Prioritization of Older Adults in Canadian Climate Change Adaptation Policies: A Policy Document Analysis

Older adults experience disproportionately high morbidity and mortality from climate change due to increased risk of heat-related illness, reduced mobility and dependence on others during climate emergencies, and cardiorespiratory distress from air pollution and wildfires [1]. Prior studies have described the prioritization of older adults in US climate plans, but Canadian plans remain unstudied [2]. Our study examines the extent to which Canadian climate plans include references to older adults and whether seniors' strategies address climate change. We searched government websites and online policy documents, identifying the most recent available climate plans and seniors' strategies for Canada's 10 provinces, 3 territories, and nationally. We developed two keyword lists (Table 1), informed by a prior analysis of US climate and aging plans, to investigate whether climate plans addressed older adults and whether seniors' plans addressed climate change [2]. We used a dichotomous classification (yes/no), coding a keyword as “yes” if it was used in a relevant context (e.g., “senior” referring to an older adult and not a position of authority). Content involving each keyword mention was then analyzed to determine the context and proposed policy responses. For Quebec (French-speaking province), keywords were translated into French by a native French speaker (Table S1). If the keyword was identified in the document, surrounding paragraphs were translated using DeepL and analyzed. Older adult or person Elder or elderly Aging Retiree Senior or seniors Nursing home Assisted living Senior center Climate change, global warming Extreme weather, extreme temperature Extreme heat Flooding Wildfires Air quality, air pollution Drought, water scarcity, water quality Sea-level rise Extreme cold, winter emergencies Storms, hurricanes, typhoons Landslides, erosion Canada has a national climate plan but no national seniors' strategy. All 13 Canadian provinces and territories had climate plans, and 11 of 13 had seniors' strategies (Table S2). Of the 23 plans and strategies analyzed, just 4 (Canada's, Prince Edward Island's [PEI], and British Columbia's [BC] climate plans, and Quebec's seniors' strategy) included relevant keywords (Table 2). Canada's climate plan included references to “elderly” and “seniors” when recognizing groups that experience disproportionate climate change health impacts due to a higher burden of ill health (e.g., economically disadvantaged, elderly, and racialized groups). It underscored how the intersection of multiple vulnerabilities may worsen these effects [3]. Recommendations included reducing carbon pollution and expanding the use of clean electricity to protect individuals with respiratory health conditions. The PEI climate plan mentioned “seniors” in the context of establishing a Heat Alert and Response System to identify temperature thresholds at which enhanced responses are necessary to protect vulnerable populations [4]. The plan also described providing cooling and shade systems to seniors' housing, and disseminating food and water to vulnerable populations during weather emergencies. The BC climate plan included “elderly” when emphasizing the increased risk of morbidity and mortality in older adults due to heatwaves [5]. The plan highlighted the development of an extreme heat preparedness framework that will integrate feedback from consultations with older adults; this includes a heat alert response system, heat preparedness education, and a community emergency preparedness fund for extreme heat. The Quebec seniors' strategy was the only seniors' plan that addressed climate change [6]. It highlighted the impact of extreme weather on older adults and stressed prioritizing those with impaired decision-making, reduced mobility, or disabilities in climate emergencies. The plan incorporated recommendations from Quebec's climate strategies on emission targets, community adaptation, and climate literacy. It made two recommendations for older adults and climate change: promoting preventive behaviors (e.g., using the heat alert system to prepare for extreme heat) and training health professionals to educate older adults on climate risks and protective measures. Our policy document analysis found very limited prioritization of older adults in Canadian climate adaptation policies. Among the available plans, common recommendations included developing heat response frameworks, promoting climate education for older adults, and reducing air pollution. None of the plans addressed critical issues such as long-term care home infrastructure, comprehensive community support for older adults during climate emergencies, and healthcare system preparedness to address the health impacts of climate change on older adults. Climate adaption plans from the US and UK, along with global strategies for vulnerable populations, like children, offer valuable frameworks [2, 7, 8]. Recommendations from international plans that Canada could consider include (1) promoting climate-resilient community infrastructure (e.g., weatherizing housing and ensuring transportation for populations without personal vehicles) [2, 7]; (2) developing emergency climate plans for older adults (e.g., accessible cooling centers and evacuation plans for older adults with mobility and functional impairment) [2, 7, 8]; and (3) integrating climate change into health care delivery (e.g., clinical recommendations for adjusting medications during extreme heat and prioritizing home visits during climate events) [8]. Canadian climate plans and seniors' strategies present few actionable steps to address the disproportionate impacts of climate change on older adults. To promote climate resilience, policymakers should better prioritize older adults in adaptation strategies. G.M.K., A.J., N.M.S., and K.M.K. contributed to the conception and design of the work. G.M.K., A.J., and K.M.K. performed the literature search. G.M.K. and A.J. performed the data interpretation and wrote the initial draft of the manuscript. N.M.S. supervised the development of the manuscript. All of the authors critically revised the manuscript for important intellectual content. The authors would like to thank Alexander Bailey for performing the French translation of keywords. The authors have nothing to report. The authors declare no conflicts of interest. Table S1. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.