British Columbia, Canada, as a bellwether for climate-driven respiratory and allergic disorders

Touching briefly on health effects related to climate change, we orient this Paradigms and Perspectives article within the context of British Columbia, Canada, in hopes that highlighting challenges in British Columbia will be informative and inspirational to others. We describe issues faced in our context, in which extreme climatic events have accelerated dramatically in a setting in which mitigation and adaptation efforts are complicated by challenges of inequity driven by rural-urban differences, inattentiveness to Indigenous concerns, and tensions between respect for the natural environment and development to accommodate a growing geographically dispersed population. Given Indigenous Peoples’ long-standing relationships with the land now called British Columbia and expertise in the environmental stewardship of their traditional territories, they must play a critical role in informing solutions to the health and social problems posed by climate change in a manner that is respectful, centered in justice, and potentially restorative. A historically cooler climate in British Columbia, as well as in Canada in general, means that extreme temperature excursions (such as the record-breaking “heat dome” of 2021) impose acute hazards to segments of the population that are less prepared physiologically or otherwise, and social deprivation can magnify these risks. Given the intransigence of this trend, we emphasize community orientation to adaptation and resiliency while responsible authorities continue to focus on mitigation. We explicitly recognize that distrust of the health care system by Indigenous Peoples in British Columbia is justified and poses additional challenges to reduce the health impacts of a changing climate.