifted toward planning and developing the Strategy for the 2016-2019 cycle. This research is to enhance Environment Canada’s Sustainable Development Office (SDO)’s understanding of federal government activities in health and how they compare to international sustainable development strategies. Based on the findings, four options are presented for integrating environmental health issues in the 2016-19 FSDS.

This research is the first stage of a broader SDO effort aimed at expanding the coverage of social and economic information in the FSDS. The results of this research and the proposed options will help prepare for future consultations with other federal departments.

1.2 Sustainable Development 1.2.1 History

According to the United Nations World Commission on Environment and Development (1987) report Our Common Future, now commonly known as the Brundtland Report, sustainable development is “development that meets the needs of the present without compromising the ability of future generations to meet their own needs.” This definition has shaped public policy for decades and encourages decision making on all levels, including governments, businesses and individuals, to be informed by the need to take better care of the planet now and in the future (Environment Canada [EC], 2010). Furthermore, sustainable development emphasizes the

interconnectedness of the three dimensions of environmental, social, and economic development. For example, economic growth and development can have an effect on both the physical

ecosystem and social structures.

Since the Brundtland Report’s release, there have been several international summits that reaffirmed commitments to sustainable development. The UN Conference on Environment and Development (UNCED), held in Rio de Janeiro, Brazil, in 1992, released Agenda 21, a non-binding action plan for sustainable development. Agenda 21 addresses social challenges relating

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air, and biodiversity (UNCED, 1992). In 2002, the UN’s World Summit on Sustainable Development (WSSD), also known as Rio+10, was held in Johannesburg, South Africa to discuss sustainable development. The Johannesburg Declaration pledged to address the conditions that pose barriers to sustainable development, including those related to poverty, violence, disasters, trafficking, intolerance, and diseases (WSSD, 2002).

In 2012, the United Nations Conference on Sustainable Development (UNCSD), also known as Rio+20, renewed international commitments to address poverty, food, water, energy, transport, health, chemicals, disaster risks, climate change, etc. Another key outcome of Rio+20 was the commitment to create Sustainable Development Goals (SDGs), which include measurable targets to address common challenges. The SDGs will eventually replace the Millennium Development Goals (MDGs) in 2015, with additional emphasis on the role of the environment (UNCSD, 2012).

1.2.2 Sustainable Development in Canada

Canada’s federal system of governance limits its ability to develop a single sustainable development strategy for all levels of government. Many areas of responsibility related to

sustainable development fall to provincial or territorial jurisdiction. Past efforts, therefore, lacked coherence, comprehensiveness, and major results in the years after the Brundtland Report (EC, 2010). This led to amendments to the federal Auditor General Act in 1995 that created the position of the Commissioner of the Environment and Sustainable Development (CESD) to strengthen the Auditor General’s ability to assess environmental and sustainable development issues, which paved the way for accountable and transparent environmental decision-making in the Federal Government (Office of the Auditor General of Canada [OAG], 2014).

The changes also required federal departments and agencies to prepare departmental sustainable development strategies (DSDSs) and update them every three years. DSDSs must outline

departmental objectives and plans within their areas of jurisdiction that contribute to sustainable development. The CESD then monitors these objectives and plans to ensure that federal

departments and agencies follow through (EC, 2010). However, the CESD criticized DSDSs as lacking substance or coherence, becoming “little more than a mechanical exercise, required to fulfill a statutory obligation” (OAG, 2007, para. 13). The CESD recommended that the

Government of Canada start planning for sustainable development using a government-wide approach that details a common set of goals, targets, and actions.

As a result, the government passed the Federal Sustainable Development Act (FSDA) in 2008 that required the creation of the Federal Sustainable Development Strategy to address the

limitations of the previous approach and make environmental decision-making more transparent and accountable to Parliament (Government of Canada, 2008). The Government of Canada released the FSDS in 2010 and updated it in 2013. Figure 1 provides a timeline of sustainable development approaches in Canada. Although the concept of sustainable development is decades old, it is clear that the development of a federal strategy is relatively new in Canada, and much

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work still remains to refine it. Furthermore, the FSDS only includes issues under federal

jurisdiction, with the provinces continuing to play a role in addressing sustainable development.

Figure 1. Sustainable development strategies timeline (Environment Canada, 2013a, p. 9).

1.3 Federal Sustainable Development Strategy

The SDO is responsible for developing the FSDS in three-year cycles. The objectives of the FSDS are to:

• develop an integrated, whole-of-government approach to environmental sustainability; • link sustainable development in the government approach to environmental

sustainability; and

• track and report on progress to Canadians (EC, 2010).

In its whole-of-government approach, the current 2013-16 FSDS has four priority theme areas: 1. Addressing Climate Change and Air Quality;

2. Maintaining Water Quality and Availability; 3. Protecting Nature and Canadians; and

4. Shrinking the Environmental Footprint – Beginning with Government (EC, 2013a). Each theme contains a set of targets, implementation strategies, and indicators to support the federal government’s goals in the area (see Annex I). The SDO also develops progress reports to determine the extent to which federal departments and agencies had achieved their goals and targets as set out in the Strategy (EC, 2012). Overall, the FSDS has a strong environmental focus and does not necessarily include social and economic issues that have been cited in the

international summits. For example, issues like poverty eradication, education, sustainable transport, and employment are not included in the Strategy.

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1.4 Three Pillars of Sustainable Development

The economy, society, and the environment are the three pillars sustainable development, and are recognized in Section 5 of the FSDA (Government of Canada, 2008). However, stakeholders from within and outside the Government of Canada have suggested that the SDO expand the social and economic dimensions in the FSDS.

Legislated stakeholders emphasize the importance of integrating all three pillars of sustainable development, namely the social, economic, and environmental dimensions. Both the Sustainable Development Advisory Council – which includes representatives from each province and

territory, and representatives from Aboriginal peoples, environmental and non-government organizations, businesses, and labour groups – and the House Standing Committee on

Environment and Sustainable Development are dissatisfied with the level of attention paid to the social and economic dimensions of sustainable development (EC, 2013a, p. 12-15; 2013b; Parliament of Canada, 2013a). The CESD agrees and has recommended that Environment Canada further integrate environmental, social, and economic objectives in decision-making for the 2016-19 FSDS (OAG 2011; 2013).

Public consultations for the 2013-16 FSDS also resulted in many specific recommendations regarding socio-economic integration, such as public safety, health (especially First Nations and drinking water), consumption and production patterns (e.g. recycling, materials management, toxics), the North/Arctic, climate change, energy, and others (EC, 2013b).

Similarly, non-legislated stakeholders such as the International Institute for Sustainable Development recommend including social and economic priorities and linking them to

environmental targets, and that targets should include a description of their potential benefit and impact on key socio-economic issues in Canada (e.g. job creation, green economic growth, energy security, local health and air quality, climate change adaptation) (Parliament of Canada, 2013a). The now defunct National Round Table on the Environment and the Economy (2012) also advocated for a more forceful environment-economy link, such as by setting sector priorities, presenting complementary economic objectives or actions, and highlighting water use/sustainability.

In sum, comments received on the FSDS to date illustrate the expectation that the Government of Canada would provide greater socio-economic context in the Strategy. More specifically,

stakeholders want new information that illustrates stronger environment-society and

environment-economy linkages. To an extent, the SDO has investigated and acted upon many of these recommendations in the 2012 Progress Report and the 2013-16 FSDS. For example, both these documents include a “Why it Matters” section that emphasizes the social and economic significance of the various environmental sustainability issues in the Strategy (EC, 2012; 2013a).

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1.5 Health

In response to these criticisms, Environment Canada agreed to explore socio-economic issues for the 2016-19 FSDS, while maintaining the environmental focus of the Strategy (OAG, 2013). The SDO identified health as one issue that may contribute toward that integration. The current Strategy tabled in November 2013 has made considerable improvement in the area of health, such as:

• broadening of Theme III on Protecting Nature to include protecting Canadians;

• adding a social and economic dimensions section for each of the environmental themes, including health-related information (e.g. benefits to human health from climate change adaptation, drinking water guidelines, the negative health impacts that can result from exposure to harmful substances); and

• consolidating two previously independent chemical management targets into one target placed in the Protecting Nature and Canadians theme (EC, 2013a).

The SDO committed to further examining the integration of health for the 2016-19 FSDS. As a first step, this report contributes to that commitment by conducting research and developing possible options.

1.6 Organization of the Report

The remainder of this report is organized as follows. The next section outlines the methodology used to achieve the project objectives. Next, a conceptual framework centred on the concept of “environmental health” focuses the health issues within the context of the environment, while leaving room for socio-economic considerations. This is followed by a review of international experiences to find common practices as it relates to sustainable development, which is useful for identifying gaps in the FSDS, and an examination of federal legislation and programs to determine what environmental health activities could be included in the future FSDS. The results of this research are then presented to a focus group consisting of SDO policy analysts to gain feedback on environmental health, the activities and practices related to it, and the feasibility of including them in the next Strategy. Next, a discussion section addresses the gaps and identifies important considerations. Finally, four options for integrating health into the FSDS are presented for consideration in future consultations.

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2

Methodology

The research for this report [1] explored how the environment affects health and identified the type of health content and approaches that can potentially be included in the next FSDS; and [2] identified alternative ways to incorporate this information into the FSDS architecture. This is achieved using a qualitative methodology that includes a needs assessment aimed at identifying and addressing the gaps in environmental health coverage by employing strategic planning concepts, reviewing related federal documents and legislation and international sustainable development strategy documents, and conducting focus group research.

The FSDS is essentially the federal government’s strategic plan for achieving sustainable development. It communicates goals and targets, the actions needed to achieve them, and all of the other critical elements developed during the planning exercise. J.M. Bryson (2011) defines strategic planning as a “deliberative, disciplined approach to producing fundamental decisions and actions that shape and guide what an organization (or other entity) is, what it does, and why.” The process is meant to encourage strategic thinking, acting, and learning. It also aims to improve decision-making, enhance organization effectiveness, responsiveness, resilience and legitimacy, and benefit its stakeholders (Bryson, p. 14-17).

Part of the strategic planning process involves an environmental scan that explores the external environment to better understand the nature of and trends in environmental health and

sustainable development. This step is crucial to identifying potential opportunities and challenges for consideration by the SDO. An internal environmental scan can then be utilized to compare the gaps with what the organization is currently doing to determine how those gaps can be addressed. The remainder of this chapter elaborates on how the research was conducted, the rationale for choosing the approaches taken, and the limitations and delimitations of the research design.

2.1 Document and Legislative Review

The document review assesses both the external and internal environments. First, a scan of international documents provides a useful overview of other strategies related to health and the environment, and identifies the gaps in the FSDS. This review focuses on the sustainable development strategies of several member countries of the Organization for Economic Co-operation and Development (OECD) and Quebec, as well as grey literature from international organizations. These sources offer useful perspectives and practices on the environmental health issues that can be applicable to Canada. The analysis for this research is thematic and identifies the common environmental health topics and international approaches to them.

Second, federal environmental health-related legislation and programs are examined, comparing them to international experiences to determine how to address the gaps in the FSDS. The

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Canada and Health Canada administer. The analysis also identifies existing federal programs that could be formally recognized in future strategies. This primarily includes an analysis of the Reports on Planning and Priorities (RPPs) of all participating FSDS departments and agencies. 2.2 Focus Group

The research included an internal consultation through a focus group approach to: • Determine general views on integrating human health in the next FSDS;

• Solicit feedback on the concept of environmental health and the related issues that could potentially be included in the next Strategy;

• Identify how other SDO activities and other considerations, both current and upcoming, could be affected by or contribute to the integration of environmental health in the next FSDS.

Focus groups solicit feedback from multiple people through questions from the researcher and interaction among the participants (Kitzinger, 1995, p. 299). This method facilitates discussion among participants by using their knowledge and experiences, and is particularly effective with open-ended questions. Focus groups help researchers understand an issue from the perspective of a specific population and are ideal for “needs assessment, development or refinement of

instruments, and exploration of the interpretation of research results” (Asbury, 1995, p. 415). This stage of the project is crucial for vetting the findings from the international scan and the review of federal activities. It is also important to gauge how changes to the FSDS may affect what SDO analysts are doing and how their work could support socio-economic integration generally and environmental health issues specifically. Analysts at the SDO’s Policy Division were targeted for the focus group. These analysts primarily lead the conceptual framework development and research for the 2016-19 FSDS. In particular, analysts working on the integration of the social and economic dimensions of sustainable development into the next Strategy were able to relate their work and offer critical advice on the health file, especially in regards to the considerations and options for a three pillar strategy.

The focus group took place on 7 April 2014 in a regular meeting room at the SDO. Of the 14 analysts in the Policy Division, 11 participated. With an allotted time of one hour, the focus group began with a 15-minute presentation on the findings of the research on environmental health, international experiences, and federal programs, and an outline of future considerations and questions for discussion (see Annex II).

The researcher then facilitated and took notes on the subsequent discussion. Following the focus group session, the notes were transcribed onto a computer. The researcher utilized qualitative analytical approaches to identify and code common themes surrounding the environmental health concept, the identified gaps, the different methods for addressing them, and the key

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validate the initial results of the research and develop options for integrating environmental health into the FSDS.

2.3 Limitations and Delimitations

A key limitation of this research is the scope of consultations. There were no consultations with federal departments and agencies other than Environment Canada’s SDO. Due to timing issues and concerns with synchronicity with related projects, the client delayed these consultations indefinitely. Interviews with key stakeholders from other agencies could have provided greater insight into the appropriateness of the environmental health concept and the feasibility of the options proposed. Consequently, the report does not make formal recommendations on next steps. However, the research is a first step toward the development of the broader socio-economic integration in the FSDS and provides the necessary research and analysis needed to conduct federal consultations in the future.

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3

Conceptual Framework

Since health is a broad topic, environmental health provides a useful framework for determining the key issues related to health, the environment, and sustainable development. These issues include the common environmental factors that impact human health and how they are

addressed. This section details the rationale behind the environmental health scope and clarifies the definition that is used throughout. It also expands on the types of environmental health challenges and approaches that is crucial to identifying relevant content and how they can be integrated into the FSDS

3.1 Environmental Health Scope

When Environment Canada agreed to further integrate the social and economic dimensions of sustainable development in the 2016-19 FSDS, the Department also emphasized that this does not mean that the full range of socio-economic issues affecting Canadians will be included. Instead, the focus will primarily be on those issues that are linked to the well-being of the environment (OAG, 2013). This is in keeping with the purpose of the FSDA, which centres on improvements in environmental decision-making. Health issues examined in this document are, therefore, limited to those that are closely related to environmental factors, and are considered as “environmental health” issues in the international literature.

3.2 Defining Environmental Health

There is no consensus on the definition of environmental health, though it generally includes the protection of the public from environmental hazards. Definitions can also include different areas of focus. For example, the US National Center for Environmental Health promotes health-enhancing environments and the prevention of “premature death and avoidable illness and disability caused by non-infectious, non-occupational environmental and related factors”

(Centers for Disease Control and Prevention, 2014). The Royal Environmental Health Institute of Scotland (2013) defines environmental health as the “area of Public Health activity which strives to improve, protect & maintain health & well-being through action on the physical environment and on life circumstances." Other definitions focus on environmental health as an academic field or as an area of public health practice. Indeed, the US Department of Health (1998) listed 26 definitions from different sources, which highlights the lack of a universal understanding. Even the WHO’s own definition of environmental health has evolved over the years. For example, the WHO’s European Charter on Environment and Health (1989) also considers the effects of the psychological and social environments on health and well-being. This definition carried over for several decades. However, the WHO’s most recent definition as found on its website excludes these factors, which suggests a change in how the organization interprets the term:

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“Environmental health addresses all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviours. It encompasses the assessment and control of those environmental factors that can potentially affect health. It is targeted towards preventing disease and creating health-supportive environments. This definition excludes behaviour not related to environment, as well as behaviour related to the social and cultural environment, and genetics.” (WHO, 2014)

Due to the WHO’s recognized leadership and authority in the area and the clarity it provides in regards to what factors should be excluded from the term, this definition of environmental health will be used to integrate health into the FSDS.

This definition of environmental health links the quality of both the natural and built environments to public health and well-being. In other words, it places special attention on the environmental hazards or factors that impact human health. It also showcases the interconnectedness of human activities, the physical and biological environments, and health outcomes as illustrated in Figure 2. For example, human activity (the spraying of toxic chemicals) can reduce exposure to environmental diseases that are posed by mosquito breeding sites. However, human activities can also negatively affect the environment, such as the release of toxic chemicals into the air and water resources (Landon, 2006, p. 6).

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Figure 2. Interaction between human activities, the environment, and health. (Landon, 2006, p. 6). 3.3 Integrating Environment and Health

Based on Agenda 21, the WHO (2002a) identified a number of elements required for the integration of health concerns into environmental planning. They include:

1. the identification and assessment of health hazards or challenges associated with environment and development; and

2. the development of environmental health policy incorporating common principles and guidelines.

These elements are used to determine what environmental health issues and strategies are included in international documents and federal policy and whether they should be integrated into the FSDS.

3.3.1 Environmental Health Challenges

Based on the WHO definition of environmental health, common challenges were identified in the international literature. Each challenge was examined for its relevance in promoting both

environmental sustainability and good health outcomes in Canada. They include:

• Climate change and air quality: Climate change and its related problems – including severe weather and deteriorated air quality – have significant impacts on human health.

HEALTH

Physical environment

soils and their chemical composition, air and water resources, climate, workplace

Human activities

agriculture, industry, energy production, water use, waste, urbanization, health and public services, working and natural environments

Biological environment

type and distribution of habitats, flora, fauna, pathogens,

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For example, exposure to air pollution has been linked to a number of adverse effects on health, including lung and respiratory problems (WHO, 1997, p. 81). Sources of these air pollutants come from human activities such as transportation (e.g., driving cars, trucks), the burning of fuels, industrial processes, and the use of certain products (e.g., paints, solvents). They are also released through natural sources such as forest fires and vegetation. These activities can lead to climate change, which results in an increased likelihood of extreme weather events and other changes in the environment that impact human health (Frumkin, 2010, p. 280-9).

• Water quality and access: Water scarcity, poor water quality, and inadequate sanitation can negatively impact human health. As water is a very effective solvent, it can leach metals and other substances out of man-made materials. Minerals and contaminants found in the soil and water or deposited from the air can be harmful to people. For example, water-related illnesses such as typhoid fever, cholera, and dysentery are constant threats to the public and underscore the need for maintaining strict control and regulations. Therefore, safe drinking water, sanitation, and hygiene are fundamental to environmental health and overall well-being (WHO, 1997, p. 96-104).

• Chemicals and waste: Chemicals and waste are environmental issues that can have significant consequences for human health. Toxic chemicals that enter through different sources (e.g. air and water) can come from industry, agriculture, and the home. This includes the use of pesticides, which can have harmful effects through skin contact, breathing, or consumption through food or water (Laboy-Nieves, Schaffner, Abdelhadi, & Goosen, 2009, p. 347-9). Preventing potential human health problems associated with these pollutants require sound management practices and the strengthening of national capabilities and capacities for safe handling and use.

• Disasters and emergencies: There are different types of environmental disasters, such as forest fires, earthquakes, floods, hurricanes or ice storms. These natural events accounted for 54% of environmental disasters between 1997 and 2006 (Frumkin, p. 849). There are also environmental disasters and emergencies caused by human activity, such as

industrial or transportation related accidents that release hazardous substances, thereby endangering the environment and human health. Therefore, the onset of climate change, increased human activity, and other environmental risk factors have led to emergencies, disasters, and disease outbreaks. Planning, prevention, and preparedness are increasingly part of the efforts to mitigate and adapt to climate change and improve responses to disasters and emergencies.

• Food safety and security: Food safety is one of the most common environmental health-related topics. The content of pollutants in the food chain, such as chemical substances and polluted water, can have a significant impact on human health (WHO, 1997, p. 104-111). Furthermore, as consumer demand rises, the environmental costs of

growing/raising, manufacturing, transporting, retailing, catering, and preparing food also increase, including greenhouse gas emissions and waste. This comes full circle as the

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resulting climate change and environmental pressures place additional burden on

agriculture and the supply and quality of food. New problems like bee colony collapses, which are affected by pesticides, can also impact food security. According to the United Nations, 71 of the 100 crop species that supply 90% of food worldwide are dependent on bees for pollination (United Nations Environment Programme, 2010, p. 1).

• Occupational health and safety: Environmental health can also be linked to

employment conditions and occupational health and safety. Human exposure at work to carcinogenic substances, UV radiation, indoor radon or air pollution is linked to higher cancer rates and other health complications (Frumkin, p. 735). Workplace equipment and procedures can also lead to death and injury.

Figure 3 adapts Landon’s (2006) visual representation of the interaction between human activities and the physical and biological environments, identifying two sets of impacts that are relevant to the integration of health in the FSDS: environmental impacts or hazards that in turn have human health impacts. Understanding the environmental impacts is crucial to determining the types of health-related goals, targets, implementation strategies, or indicators that are appropriate for the FSDS.

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Figure 3. Environmental and human health impacts resulting from the interaction between human activities and the physical and biological environments.

Environmental impacts lead to human health impacts, namely disease and illness. Disease and illness are often addressed as a separate environmental health issue in the literature. The spread of disease and illness from environmental factors, such as inadequate water and sanitation, indoor and outdoor air pollution, and chemical contamination means that environmental protection is often motivated by a desire to avoid negative human health impacts. 3.3.2 Environmental Health Principles and Guidelines

While most of the challenges identified in the international literature contain elements from all three dimensions of sustainable development, most clearly relate to environmental health.

Various frameworks developed by jurisdictions such as Quebec and Australia and NGOs like the David Suzuki Foundation contain similar principles or guidelines for addressing environmental health challenges:

Environmental impacts

Climate Change and Air Quality

Water Quality and Access Chemicals and Waste Disasters and Emergencies

Food Safety and Security Occupational Health and Safety

Human

activities

Agriculture, industry, energy production, water use, waste, urbanization, health

and public services, transport

Human health impacts

Diseases and Illnesses

Biological/physical environments

Type and distribution of habitats, flora,

fauna, pathogens, soils and their chemical composition, air and water

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• Enhance preparedness and capacity to respond to environmental emergencies or disasters; • Anticipate and plan for the most critical public health issues stemming from biological,

chemical or physical threats related to the environment;

• Provide expertise and guidance that supports environmental health decision making; • Improve standards, guidelines, regulations, legislations, indicators, and risk assessment

tools to protect human health;

• Increase capacity of the environmental health sector and improve conditions, especially in vulnerable communities (Institut national de santé publique du Québec, 2012;

Australia Department of Health, 2007; Boyd, 2007).

In general, many international sources use similar frameworks to address human health, the environment, and sustainable development. The following section on international experiences provides greater detail on specific goals, targets, actions, and indicators to identify promising practices in environmental health.

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4

International Experiences

This section provides a review of the international grey literature and the sustainable

development strategies of other jurisdictions related to the integration of human health into the FSDS. In particular, it identifies content related to the environmental health challenges discussed in the previous section.

The review included documents from the WHO, the Pan-American Health Organization

(PAHO), and the UN Conference on Sustainable Development (Rio+20). Documents from other jurisdictions relate to their national sustainable development strategies (NSDSs). Several OECD countries were selected because of the significant health sections or components in their

strategies. The chosen OECD countries are limited to those with recently released strategies available in English.1 They include: the Czech Republic, Estonia, Finland, France, Germany, Iceland, Ireland, Korea, Spain, Sweden, and Switzerland. Since some OECD country strategies are based on European Union (EU) policies, the EU sustainable development strategy is also used. Finally, Quebec is included because it is the only Canadian province with a recent strategy that contains significant health-related information.

Using examples from the reviewed jurisdictions, this section highlights components that may be relevant to Canada’s FSDS, such as the types of goals, targets, implementation strategies, and indicators that are used. The review results are then compared to the FSDS to identify gaps in how environmental health issues are addressed.

4.1 Environmental Health Issues and Challenges 4.1.1 Climate Change and Air Quality

The UN Rio+20 conference stressed the importance of international cooperation on climate change and air quality. The conference’s outcome document, The Future We Want, emphasized that global greenhouse gas emissions can be reduced through the cooperation of all countries and their participation in effective and appropriate international responses (UNCSD, p. 37). Some countries have framed the climate change and air quality issue from a primarily health-oriented angle. For example, in Finland, the focus is on preparation for health threats that will arise from climate change, which will require the cooperation of many actors such as researchers and various authorities (Prime Minister’s Office [Finland], 2006, p. 101). Developing sustainable industry practices and clean energy sources that minimize outdoor air pollution and greenhouse gas emissions is another option that has environmental health advantages. In Iceland, there are

1 The OECD countries that do not contain significant health components or sections include: Israel, Japan, Norway,

Poland, Turkey, and the United Kingdom. Countries that do not have reliable English translations of their full strategies include: Austria, Belgium, Denmark, Hungary, Luxembourg, Netherlands, and Portugal. Countries whose strategies are more than ten years old include: Australia, Greece, New Zealand, and Slovakia. Finally, some OECD

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efforts to reduce levels of emissions from energy sources, specifically hydrogen sulphide (H2S) from geothermal power plants, by adopting cleaner energy sources (Ministry for the

Environment and Natural Resources [Iceland], 2010, p. 13).

Increasingly, countries are also encouraging transportation reforms to reduce premature deaths and cases of acute respiratory infections. Rio+20 insisted that sustainable transport requires the development of energy-efficient multimodal transport systems, notably public mass

transportation systems, clean fuels and vehicles, and improved transportation systems in rural areas (UNCSD, p. 25-6). In Korea, the emphasis is on vehicle technology, such as developing efficient engines or using low-emissions fuels, as a way of reducing emissions and improving air quality (Presidential Commission on Sustainable Development [Korea], 2006, p. 132-3). Spain promotes economic instruments and measures for efficient and/or clean energy vehicles

(technologies and fuels) for road transport (cars, buses, trucks, etc.), the increase in bio-fuel use, and the use of clean buses in urban public transport (Ministry of Environment [Spain], 2007, p. 68-71).

Sample relevant indicators include:

• Urban air quality measures of particulate pollution – with reference to WHO air quality guidelines

• Measures of urban population exposure to air pollution by particulate matter, ozone, sulphur dioxide, and nitrogen oxides

• Greenhouse gas emissions

• Clean electricity power generation across the energy supply chain in terms of pollution and greenhouse gas emissions

• Number of motorcars per thousand inhabitants • Distribution of low-emission vehicles

• Average CO2 specific emission of new cars

• Energy intensity of private passenger (per capita) and merchandise transport • Energy intensity of the interurban inner transport of passengers and merchandise • Public transport usage rates

• Non-compliance rate of particulate matter reduction measures in industrial facilities upon inspection

• Annual primary energy consumption by source type

• Proportion of energy and electricity production of renewable origin • Proportion of fuel consumption from bio-fuels

4.1.2 Water Quality and Access

Rio+20 stressed the need to adopt measures to significantly reduce water pollution and increase water quality, improve wastewater treatment and water efficiency, and reduce water losses. Many countries have specific water-oriented goals and targets. One goal of the French strategy is

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to restore water quality and preserve water renewal (Ministry of Ecology, Sustainable Development, and Energy [France], 2010, p. 36). Iceland’s strategy is more specific, with objectives to improve access to abundant clean water unpolluted by chemicals and

micro-organisms for all types of use and decrease incidents of drinking water contamination (Iceland, p. 14). Furthermore, organizations such as the PAHO (2012, p. 13) argue that water issues require attending to the challenges related to population growth, increasing urbanization, and the rural population.

The Estonian and Icelandic strategies propose to develop and implement a system of regulations and strengthen expertise to reduce environmental contaminants in drinking and bathing water (Ministry of the Environment [Estonia], 2005, p. 35; Iceland, p. 14). Similarly in France (p. 36) and Iceland (p. 14), efforts are being made to prevent water pollution and bring all purification stations up to standard. Strategies also include the protection of water sources and preservation of marine ecosystems.

Sample relevant indicators include:

• Proportion of population that has access to a sustainable safe water supply and hygienic sanitation in the household

• Per capita spending and percentage of GDP dedicated to water resource management functions

• Percentage of population that has access to climate resilient safe water sources and hygienic sanitation facilities

• Percentage of health services that have a reliable safe water supply and adequate sanitation, both of which are resilient to extreme weather related events

• Number of outbreaks of illnesses due to the contamination of water and the number of the sick in the case of the outbreak of an illness

• Concentration of nitrogen and phosphorous in selected rivers and lakes 4.1.3 Chemicals and Waste

Chemicals and waste can affect anything from food safety and security to water and consumer goods. In Rio+20, commitments were made to achieve the sound management of chemicals throughout their life cycle and of hazardous waste in ways that lead to minimization of

significant adverse effects on human health and the environment, as set out in the Johannesburg Plan of Implementation (UNCSD, p. 41-3).

Chemicals and waste issues are widely covered across the jurisdictions examined, which reflect their importance in this context. For example, the Czech, Icelandic, and EU strategies aim to reduce exposure to polluting chemical substances and physical agents in air, water, soil, and food and the associated health risks (Ministry of the Environment [Czech Republic], 2010, p. 19); Iceland, p. 16). Moreover, the EU developed a target to ensure that by 2020 chemicals, including pesticides, are produced, handled and used in ways that do not pose significant threats to human

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health and the environment (European Commission [EU], 2006, p. 15). In this regard, the EU adopted the Regulation on Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH), a milestone legislative framework that will eventually replace substances of very high concern with suitable alternative substances or technologies.

Other strategies also propose a set of different instruments related to specific chemical threats. In Ireland, a strategy will be developed to ensure that exposure to radon gas is addressed by all relevant public authorities through effective and coordinated ways (Department of Environment, Community and Local Government [Ireland], 2012, p. 76). The Icelandic strategy plans to prohibit and restrict the use of bisphenol A (BPA) through regulations, with special attention on baby bottles (Iceland, p. 16).

Sample relevant indicators include:

• Measures related to biochemical monitoring • Measures related to the disposal of nuclear waste

• Number of hazardous substances designated as restricted and banned chemicals

• Quantities of restricted hazardous substances released in air, water, or land by industrial polluters

4.1.4 Disasters and Emergencies

According to international sources, communities need to enhance their resilience to disasters and emergencies by improving risk assessment, prevention, preparedness, response, and recovery monitoring (UNCSD, p. 36; WHO, 2012, p. 4). Countries use a plethora of different instruments to develop this capacity. The Estonian strategy proposes the development of a training system for emergency preparedness. This includes participation in international undertakings in the fields of crisis management and protection of the population (Estonia, p. 36). In France, the focus is on creating about 2500 plans and strategies by 2012 for every foreseeable disaster, which would also depend on unique considerations according to regions (France, p. 36). In Quebec, the prospect of increased disasters resulting from climate change has led to a new cooperative framework that includes the participation of five government departments in taking joint

preventive action in the management of different natural events like soil movement, floods, and coastal erosion (Quebec, p. 28).

Sample relevant indicators include:

• Percent of counties, states, provinces, or population covered by sufficient capacity to respond to floods and storm damage, natural fires, industrial and transport fires, and chemical and radiation accidents

• Average wait-time upon reception of emergency notices • Proportion of health facilities that can withstand hazards

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• Measures of reliability of access to clean energy and water supplies, routinely and in emergencies

4.1.5 Food Safety and Security

Rio+20 reaffirmed the importance of international commitments to safe, sufficient, and nutritious food (UNCSD, p. 22). The WHO (2002b, p. 67) suggests “new fiscal policies can support food safety by discouraging the use of harmful products on food, stimulating the consumption of nutritious foods, and encouraging the adoption of healthy lifestyles.” The WHO proposes improved monitoring to help prevent contamination or the spread of food-related illnesses and increase environmental-health (p. 69). In Estonia (p. 35) and Iceland (p. 15), for example, this includes improving the information system of food contaminants to enable informed decisions, including the recall of products, and to increase the awareness of the population. Food

inspections based on risk assessment and on coordinated monitoring plans are another option. Food security can be promoted by legislation and by the consumption and production of traditional foods that reduce reliance on imported goods (Iceland, p. 15).

Sample relevant indicators include:

• Measures of access to fresh food and dietary quality and diversity • Prevalence or incidence of food borne disease outbreaks

• Confirmed cases of Salmonella and Campylobacter • Measures related to pesticide use

• Measures related to the nutritional status of children 4.1.6 Occupational Health and Safety

The WHO (2014) also links environmental health to employment conditions and occupational health and safety. In Quebec, managing health and safety on the job involves identifying, correcting, and controlling dangers and hazards on sites where goods and services are produced (Quebec, p. 28). This policy-based approach has links to environmental health and centres on developing a culture of prevention among future employers and workers, and in reducing serious injury from machines and tools. In Sweden, psychological or stress-based illnesses are also deemed important to occupational health and national welfare (Ministry of the Environment [Sweden], 2004, p. 31-2).

Sample indicator includes:

• Rates of work-related accidents, injuries, illnesses, and deaths 4.1.7 Diseases and Illnesses

Addressing the problem of diseases and other illnesses requires adequate prevention,

surveillance, and action plans. The WHO (2002c, p. 26) suggests that increasing national rapid detection and response capacities for outbreaks can help stop the spread of communicable

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scientifically and systematically investigating and researching suspicious cases of environmental diseases (p. 129). Korea (p. 130) and Sweden (p. 36-7) also acknowledge the importance of international cooperation and of actively participating in programs such as those at the WHO and UNEP. In Sweden, the sustainable development strategy plans to study ways of encouraging the development of medications, including antibacterial drugs and HIV vaccines (Sweden, p. 37). Sample relevant indicators include:

• Under-five mortality rate • Life expectancy at birth

• Immunization rates against infectious childhood diseases • Standardized mortality rate by disease group

• Rate of deaths caused by respiratory diseases • Incidence of asthma in schoolchildren

4.2 Comparison to the FSDS

The list of sustainable development issues that impact human health is wide and diverse. Most of the issues discussed above have relevance to the FSDS, with the exception of occupational health and safety. Despite the international scan identifying it as an important environmental health issue, occupation health and safety falls largely under provincial jurisdiction. Moreover, it refers to the built environments and the impacts it has people who work in them, which differs from the other environmental health issues that are based on the natural environments. For these reasons, it is not found in the Strategy and, as such, is excluded from the comparative analysis below. Table 1 compares the common environmental health challenges found in the international literature with the FSDS. It provides a rating of how well the Strategy’s goals, targets, and implementation strategies (ISs) cover the various environmental health approaches. The rating system is based on a “good,” “fair,” and “poor” scale, which primarily measures the quantity of related content found in the FSDS. The most important measures are the ISs because they detail the specific actions that aim to achieve the goals and targets. An environmental health approach receives a “poor” rating if there are three or fewer ISs that cover it. A “fair” rating refers to four or five IS coverage. Finally, a “good” rating contains six or more IS coverage. To an extent, the ratings also consider the quality of the related ISs, such as its specificity and relevance of the actions.

Table 1. Coverage of Environmental Health Challenges in the FSDS

International environmental health approaches

Related FSDS goals, targets, and implementation strategies (ISs)

Rating Climate Change and Air Quality

Coordinate climate change response with different actors, such as researchers, industry, and various authorities

Goals: 1, 2 Targets: 1.1, 1.2, 2.1 ISs: 1.1.1, 1.1.5, 1.1.12, 1.1.24, 1.1.29, 1.1.32, 1.1.40, 1.1.41, 1.1.47, 1.1.48, 1.1.49, 1.1.50, 1.1.51, 1.1.52, 1.1.53, 1.1.54, 1.1.55, 1.1.56, 1.1.57, 1.2.1, 1.2.2, 1.2.3, Good

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1.2.4, 1.2.5, 1.2.6, 1.2.7, 1.2.8, 1.2.9, 1.2.11, 1.2.12, 1.2.13, 2.1.10, 2.1.11, 2.1.12, 2.1.13, 2.1.14, 2.1.15, 2.1.16, 2.1.17, 2.1.18, 2.1.19, 2.1.20, 2.1.21, 2.1.22

Develop clean energy sources Goals: 1, 2

Targets: 1.1, 2.1

ISs: 1.1.2, 1.1.21, 1.1.23, 1.1.32, 1.1.38, 1.1.39, 1.1.40,

1.1.42, 1.1.43, 1.1.46, 1.1.48, 2.1.2, 2.1.3, 2.1.4, 2.1.8, 2.1.9

Good

Develop energy-efficient multimodal transport systems (e.g. public mass transportation, clean fuels, energy-efficient vehicles) Goals: 1, 2 Targets: 1.1, 1.2, 2.1 ISs: 1.1.4, 1.1.20, 1.1.25, 1.1.26, 1.1.27, 1.1.28, 1.1.30, 1.1.33, 1.1.34, 1.1.35, 1.1.36, 1.1.37, 1.2.10, 2.1.5, 2.1.6, 2.1.7, 2.1.24, 2.1.26, 2.1.27 Good

Water Quality and Access

Improve wastewater treatment Goals: 3

Targets: 3.1, 3.11

ISs: 3.1.1, 3.1.2, 3.1.3, 3.1.6, 3.11.2

Fair

Improve access to clean water Goals: 3

Targets: 3.1, 3.2, 3.12

ISs: 3.1.1, 3.1.2, 3.1.3, 3.1.4, 3.1.5, 3.1.6, 3.2.1, 3.12.4,

3.12.7, 3.12.8

Good

Restore water quality Goals: 3

Targets: 3.3, 3.5, 3.6, 3.7, 3.8, 3.9, 3.10, 3.12 ISs: 3.3.1, 3.3.2, 3.3.3, 3.3.5, 3.3.6, 3.5.2, 3.5.3, 3.6.1,

3.7.1, 3.7.2, 3.8.1, 3.8.2, 3.9.2, 3.10.4, 3.12.1, 3.12.4, 3.12.7, 3.12.9

Good

Chemicals and Waste

Reduce exposure to polluting chemical substances and waste in the air, water, soil, and food

Goals: 3, 4 Targets: 3.3, 3.6, 3.11, 3.12, 4.8 ISs: 3.3.3, 3.6.1, 3.11.3, 3.11.4, 3.12.3, 4.8.1, 4.8.2, 4.8.4, 4.8.5, 4.8.6, 4.8.7, 4.8.8, 4.8.9, 4.8.10, 4.8.11, 4.8.12 Good

Disasters and Emergencies

Develop response capacity (e.g. training systems, international and

intergovernmental cooperation, planning, etc.)

Goals: 4 Targets: 4.7

ISs: 4.7.1, 4.7.2, 4.7.3, 4.7.4, 4.7.5, 4.7.6

Good

Food Safety and Security

Improve the monitoring of food systems (e.g. food inspections, information and awareness)

Goals: 3

Targets: 3.10, 3.11 ISs: 3.10.1, 3.11.1

Poor

Promote the sustainable production and consumption of healthy or traditional foods

Goals: 1, 5

Targets: 1.1, 5.1, 5.4 ISs: 1.1.12, 5.1.1, 5.4.2

Poor

Diseases and Illnesses

Increase national rapid detection and response capacities

Goals: 1, 4

Targets: 1.2, 4.6, 4.7

ISs: 1.2.2, 4.6.10, 4.7.1, 4.7.2, 4.7.4

Fair

FSDS Theme I on climate change and air quality includes a comprehensive set of goals, targets, indicators, and ISs that match many of the findings from the international literature. For

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quality targets (EC, 2013a, p. 37-9). Furthermore, Canada’s strategy supports several renewable energy projects and initiatives to improve outdoor air quality and its effects on human health, which are similar to activities found in the Icelandic and Korean strategies. However, climate change and air quality are broad topics with many related issues that have some health impact. Therefore, coverage of this environmental health challenge is high in the FSDS, but many do not necessarily draw direct links to health.

FSDS Theme II covers water quality and access issues, all of which align with the goals and commitments made in Rio+20 and in several NSDSs (EC, 2013a, p. 46-8). On ensuring access to clean water, the focus of Target 3.2 on drinking water regulations is similar to the activities found in the Estonian and Icelandic strategies. There are also many ISs that focus on restoring water quality, especially in lakes, rivers, and other natural settings. Due to the division of federal and provincial responsibilities, wastewater management is limited to First Nations reserves. Therefore, the “fair” rating it received is misleading. Overall, it highlights the water inequities that continue to exist in some rural, Aboriginal, and northern communities.

Chemicals management is well-represented under Theme III with its own target (Target 4.8) that aims to reduce risks to Canadians and impacts on the environment and human health posed by releases of harmful substances. The implementation strategies are similar to those found in Rio+20 commitments, SDG discussions, and the EU strategy, including the regulation of pesticides, the monitoring of substances, and risk management measures (EC, 2013a, p. 67-8). Disasters and emergencies (Target 4.7) fall under Theme III of the FSDS on protecting nature and Canadians. The target aims to prevent or mitigate the impacts of environmental disasters, incidents, and emergencies. The implementation strategies on emergency management plans and disaster mitigation, and several federal government programs, also bring Canada in line with Rio+20 commitments and with what jurisdictions like France and Quebec are doing in planning and preparation (EC, 2013a, p. 65-7).

References to preventing and reducing diseases resulting from outdoor air pollutants are found under Theme I on climate change and air quality. In particular, the FSDS highlights activities that aim to reduce infectious disease risks and public health threats related to climate change by increasing health capacity and expertise through targeted research, modelling and cost-benefit analysis (IS 1.2.2.) (EC, 2013a, p. 35). Preventing the spread of disease across borders is also important in the Strategy (4.6.10.) as it is in international discussions and in other strategies (EC, 2013a, p. 65). It is also important to note that the disaster and emergency target and ISs may also include responses to disease and illness outbreaks. However, references to diseases and illnesses are not explicit, which resulted in a “fair” rating for this issue.

Finally, the FSDS does not specifically mention food safety and security issues. While there are some ISs that may include these issues, such as the adoption of sustainable agricultural practices, the links are not clear.

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Clearly, the FSDS covers most environmental health issues found in the literature and in other jurisdictions. These include issues related to climate change and air quality, water quality and access, chemicals and waste, and disasters and emergencies. However, food safety and security and diseases and illnesses are environmental health challenges that require further attention. The next section examines federal legislation and programs related to all of the environmental health issues, and identifies content that could be considered for the next cycle of the FSDS.

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5

Federal Legislation and Programs

Human health and the provision of health services to Canadians is primarily the role of

provincial governments in Canada. The Federal Government is constitutionally responsible for select areas of health care, including marine hospitals, quarantines, and the oversight of food, pharmaceutical and medical device safety. Additionally, the federal spending power provides the basis for federal initiatives in health research, promotion, and information, and disease

prevention and control (Parliament of Canada, 2008). Therefore, the government can still play a role in health issues across the country, including those related to environmental health.

This section of the paper examines health-related legislation and programs administered by the Government of Canada. The purpose is to highlight the types of federal environmental health activities already in place that can be considered for inclusion in the FSDS (see Table 2).

Table 2. Federal Government Legislation and Programs Related to Environmental Health Challenges

Legislation Programs

Climate Change and Air Quality • Canadian Environmental Protection Act • Department of the Environment Act • Federal Sustainable Development Act

• Canada Foundation for Sustainable Development Technology Act

• Weather Observations, Forecasts and Warnings • Health-related Meteorological Information • Climate Information, Predictions and Tools • Climate Change and Clean Air

Water Quality and Access

• Canadian Environmental Protection Act • Water Governance and Legislation • Federal Sustainable Development Act • Fisheries Act

• Canada Foundation for Sustainable Development Technology Act

• Water Quality and Aquatic Ecosystem Health • Hydrological Service and Water Survey • Clean Water Regulatory Framework

Chemicals and Waste

• Canadian Environmental Protection Act • Federal Sustainable Development Act • Pest Control Products Act

• Substances and Waste • Pest Management • Pesticides

• Environmental Radiation Monitoring and Protection • Northern Contaminants

Disasters and Emergencies

• Canadian Environmental Protection Act • Federal Sustainable Development Act

• Environmental Response Services • Search and Rescue Coordinated Response • Environmental Emergencies

• Hydrological Service and Water Survey • Weather Observations, Forecasts and Warnings • International Policy Advice and Integration Food Safety and Security

• Canada Agricultural Products Act • Fertilizers Act

• Food and Drugs Act

• Assurance Systems

• Research Accelerating Innovation • Food Safety Program

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• Safe Food for Canadians Act • Animal Health and Zoonotics Program; Aquatic Animal Health; Feed; and Plant Resources Program Diseases and Illnesses

• Canadian Environmental Protection Act • Department of Health Act

• Federal Sustainable Development Act

• Public Health Capacity Building • Public Health Laboratory Systems • Infectious Disease Prevention and Control • Border Health Security

• Biosecurity

5.1 Federal Legislation

There are several important pieces of federal legislation that apply to environmental health challenges. For example, the Department of the Environment Act and the Department of Health Act provide the two relevant departments with the mandate and the tools to protect the

environment and the health of Canadians. There are also other overarching laws that expand on the two departments’ responsibilities. The Canadian Environmental Protection Act, 1999

(CEPA) is responsible for pollution prevention and the protection of the environment and human health (Government of Canada, 1999). As such, CEPA provides regulations that contribute to air quality and the safe management of chemical substances.

Because the Constitution Act, 1867 did not specifically identify the environment as a subject matter, both federal and provincial governments play a role in addressing key environmental health challenges (Parliament of Canada, 2013b). The Government of Canada negotiates agreements with the provinces and territories regarding environmental issues related to water, air, and land. For example, Canada and Ontario established a work-sharing agreement to ensure the quarter quality and ecosystem health of the Great Lakes, which is included in the current FSDS (EC, 2013a, p. 47-8).

Overall, all the environmental health challenges are well covered in current federal legislation. The previous section identified food safety and security and diseases and illnesses as gaps in the FSDS. Several laws are in place to help ensure a safe and secure food system for Canadians, including those related to fertilizer use and inspections. Finally, diseases and illnesses are covered under various health and environmental acts. With sufficient legislation and related regulations on these topics, it is clear that the Federal Government has both the responsibility and the mandate to address them in the sustainable development strategy.

5.2 Federal Programs

Of particular interest to this report are the federal programs that detail specific actions addressing environmental health concerns. As stated earlier, many programs are already present in the Strategy, but there are also several activities worth mentioning in the event that other federal departments or stakeholders desire more content to be added (see Table 2). For this exercise, the research assessed the 2014-2015 RPPs of all FSDS departments and agencies.

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