The Lancet Countdown on Health and Climate Change
Policy brief for Canada
1 Finding: Exposure to wildfires is increasing in Canada, with more than half of the
448,444 Canadians evacuated due to wildfires between 1980 and 2017 displaced in the
Recommendation: Incorporate lessons learned from recent severe wildfire seasons
into a strengthened pan-Canadian emergency response approach that anticipates
increasing impacts as the climate continues to change.
Finding: The percentage of fossil fuels powering transport in Canada remains high, though
electricity and biofuels are gaining ground. Fine particulate air pollution generated by
transportation killed 1063 Canadians in 2015, resulting in a loss of economic welfare for
Canadians valued at approximately $8 billion dollars.
Recommendation: Develop provincial and territorial legislation requiring automakers to
gradually increase the annual percentage of new light-duty vehicles sold that are zero
emissions, working toward a target of 100% by 2040.
Finding: Canada has the third-highest per capita greenhouse gas emissions from healthcare in
the world, with healthcare accounting for approximately 4% of the country’s total emissions.
Recommendation: Establish a sustainable healthcare initiative that assembles experts from
research, education, clinical practice, and policy to support Canada’s healthcare sector in
reducing greenhouse gas emissions and preventing pollution-related deaths, consistent with
healthcare’s mandate to ‘do no harm’ and the timelines and goals of the Paris Agreement,
charting a course for zero-emissions healthcare by 2050.
Finding: The health of Canadians is at risk due to multiple and varied risks of climate
change, including those described in this policy brief (see Figure 1). An ongoing,
coordinated, consistent and pan-Canadian effort to track, report, and create healthy
change is required.
Recommendation: Integrate health considerations into climate-related policymaking
across sectors, including in Canada’s updated 2020 Nationally Determined Contribution
Commitments under the United Nations Framework Convention on Climate Change
(UNFCCC) process, and increase ambition to ensure Canada commits to doing its fair share
in achieving the goals of the Paris Agreement.
Climate change is the biggest global health threat of the 21st century,1 and tackling it could be our greatest health opportunity.2
“The health of a child born today will be impacted by climate change at every stage in their life. Without significant intervention, this new era
will come to define the health of an entire generation.”3
However, another path is possible: a world that meets the ambition of the Paris Agreement and proactively adapts to protect health from the
climate impacts we cannot now avoid. This year’s briefing presents key findings and recommendations toward this path.
Key messages and recommendations
Health and climate change in Canada
Imagine an infant born today in Canada. This child enters a country warming at double the global rate, with the average temperature in
Canada having increased 1.7oC between 1948-2016.4 The North is warming even faster: areas in the Northwest Territories’ Mackenzie
Delta are now 3oC warmer than in 1948.5 Climate-related impacts on health and health systems are already being felt,6 with examples
outlined in Figure 1. By the time the child is in their twenties, in all feasible emissions scenarios, Canada will have warmed by at least
1.5oC as compared to a 1986-2005 reference period.4
Two scenarios are possible for the remainder of the child’s life.
If GHG emissions continue to rise at the current rate (a situation referred to by the Intergovernmental Panel on Climate Change (IPCC) as
the “high emissions scenario,” or ‘RCP8.5’) temperature increases in Canada will continue after 2050, reaching 6oC relative to
1986-2005 by the time the child is in their child’s sixties.4 Globally, this degree of warming places populations at a greater risk of
wildfires, extreme heat, poor air quality, and weather-related disasters. It will also lead to changes in vector-borne disease, as well as
undernutrition, conflict, and migration. These impacts and others negatively impact mental health,3 including via ecological anxiety
and grief.8 Climate change will not impact everyone equally, and can widen existing disparities in health outcomes between and within
populations, with Indigenous populations, people in low-resource settings,28 and future generations29 disproportionately affected.30 This
degree of warming has the potential to disrupt core public health infrastructure and overwhelm health services.2
Alternatively, if global emissions peak soon and quickly fall to net zero, consistent with the IPCC’s low-emissions scenario, (RCP 2.6),
temperatures will remain steady from 2040 onwards.4 Measures needed to accomplish this, such as increasing clean energy, improving
Figure 1: Examples of impacts of Climate Change on Health and Health Systems in Canada
Indicators of climate-related health impacts
This year’s policy brief presents information on three key indicators of climate-related health impacts and adaptive responses. Additional
recommendations can also be found in the 2017 and 2018 policy briefs.6,24
Lancet Countdown data indicates that the number of daily population wildfire exposure events increased from an average of 35,300 in
2001-2004 to 54,100 in 2015-2018, not including those subjected to wildfire smoke. Canadian data supports increasing impacts: more
than half of the 448,444 Canadians evacuated due to wildfires between 1980-2017 were displaced in the last decade.35 These exposures
not only pose a threat to public health, but also result in major economic and social burdens.
2019 marks a crux point for humanity: choices and policies made in
the lead up to the 2020 UNFCCC Nationally Determined Contribution
submissions will determine whether the world follows the disastrous
high-emissions scenario, or the safer low-emissions path. Children
are taking to the streets to demand a livable world. It is the task of
today’s political leaders and other adults to exert maximal effort
within their spheres of influence in order to set a course for a
healthy response to climate change.
public transit, cycling and walking rates, and adhering to a plantrich
diet in accordance with Canada’s new food guide,
decrease emissions, and also improve health and decrease
Canada is not on track: in 2016, total Canadian GHG emissions were
704 Mt CO2e, an increase of more than 100 Mt since 1990.31
Policies and measures currently under development but not yet
implemented are forecast to reduce national emissions to 592 Mt
CO2e by 2030,32 79 Mt CO2e above Canada’s 2030 target of 513
32—a goal which is itself too weak to represent a fair
contribution by Canada to the emissions reductions necessary to
meet the goals of the Paris Climate Change Agreement.
The Earth as a whole is warming less quickly than Canada—but still
far too fast. The IPCC and the World Health Organization have
emphasized that keeping global surface temperature warming to
1.5oC is key to obtaining the best outcomes now possible for human
health.33,34 To do so would require global net human-caused
emissions to fall by about 45% from 2010 by 2030, reaching ‘net
zero’ by 2050.34 Updated Nationally Determined Contributions to
the Paris Agreement are due to be submitted by 2020: policymakers
must integrate health considerations through proposed
Figure 2: Number of Wildfire Evacuees in Canada 1980-2017.*
Source: Wildland Fire Evacuation Database, Natural Resources Canada.35 (used with permission)
*N.B. Reporting for 2017 only includes evacuations up to and including July
In a mid-range GHG emissions scenario, wildfires in Canada are
projected to rise 75% rise by the end of the 21st century,36
necessitating a strong adaptive response. Human health impacts of
fire include death, trauma, and major burns,37 anxiety during
wildfire periods,35,38 and post-traumatic stress disorder, anxiety
and depression related to evacuations.39,40 Wildfire smoke also
travels vast distances41 and increases asthma and chronic
obstructive pulmonary disease exacerbations, with growing evidence
of an association with all-cause mortality.41 Impacts on health
systems can be severe: during the Fort McMurray fire hospital staff
evacuated 103 patients in a matter of hours,10,42 and the 2017 British
Columbia wildfires resulted in 700+ staff displaced, 880 patients
evacuated, and 19 sites closed by the Interior Health Authority, at a
cost of $2.7 million.12 Such devastating events also generate
significant emissions, contributing to climate change, and helping to
generate conditions conducive to future blazes.43
Much can be done to lessen the health impacts of wildfires.
Qualitative data indicates that populations who are better-briefed
on the local evacuation plan, as well as ways to lessen the risk of fire
to their property, are not only more prepared but also less
anxious.35,38 Building codes can be changed to help keep smoke out,
primary care practitioners can ensure vulnerable patients receive
at-home air filtration systems and respiratory medications prior to
wildfire season,44 public health professionals can collaborate with
municipal officials to maximize smoke forecast-informed outdoor
and well-ventilated indoor recreation opportunities,38 and health
personnel can help ensure evacuation plans are clearly
Sustainable and healthy transport
since 2000, they account for less than 4% of the energy used in
transport (Figure 3). This rate of change is inconsistent with the
emissions pathway required to keep today’s and future children
Support is therefore required for investments in public transit,47
and cycling infrastructure,48 creating win-wins for health by
increasing physical activity levels and improving community
cohesion, while reducing chronic disease, healthcare costs and
GHG emissions.49,50 Zero emissions vehicles also reduce air pollution
and are increasingly affordable: the up-front cost of electric vehicles
is forecast to become competitive on an un-subsidized basis from
2024 onwards.51 British Columbia recently passed legislation
requiring all new cars sold to be zero-emission by 2040.52 Other
provinces would benefit from matching this ambition.
Figure 3: Per Capita Fuel Consumption for Transport in Canada.
Source: Lancet Countdown
Transport-related pollution is harming the health of Canadians. Fine
particulate matter (PM2.5) air pollution related to land-based
transportation was responsible for approximately 1063 deaths in
2015 in Canada, resulting in a loss of economic welfare for
Canadians valued at approximately $8 billion dollars.24 Additionally,
Canada has the highest pediatric asthma rate amongst countries of
comparable income level, with nitrogen dioxide (NO2) from traffic
responsible for approximately 1 in 5 new cases of asthma in
With transport responsible for 24% of national GHG emissions in
2017,31 decarbonizing this sector must be prioritized. Progress is
entirely too slow: total fuel consumption for road transport per
capita decreased 5.4% from 2013 to 2016. While per capita
use of electricity and biofuels for transport increased by 600%
Healthcare sector emissions
Though Canadians are proud of the care they provide for one another
with this country’s system of universal healthcare,53 Lancet Countdown
analysis reveals an area which should give pause to all who endeavor to
“do no harm”: Canada’s healthcare system has the world’s third highest
emissions per capita.
Previous analysis showed healthcare sector emissions to be responsible
for 4.6% of the national total,54 as well as more than 200,000 tons of
other pollutants, resulting in 23,000 disability-adjusted life years (DALYs)
lost annually.54 Emissions from the health sector represent a strategic
mitigation target in a single-payer healthcare system straining under
the weight of an inexorably increasing burden of disease.
While Canadian healthcare sector emissions are increasing, the
world-leading Sustainable Development Unit in England reported an
18.5% decrease in National Health Service, public health and social
care system emissions from 2007-2017 despite an increase in clinical
Despite healthcare being a provincial jurisdiction, there is a role for
pan-Canadian sustainability initiatives to unite diverse experts
spanning public health and the spectrum of clinical disciplines,
economics, sustainability science and beyond. This demands health
sector-wide education, consistent with existing efforts to increase
environmental literacy for health professionals.56
1. Costello A, Abbas M, Allen A, Ball S, Bell S, Bellamy R, et al. Managing the
health effects of climate change: Lancet and University College London
Institute for Global Health Commission. Lancet 2009;373(9676):1693-733.
2. Watts N, Amann M, Arnell N, et al. The 2018 report of The Lancet
Countdown on health and climate change: shaping the health of nations
for centuries to come. Lancet 2018; vol. 392: 2479–514.
3. Watts N, Amann M, Arnell N, et al. The 2019 report of The Lancet
Countdown on health and climate change: ensuring that the health of a
child born today is not defined by a changing climate. Lancet 2019; vol.
4. Government of Canada. Canada’s Changing Climate Ottawa, Ontario,; 2019.
5. Government of the Northwest Territories. Climate Observations in the Northwest
Territories (1957-2012) Inuvik * Norman Wells * Yellowknife * Fort Smith.
6. Howard C, Rose C, Hancock T. Lancet Countdown 2017 Report: Briefing for
Canadian Policymakers. Lancet Countdown and Canadian Public Health Association;
2017 October 31st, 2017.
7. Rosol R, Powell-Hellyer S, Chan HM. Impacts of decline harvest of country food
on nutrient intake among Inuit in Arctic Canada: impact of climate change
and possible adaptation plan. Int J Circumpolar Health 2016;75(1):31127.
8. Cunsolo A, Ellis N. Ecological grief as a mental health response to climate
change-related loss. Nature Climate Change 2018;8:275-81.
9. Yao J, Eyamie J, Henderson SB. Evaluation of a spatially resolved forest fire
smoke model for population-based epidemiologic exposure assessment. J
Expo Sci Environ Epidemiol 2016;26(3):233-40.
10. Hampshire G. Hospital heroes get patients to safety during Fort McMurray fire:
17 buses took 105 patients to safety in dramatic evacuation. CBC News. 2016.
Available from: http://www.cbc.ca/news/canada/edmonton/hospital-heroesget-
11. Kirchmeier-Young M, Zwiers F, Gillett N, Cannon A. Attributing extreme fire risk
in Western Canada to human emissions. Climatic Change 2017;144(2):365-79.
12. British Columbia Interior Health Authority. Wildfire Emergency Response
13. Kirchmeier-Young M, Gillett N, Zwieres F, Cannon A, Anslow F. Attribution of
the Influence of Human-Induced Climate Change on an Extreme Fire Season.
Earth’s Future: American Geophysical Union 2018.
14. Alberta Health. Impact of Wildfires on the Mental Health of Fort McMurray
Residents: Neurotic Disorders, Daily Physician Visits within an Emergency
Department 2015 vs. 2016. Alberta Health, Health Standards, Quality and
Performance Division, Analytics and Performance Reporting Branch,; 2016.
15. Teufel B, Diro GT, What K, Mildrad SM, Jeong DI, Ganji A, et al. Investigation
of the 2013 Alberta flood from weather and climate perspectives. Climate
16. Canadian Broadcasting Corporation. Alberta Flood 2013: The five people we
lost. 2014. Available from: https://www.cbc.ca/calgary/features/albertaflood2013/
17. United Nurses of Alberta. UNA Calgary office closed, many health facilities
affected by southern Alberta flooding. 2013 June 21, 2013.
18. Yusa A, Berry P, J JC, Ogden N, Bonsal B, Stewart R, et al. Climate Change,
Drought and Human Health in Canada. Int J Environ Res Public Health
19. Smoyer-Tomic KE, Klaver JD, Soskolne CL, Spady DW. Health Consequences of
Drought on the Canadian Prairies. EcoHealth 2004.
20. Government of Canada Agriculture and Agri-Food Canada. Impact of Climate
Change on Canadian Agriculture. 2015 [Oct 22, 2017]; Available from: http://
21. Cryderman K. Drought in Western Canada is becoming an agricultural nightmare
for farmers. 2018. Available from: https://www.theglobeandmail.com/
22. Ziska LH, Makra L, Harry SK, Bruffaerts N, Hendrickx M, Coates F, et al.
Temper-ature-related changes in airborne allergenic pollen abundance and
seasonality across the northern hemisphere: a retrospective data analysis.
Lancet Planet Health 2019;3(3):e124-e31.
23. Nelder MP, Wijayasri S, Russell CN, Johnson KO, Marchand-Austin A, Cronin
K, et al. The continued rise of Lyme disease in Ontario, Canada: 2017.
Canadian Communicable Disease Review 2018;44(10):231-6.
24. Howard C, Rose C, Rivers N. Lancet Countdown 2018 Report: Briefing for
Canadian Policymakers. Canadian Medical Association, Canadian Public
Health Association, The Lancet Countdown; 2018 November.
25. a. Regional Public Health Department of Montreal. Epidemiological
Investigation Heat Wave Summer 2018 in Montréal - Summary. 2019.
b. Vogel MM, Zscheischler J, Wartenburger R, et al. Concurrent 2018 hot
extremes across Northern hemisphere due to human-induced climate
change. Earth's Future, 2019; vol. 7, 692–703. https://doi.org/10.1029/
26. Fenech A. Yes, Mr. Premier, Your Province is Shrinking! 2014 [cited 2019
Sept 20, 2019]; Available from: http://projects.upei.ca/climate/2014/02/16/
27. Kelleya C, Mohtadib S, Canec M, Seagerc R, Kushnirc Y. Climate change in the
Fertile Crescent and implications of the recent Syrian drought. Proceedings
of the National Academy of Science 2015;112 no 11: 3241–6,.
28. Berry HL, Bowen K, Kjellstrom T. Climate change and mental health: a causal
pathways framework. Int J Public Health 2010;55(2):123-32.
29. Walpole SC, Rasanathan K, Campbell-Lendrum D. Natural and unnatural
synergies: climate change policy and health equity. Bull World Health Organ
30. Watts N, Adger WN, Agnolucci P, Blackstock J, Byass P, Cai W, et al. Health
and climate change: policy responses to protect public health. Lancet
31. Government of Canada. Greenhouse Gas Emissions. 2018 [June 13, 2018.];
Available from: https://www.canada.ca/en/environment-climate-change/
32. Environment and Climate Change Canada. Canadian Environmental Sustainability
Indicators: Progress Towards Canada’s Greenhouse Gas Emissions
Reduction Target. 2019 [Sept 3, 2019]; Available from: https://www.canada.
33. Ebi K, Campbell-Lendrum D, Wyns A. The 1.5 Health Report--Synthesis on
Health and Climate Science in the IPCC SR1.5. 2018 2018.
34. Intergovernmental Panel on Climate Change. Global Warming of 1.5C--Summary
for Policymakers. 2018 October 8, 2018.
35. Christianson A. Wildland Fire Evacuations in Canada. Natural Resources
36. Wotton M, Nock C, Flannigan M. International Journal of Wildland Fire
37. Cameron PA, Mitra B, Fitzgerald M, Scheinkestel CD, Stripp A, Batey C, et
al. Black Saturday: the immediate impact of the February 2009 bushfires in
Victoria, Australia. Med J Aust 2009;191(1):11-6.
38. Dodd W, Scott P, Howard C, Scott C, Rose C, Cunsolo A, et al. Lived experience
of a record wildfire season in the Northwest Territories, Canada. Can J Public
39. McDermott BM, Lee EM, Judd M, Gibbon P. Posttraumatic stress disorder
and general psychopathology in children and adolescents following a wildfire
disaster. Can J Psychiatry 2005;50(3):137-43.
40. Papanikolaou V, Adamis D, Mellon RC, Prodromitis G. Psychological distress
following wildfires disaster in a rural part of Greece: a case-control population-
based study. Int J Emerg Ment Health 2011;13(1):11-26.
41. Reid CE, Brauer M, Johnston FH, Jerrett M, Balmes JR, Elliott CT. Critical Review
of Health Impacts of Wildfire Smoke Exposure. Environ Health Perspect
42. Matear D. The Fort McMurray, Alberta wildfires: Emergency and recovery
management of healthcare services. J Bus Contin Emer Plan 2017;11(2):128-
43. Liu Y, Goodrick S, Heilman W. Wildland fire emissions, carbon, and climate:
Wildfire–climate interactions. Forest Ecology and Management 2014;317:80-
44. Barn PK, Elliott CT, Allen RW, Kosatsky T, Rideout K, Henderson SB. Portable air
cleaners should be at the forefront of the public health response to landscape
fire smoke. Environ Health 2016;15(1):116.
45. Maguet S. Public Health Responses to Wildfire Smoke Events. BC Center for
Disease Control; 2018.
46. Achakulwisut P, Brauer M, Hystad P, Anenberg SC. Global, national, and urban
burdens of paediatric asthma incidence attributable to ambient NO2 pollution:
estimates from global datasets. Lancet Planet Health 2019;3(4):e166-e78.
47. Besser LM, Dannenberg AL. Walking to public transit: steps to help meet
physical activity recommendations. Am J Prev Med 2005;29(4):273-80.
48. United Kingdom Department of Transport. Value for Money Assessment for
Cycling Grants. 2014.
49. Woodcock J, Tainio M, Cheshire J, O’Brien O, Goodman A. Health effects
of the London bicycle sharing system: health impact modelling study. BMJ
50. Maizlish N, Woodcock J, Co S, Ostro B, Fanai A, Fairley D. Health cobenefits
and transportation-related reductions in greenhouse gas emissions in the San
Francisco Bay area. Am J Public Health 2013;103(4):703-9.
51. Willett W, Rockstrom J, Loken B, Springmann M, Lang T, Vermeulen S, et al.
Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from
sustainable food systems. Lancet 2019.
52. Zussman R. Legislation introduced to require all new cars sold in B.C. to be
zero-emission by 2040. Global News Online. 2019. Available from: https://
53. Thompson N. More Canadians take pride in symbols of the country’s present
than its past: survey. 2019.
54. Eckelman MJ, Sherman JD, MacNeill AJ. Life cycle environmental emissions
and health damages from the Canadian healthcare system: An economic-
environmental-epidemiological analysis. PLoS Med 2018;15(7):e1002623.
55. National Health System Sustainable Development Unit. Reducing the use of
natural resources in health and social care 2018 report. 2018.
56. Parkes M, Poland B, Allison A, Cole DC, Culbert I, Gislason MK, et al. In
press-Preparing for the future of public health: Ecological determinants of
health and the call for an eco-social approach to public health education.
Canadian Journal of Public Health 2019. DOI: 10.17269/s41997-019-00263-8.
Organisations and acknowledgements
The concept of this brief was developed by the Lancet Countdown on Health
and Climate Change.
This brief was written by Courtney Howard, MD; Chris Buse, PhD; Caren Rose,
PhD; Andrea MacNeill, MD, MSc; and Margot Parkes, MBChB, MAS, PhD.
Review was provided by Owen Adams, PhD; Ian Culbert; and Sandy Buchman,
Thanks to Sarah Henderson, PhD; Peter Barry, PhD; Brian Wiens, PhD;
Robin Edger, LLB, LLM; Jeff Eyamie, and Ashlee Cunsolo, PhD for their
Contributions and review on behalf of the Lancet Countdown were provided
by Jess Beagley and Nick Watts, MBBS.
THE LANCET COUNTDOWN
The Lancet Countdown: Tracking Progress on Health and Climate Change is an
international, multi-disciplinary collaboration that exists to monitor the links
between public health and climate change. It brings together 35 academic
institutions and UN agencies from every continent, drawing on the expertise
of climate scientists, engineers, economists, political scientists, public health
professionals, and doctors. Each year, the Lancet Countdown publishes an
annual assessment of the state of climate change and human health, seeking
to provide decision-makers with access to high-quality evidence-based
policy guidance. For the full 2019 assessment, visit www.lancet
THE CANADIAN MEDICAL ASSOCIATION
The Canadian Medical Association (CMA), formed in Quebec City in 1867,
has led some of Canada’s most important health policy changes. As we
look to the future, the CMA will focus on advocating for a healthy population
and a vibrant profession.
THE CANADIAN PUBLIC HEALTH ASSOCIATION
The Canadian Public Health Association (CPHA) is a national, independent,
non-governmental organization that advances public health education,
research, policy and practice in Canada and around the world through the
Canadian Journal of Public Health, position statements, discussion
documents and other resources.
Hockey is one of the most popular sports for Canadian children and youth. While the health benefits of physical activity and sport participation are well recognized, there is increasing concern around the frequency and severity of hockey-related injuries, particularly concussion. Studies consistently identify bodychecking as the primary mechanism associated with youth hockey injuries, including concussion. Policy to delay bodychecking until bantam league play (when participants are 13 to 14 years of age) will reduce the risks of injury and concussion in young ice hockey players. Bodychecking should be eliminated from non-elite youth ice hockey. The age at which bodychecking is introduced in competitive hockey leagues must be reconsidered. Both initiatives require policy change in many provinces/territories, and must be re-evaluated prospectively in light of emerging research.
More than 4.5 million Canadians are involved in ice hockey, as coaches, officials, administrators or direct volunteers, and hockey is the most popular winter sport among Canadian children and youth. Hockey Canada reported over 550,000 registered players under the age of 19 in 2008, and participation rates are increasing, especially among girls and young women. While the health benefits of physical activity and sport participation are well recognized, there is increasing concern around the frequency and severity of hockey-related injuries in youth, particularly concussion. The American Academy of Pediatrics (AAP) classifies hockey as a collision sport because of unintentional and intentional body contact, including bodychecking.
The AAP published a policy statement on youth ice hockey in 2000, recommending that bodychecking not be allowed for children younger than 15 years of age. There is passionate debate about the risk factors for injury in youth hockey and the relative merits of early or later introduction of bodychecking. Because bodychecking is not allowed in girls' or women's hockey in Canada, the present statement pertains to play in boys' and men's hockey leagues. It reviews the scientific literature on bodychecking injuries, outlines positions in the current debate and makes recommendations on when bodychecking should be introduced into the game.
DEFINING BODY CONTACT AND BODYCHECKING
Body contact is an individual defensive tactic designed to legally block or impede the progress of an offensive puck carrier. The defensive player moves to restrict action by the puck carrier anywhere on the ice, by skating, angling and positioning. The defensive player cannot hit the offensive player by travelling in an opposite direction to him or by physically extending toward him in an effort to initiate contact. There must be no action where the puck carrier is pushed, hit or shoved into the boards. In contrast, bodychecking is an individual defensive tactic designed to legally separate the puck carrier from the puck. The defensive player physically extends his body toward the puck carrier while moving in an opposite or parallel direction, a deliberate and forceful move not solely determined by the movement of the puck carrier. Bodychecking is taught based on a four-step skill development program outlined by Hockey Canada, with progression through positioning and angling, stick checking, body contact and bodychecking skills. Instruction in bodychecking includes techniques for receiving bodychecks, adhering to rules, and safe play.
Hockey Canada groups children and adolescents by age into six play levels: initiation (5 to 6 years of age), novice (7 to 8 years), atom (9 to 10 years), peewee (11 to 12 years), bantam (13 to 14 years), and midget (15 to 17 years). Historically, from the early 1980s until the 2002/2003 season, bodychecking was introduced at age 12 years in Canadian boys' ice hockey. In 2003, four of 13 provincial/territorial branches allowed checking for players as young as nine years old. Hockey Canada mandated the introduction of bodychecking in peewee leagues (ages 11 to 12) in 2009. Quebec has delayed bodychecking until bantam (age 14 from 1978 to 2002, then age 13 following an age change mandated nationally).
Despite lack of evidence, proponents of bodychecking argue that it is a fundamental skill which, learned early, may prevent future injuries. However, the evidence supports that bodychecking is the most common mechanism of injury. The Canadian Academy of Sports Medicine recommends that bodychecking be introduced only in boys' competitive hockey, and no earlier than the bantam (ages 13 to14) or midget (ages 15 to 17) level. The AAP recommends a ban on bodychecking for male players younger than 15 years of age. The present statement marks the first CPS position on this issue.
BODYCHECKING AND INJURY
Hockey is recognized as a high-risk sport. The speed of play, body contact and bodychecking all contribute to injury risk. The injury rate is also high, with Canadian data suggesting that hockey injuries account for 8% to 11% of all adolescent sport-related injuries. Unfortunately, serious injuries such as concussion, other brain injuries and spinal cord trauma are not uncommon in hockey. The incidence of traumatic brain injury appears to be rising. Ice hockey-related fatality rates are double those reported in American football, and catastrophic spinal cord and brain injury rates are almost four times higher for high school hockey players than for high school and college football players. Bodychecking is the predominant mechanism of injury among youth hockey players at all levels of competition where it is permitted, accounting for 45% to 86% of injuries.- Several published studies, including two recent systematic reviews, reported on risk factors for injury (including bodychecking) in youth hockey. Emery and colleagues conducted a systematic review of 24 studies and a meta-analysis including only studies which examined policy allowing bodychecking as a risk factor for injury. Policy allowing bodychecking was found to be a risk factor for all hockey injuries, with a summary incidence rate ratio (IRR) of 2.45 (95% CI 1.7 to 3.6). Furthermore, policy allowing bodychecking was found to be a risk factor for concussion, with a summary OR of 1.71 (95% CI 1.2 to 2.44). These data confirm that bodychecking increases the risk of all injuries and the risk of concussion specifically. Nine of ten studies examining policy allowing bodychecking provided evidence to support a greater risk in bodychecking leagues. The second systematic review found the RR of injury associated with policy allowing bodychecking ranged from 0.6 to 39.8; all but one of these studies found an increased risk of injuries associated with bodychecking.
Since the publication of these systematic reviews there have been five additional studies. A Canadian prospective cohort study compared injury rates between peewee ice hockey players in a league where bodychecking is permitted at age 11 years (Alberta) versus players in a league where bodychecking is not permitted until age 13 (Quebec). During the 2007/2008 season, a validated injury surveillance system was used to capture all injuries requiring medical attention and/or time loss from hockey (ie, time between injury and return to play) in 2154 players. There was a threefold increased risk of all game-related injuries (IRR =3.26 [95% CI; 2.31 to 4.60]) and of injury resulting in >7 days time lost from sport (IRR=3.30 [95% CI; 1.77 to 6.17]) in 11- to 12- year-old peewee players from Alberta when compared with Quebec. There was also an almost fourfold increased risk of game-related concussion (IRR=3.88 [95% CI; 1.91 to 7.89]) in Alberta peewee players. Further evidence was reported in a five-year cohort study (2002 to 2007) including all age groups, which demonstrated that injury risk increases 3.75 times (IRR=3.75 [95% CI; 1.51 to 9.74]) in leagues that allow bodychecking compared with those that do not.
A second prospective cohort study by Emery et al examined whether the introduction of bodychecking at 11 years of age (Alberta) or 13 years of age (Quebec) affected injury rates in later years (at 13 to 14 years of age). During the 2008/09 season, the same injury surveillance system cited above was used to study 1971 bantam players (13- to 14-year-olds). There was no reduction in game-related injury risk (all injuries) for this age group (IRR=0.85 [95% CI 0.63 to 1.16]), of concussion specifically (IRR=0.84 [95% CI 0.48 to 1.48]), or of concussions resulting in >10 days time lost from sport (IRR=0.6 [95% CI 0.26 to 1.41]) in the Alberta league, compared with Quebec. In fact, the concussion rate found in Alberta peewee players was higher than in bantam players in either province. Injuries to bantam players resulting in >7 days time lost from sport were reduced by 33% (IRR=0.67 [95% CI 0.46 to 0.99]) in the Alberta league, where players had had two years of bodychecking experience. However, these findings must be interpreted in light of the three- to fourfold greater injury and concussion risk among peewee players in Alberta, along with a possibly higher 'survival effect' among peewee players moving on to bantam in Quebec when compared with Alberta, where bodychecking is allowed in peewee league play.
Recent retrospective studies have examined the influence of policy change based on the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) surveillance data. Injury rates among boys presenting to emergency departments in the Kingston, Ontario area both before and after the 2002 rule change to allow bodychecking in younger players, were reported. There was no change between bodychecking injury rates in 1997 to 2002 (with bodychecking introduced at 11 years of age) and 2003 to 2007 (when bodychecking was introduced at nine years of age). Overall rates of injury actually declined over the later period. However, this retrospective study may also be biased by stronger rule enforcement, better coaching certification and temporal declines in emergency department use for this type of injury over that period. In contrast, retrospective research of CHIRPP data from 1994 to 2004 in five Ontario hospitals examined injury risk following a rule change in 1998 that allowed bodychecking in nine- and 10-year-old hockey players. A 2.2 times greater risk of injury in atom players (9 and 10 years of age) after the rule change was reported (OR=2.2 [95% CI 1.7 to 2.84]). Another retrospective study using CHIRPP data (from 1995 to 2002) compared hockey injuries in children 10 to 13 years of age playing in Ontario, where bodychecking was allowed, with data from Quebec, where bodychecking was not allowed. There was a 2.6 times greater risk of bodycheck-related injuries reported for this age group when bodychecking was allowed (OR=2.65 [95% CI 2.21 to 3.18]).
OTHER RISK FACTORS
After policy that permits bodychecking, the most commonly investigated risk factors for injury in the scientific literature are: age, session-type (ie, a practice versus a game), level of play, player position, physical size, and a previous history of injury and/or concussion. Most studies examining age found that injury risk increased with age; others suggest no elevated injury risk in older age groups.- Relative age has been examined to "describe the potential advantages (or disadvantages) that result from age differences between peers within one age group". One study examining relative age among hockey players found no evidence that younger (or older) players within a grouping were at elevated injury risk. Additional research supports this finding at the peewee level, where no increased risk was found in first-year players. In bantam leagues, however, there was a 40% greater risk of injury in first-year players when compared with players in their second year.
Based on session-type, injury risk is reported to be consistently higher in games than in practices, with RR estimates ranging from 2.45 to 6.32. One study also indicated that injury rates were higher in regular season play than during preseason, postseason or tournament games.
In general, studies examining level of play have found that injury risks rise with increasing skill levels across all age groups. However, one study reported that only peewee players in the highest skill division were at the greatest risk of injury, with no significant increase by skill level in other age groups. Larger cohort studies confirmed a consistently greater risk of injury among peewee players who were more highly skilled, but this trend was not observed in the bantam age group.
When examining player position, some researchers found that forwards were at higher risk of injury than defencemen or goalies,  while others reported the relative risk of injury was 2.18 times higher for defencemen than forwards. In all three studies, goalies were shown to be at much lower risk than other players. Additional research shows a consistent protective effect for goalies at both the peewee and bantam levels.
Research on player size has shown conflicting results, with some studies citing increased risk for smaller players in some age groups. Prospective Canadian data show a significantly greater risk of injury in peewee players in the lowest 25th percentile by weight,  though this finding was not reflected in the bantam cohort. However, additional research has found lighter bantam players to be at greater risk, while other studies report a significant weight difference, at all levels, between players who sustained a bodychecking-related injury and those who did not. Other research examining body weight as a risk factor for shoulder injuries found that heavier players were at greater risk for these injuries. One study looked at height as a possible risk factor for injury and found no evidence of effect among bantam players.
By contrast, a history of previous injury or concussion is consistently reported as a significant risk factor for reinjury and further concussion, respectively. One recent Canadian peewee cohort study showed that the risk of injury doubled for players who reported being injured within the past year (IRR=2.07 [95% CI 1.49 to 2.86]), while the risk of concussion tripled for players reporting any previous concussion (2.76 [95% CI 1.1 to 6.91]). The bantam cohort also showed greater risk of reinjury and concussion in players reporting previous injury within the past year (IRR=1.39 [95% CI 1.13 to 1.71]) or any previous concussion (IRR=1.87 [95% CI 1.19 to 2.94]), respectively.
INJURY PREVENTION AND RISK REDUCTION
Injury prevention and risk reduction programs have been implemented but have not been evaluated rigorously. The STOP (Safety Towards Other Players) program (www.safetytowardsotherplayers.com) is supported by the Ontario Minor Hockey Association (www.omha.net), and includes an education component and the "STOP patch", which is sewn on the back of players' uniforms to remind opponents not to hit from behind. A study evaluating another injury prevention program, "Fair Play", which awards points for sportsmanlike play (based on penalty minutes), suggests an approximate 60% reduction in the risk of injury (OR=0.41 [95% CI 0.11 to 1.47]) where the program is in effect, but the results were not statistically significant.
Players, parents, coaches, officials and trainers must be mindful of the potential risks of playing hockey. Hockey Canada has player development, coaching, education and safety promotion programs and resources for coaches, officials, players and parents at www.hockeycanada.ca. Concussion awareness is vital. Athletes and all those involved in their care need to know about the risks, symptoms/signs and how to manage concussive injuries. The CPS statement on concussion evaluation and management is essential reading , with additional information available from the Canadian Academy of Sport and Exercise Medicine (www.casm-acms.org), ThinkFirst Canada (www.thinkfirst.ca) and the US Centers of Disease Control and Prevention (www.cdc.gov/ncipc/tbi/Coaches_Tool_Kit.htm).
Studies consistently identify bodychecking as the primary mechanism of hockey-related injuries, including concussion. It is expected that delaying the introduction of bodychecking until the bantam level and restricting bodychecking to elite leagues for older age groups will reduce the risks of injury and concussion substantially. Delaying bodychecking until bantam will have a clear benefit in reducing the risks of injury and concussion in young ice hockey players. Bodychecking should be eliminated from recreational youth ice hockey and the age at which it is introduced in competitive hockey leagues should be reconsidered. Both initiatives require policy change in many provinces/territories in Canada, and policy changes will need to be evaluated on a regular basis in light of emerging research.
The Canadian Paediatric Society recommends the following:
* Eliminating bodychecking from all levels of organized recreational/non-elite competitive male ice hockey. (Grade II-2A evidence) *
* Delaying the introduction of bodychecking in elite male competitive leagues until players are 13 to 14 years of age (bantam level) or older. (Grade III-C evidence)*
* Implementing Hockey Canada's four-stage skill development program for bodychecking (body positioning, angling, stick checking and body contact) for all leagues.
* Educating coaches and trainers, schools, and policy-makers in sport about the signs and symptoms of common hockey injuries, especially concussion.
* Improving injury surveillance to better identify the risk factors for, and mechanisms of, hockey injuries.
* Policies to reduce injury and promote fair play in hockey, for all age groups and league levels.
Clinicians who see young hockey players in their practice should offer the following advice:
* Girls and young women should continue participating in non-bodychecking leagues.
* Boys should play in recreational/non-elite hockey leagues that do not allow bodychecking.
* Elite male players should play in hockey leagues that introduce bodychecking later, when players are 13 to 14 years of age (bantam level) or older.
* All players should adhere to fair play and a non-violent sport culture.
* Parents and caregivers should learn injury prevention and risk reduction strategies, including concussion prevention, recognition and management.
*The levels of evidence and strength of recommendations are based on the Canadian Task Force on Preventive Health Care (See Table 1). 
TABLE 1: [SEE PDF]
Levels of evidence and strength of recommendations
Level of evidence
Evidence obtained from at least one properly randomized controlled trial.
Evidence obtained from well-designed controlled trial without randomization.
Evidence obtained from well-designed cohort or case-controlled analytical studies, preferably from more than one centre or research group.
Evidence obtained from comparisons between times and places, with or without the intervention. Dramatic results in uncontrolled experiments could also be included in this category.
Opinions of respected authorities, based on clinical experience, descriptive studies or reports of expert committees.
There is good evidence to recommend the clinical preventive action.
There is fair evidence to recommend the clinical preventive action.
The existing evidence is conflicting and does not allow a recommendation to be made for or against use of the clinical preventive action; however, other factors may influence decision-making.
There is fair evidence to recommend against the clinical preventive action.
There is good evidence to recommend against the clinical preventive action.
There is insufficient evidence to make a recommendation; however, other factors may influence decision-making.
This statement was reviewed by the Community Paediatrics and Injury Prevention Committees of the Canadian Paediatric Society. Thanks to Drs. Claire MA LeBlanc, Stan Lipnowski, Peter Nieman, Christina G Templeton and Thomas J Warshawski for their input as past members of the CPS Healthy Active Living and Sports Medicine Committee.
HEALTHY ACTIVE LIVING AND SPORTS MEDICINE COMMITTEE
Members: Catherine Birken MD; Tracey L Bridger MD (Chair); Mark E Feldman MD (Board Representative); Kristin M Houghton MD; Michelle Jackman MD; John F Philpott MD
Liaison: Laura K Purcell MD, CPS Paediatric Sports and Exercise Medicine Section
Principal authors: Kristin M Houghton MD; Carolyn A Emery PT PhD
1. Hockey Canada, Annual report 2008: www.hockeycanada.ca/index.php/ci_id/55192/la_id/1.htm (Accessed July 4, 2012).
2. Rice SG; American Academy of Pediatrics, Council on Sports Medicine and Fitness. Medical conditions affecting sports participation. Pediatrics 2008;121(4):841-8.
3. American Academy of Pediatrics, Committee on Sports Medicine and Fitness. Safety in youth ice hockey: The effects of body checking. Pediatrics 2000;105(3 Pt 1):657-8.
4. Hockey Canada. Teaching checking: A progressive approach. 2002: www.omha.net/admin/downloads/Teaching%20Checking.pdf (Accessed July 4, 2012).
5. Canadian Academy of Sport Medicine. Position Statement: Violence and injuries in ice hockey. 1988. www.casm-acms.org/forms/statements/HockeyViolEng.pdf (Accessed July 4, 2012).
6. Emery CA, Risk factors for injury in child and adolescent sport: A systematic review of the literature. Clin J Sport Med 2003;13(4):256-68.
7. Caine D, Caine C, Maffulli N. Incidence and distribution of pediatric sport-related injuries. Clin J Sport Med 2006;16(6):500-13.
8. Emery CA, Meeuwisse WH. Injury rates, risk factors, and mechanisms of injury in minor hockey [comment]. Am J Sports Med 2006;34(12):1960-9.
9. Emery CA, Meeuwisse WH, McAllister JR. Survey of sport participation and sport injury in Calgary and area high schools. Clin J Sport Med 2006;16(1):20-6.
10. Emery C, Tyreman H. Sport participation, sport injury, risk factors and sport safety practices in Calgary and area junior high schools. Paediatr Child Health 2009;14(7):439-44.
11. Tator CH, Carson JD, Cushman R. Hockey injuries of the spine in Canada, 1966-1996 [comment]. CMAJ 2000;162(6):787-8.
12. Proctor MR, Cantu RC. Head and neck injuries in young athletes. Clin Sports Med 2000;19(4): 693-715.
13. Kelly KD, Lissel HL, Rowe BH, Vincenten JA, Voaklander DC. Sport and recreation-related head injuries treated in the emergency department. Clin J Sport Med 2001;11(2):77-81.
14. Mueller FO, Cantu RC. Catastrophic injuries and fatalities in high school and college sports, fall 1982-spring 1988. Med Sci Sports Exerc 1990;22(6):737-41.
15. Cantu RC, Mueller FO. Fatalities and catastrophic injuries in high school and college sports, 1982-1997: Lessons for improving safety. Phys Sportsmed 1999;27(8):35-48.
16. Brust JD, Leonard BJ, Pheley A, Roberts WO. Children's ice hockey injuries. Am J Dis Child 1992;146(6):741-7.
17. Bernard D, Trudel P. Marcotte G. The incidence, types, and circumstances of injuries to ice hockey players at the bantam level (14 to 15 years old). In: Hoerner E, ed. Safety in Ice Hockey. Philadephia: American Society for Testing and Materials, 1993:44-55.
18. Benson B, Meeuwisse WH. Ice hockey injuries. In: Maffulli N, Caine DJ, eds. Epidemiology of Pediatric Sports Injuries: Team Sports. Basel: S Karger AG, 2005:86-119.
19. Warsh JM, Constantin SA, Howard A, Macpherson A. A systematic review of the association between body checking and injury in youth ice hockey. Clin J Sport Med 2009;19(2):134-44.
20. Emery CA, Hagel B, Decloe M, Carly M. Risk factors for injury and severe injury in youth ice hockey: A systematic review of the literature. Inj Prev 2010;16(2):113-8.
21. Emery CA, Kang J, Shrier I, et al. Risk of injury associated with body checking among youth ice hockey players. JAMA 2010;303(22):2265-72.
22. Darling, SR, Schaubel DE, Baker JG, Leddy JJ, Bisson LJ, Willer B. Intentional versus unintentional contact as a mechanism of injury in youth ice hockey. Br J Sports Med 2011;45(6):492-7.
23. Emery C, Kang J, Shrier I, et al. Risk of injury associated with bodychecking experience among youth hockey players. CMAJ 2011;183(11):1249-56.
24. Kukaswadia A, Warsh J, Mihalik JP, Pickett W. Effects of changing body-checking rules on rates of injury in minor hockey. Pediatrics 2010;125(4):735-41.
25. Cusimano M, Taback N, McFaull S, Hodgins R, Tsegaye B; Canadian Research Team in Traumatic Brain Injury and Violence. Effect of bodychecking on rate of injuries among minor hockey players. Open Medicine 2011;5(1):e59: www.openmedicine.ca/article/view/246/389 (Accessed July 4, 2012).
26. Macpherson A, Rothman L, Howard A. Body-checking rules and childhood injuries in ice hockey. Pediatrics;117(2):e143-7 [Erratum in Pediatrics. 2006;117(6):2334-6].
27. Stuart MJ, Smith AM, Nieva JJ, Rock MG. Injuries in youth ice hockey: A pilot surveillance strategy. Mayo Clin Proc 1995;70(4): p. 350-6.
28. Mölsä, J, Kujala U, Myllynen P, Torstila I, Airaksinen O. Injuries to the upper extremity in ice hockey: Analysis of a series of 760 injuries. Am J Sports Med 2003;31(5):751-7.
29. Björkenheim JM, Syvähuoko I, Rosenberg PH. Injuries in competitive junior ice-hockey. 1437 players followed for one season. Acta Orthop Scand 1993;64(4):459-61.
30. Wiggins W. Implication of introducing body checking in ice hockey at different ages. OpenThesis. Lakehead University, 1998: www.openthesis.org/documents/Implication-introducing-body-checking-in-182710.html (Accessed July 4, 2012).
31. Wattie N, Cobley S, Macpherson A, Howard A, Montelpare WJ, Baker J. Injuries in Canadian youth ice hockey: The influence of relative age. Pediatrics 2007;120(1):142-8.
32. Roberts WO, Brust JD, Leonard B. Youth ice hockey tournament injuries: Rates and patterns compared to season play. Med Sci Sports Exerc 1999;31(1):46-51.
33. Williamson IJS. An epidemiological investigation of concussion in youth ice hockey. Simon Fraser University: MSc thesis, 2006.
34. Smith AM, Stuart MJ, Wiese-Bjornstal DM, Gunnon C. Predictors of injury in ice hockey players. A multivariate, multidisciplinary approach. Am J Sports Med 1997;25(4): 500-7.
35. McKay C, Emery CA, Campbell T, Meeuwisse W. The effect of premature return to play on re-injury risk in elite adolescent ice hockey and associated psychosocial predictors [Abstract]. Br J Sport Med 2008;42(6):532-3.
36. Willer B, Kroetsch B, Darling S, Hutson A, Leddy J. Injury rates in house league, select, and representative youth ice hockey. Med Sci Sports Exerc 2005;37(10):1658-63.
37. Finke RC, Goodwin Gerberich S, Madden M, et al. Shoulder injuries in ice hockey. J Orthop Sports Phys Ther 1988;10(2):54-8.
38. Brunelle JP, Goulet C, Arguin H. Promoting respect for the rules and injury prevention in ice hockey: Evaluation of the fair-play program. J Sci Med Sport 2005;8(3):294-304.
39. Canadian Paediatric Society, Healthy Active Living and Sports Medicine Committee. Identification and management of children with sport related concussion (Principal author Laura K Purcell). Paediatr Child Health 2012;17(1):31 www.cps.ca/en/documents/position/concussion-evaluation-management.
40. Canadian Task Force on Preventive Health Care, New grades for recommendations from the Canadian Task Force on Preventive Health Care for specific clinical preventive actions. CMAJ 2003;169(3):207-8.
41. Canadian Task Force. Quality of Published Evidence. www.canadiantaskforce.ca/_archive/index.html (Accessed July 19, 2012).
Disclaimer: The recommendations in this position statement do not indicate an exclusive course of treatment or procedure to be followed. Variations, taking into account individual circumstances, may be appropriate. Internet addresses are current at time of publication.
Dear Minister Freeland:
We are a national consortium of experts who serve and advocate for the needs and rights of older people. We are delighted by the recent appointment of a new Minister of Seniors, and send our congratulations to the Honourable Filomena Tassi. We are also encouraged by our Government’s commitment to support the health and economic well-being of all Canadians, and heartened by your promise to listen to, and to be informed by feedback from Canadians. It is in this spirit that we are writing today regarding the need for Canada to provide support and leadership with a goal of developing and ratifying a United Nations (UN) Convention on the Rights of Older Persons.
In the context of massive global demographic shifts and an aging population, insightful and careful reflection by the leaders of our organizations has led to universal and strong support for the creation and implementation of a UN Convention to specifically recognize and protect the human rights of our older persons.
A UN Convention on the Rights of Older Persons will:
enshrine their rights as equal with any other segment of the population with the same legal rights as any other human being;
categorically state that it is unacceptable to discriminate against older people throughout the world;
clarify the state’s role in the protection of older persons;
provide them with more visibility and recognition both nationally and internationally, which is vitally important given the rate at which Canadian and other societies are ageing;
advance the rights of older women at home and as a prominent factor in Canada’s foreign policy;
have a positive, real-world impact on the lives of older citizens who live in poverty, who are disproportionately older women, by battling ageism that contributes to poverty, ill-health, social isolation, and exclusion;
support the commitment to improve the lives of Indigenous Peoples; members of the LGBTQ community, and visible and religious minorities; and,
provide an opportunity for Canada to play a leadership role at the United Nations while at the same time giving expression to several of the Canadian government’s stated foreign policy goals.
We have projected that the cost and impact of not having such a Convention would have a significant negative impact on both the physical and mental health of older Canadians. The profound and tragic consequence would have a domino effect in all domains of their lives including social determinants of health, incidence and prevalence of chronic diseases, social and psychological functioning, not to mention massive financial costs to
society. There is recognition of this need internationally and ILC-Canada, along with other Canadian NGOs and organizations have been active at the UN to help raise awareness of the ways a UN Convention on the Rights of Older Persons would contribute to all countries.
Changes have already been implemented by our Government that are consistent and aligned with a UN Convention, such as improving the income of vulnerable Canadian seniors, funding for long term care and support for community based dementia programs. These initiatives are all in keeping with support for a Convention on the Rights of Older Persons. They are also reflective of our country’s commitment to engage more fully with the United Nations and provide Canada the stage to demonstrate leadership on a vital international issue. It is an opportunity to champion the values of inclusive government, respect for diversity and human rights including the human rights of women.
Scientific evidence demonstrates that human rights treaties help to drive positive change in the lives of vulnerable groups of people. In many countries in the world, older people are not adequately protected by existing human rights law, as explicit references to age are exceedingly rare. Even in countries like Canada, where there are legal frameworks that safeguard older people, a Convention would provide an extra layer of protection, particularly if the Convention has a comprehensive complaints mechanism.
Older adults need to be viewed as a growing but underutilized human resource. By strengthening their active role in society including the workforce, they have tremendous capacity, knowledge, and wisdom to contribute to the economy and general well-being of humankind.
We are requesting you meet with our representatives, to discuss the vital role of a UN Convention on the Rights of Older Persons and the role your government could play in improving the lives of older people in Canada and around the world. The fact that Canada is ageing is something to celebrate. We are all ageing, whether we are 20 or 85. This is a ”golden opportunity” to showcase Canada as a nation that will relentlessly pursue doing the “right thing” for humanity by supporting a UN Convention that ensures that our future is bright.
Please accept our regards, and thank you for your attention to this request. We await your response. Sincerely,
Margaret Gillis, President, International Longevity Centre Canada
Dr. Kiran Rabheru, Chair of the Board, International Longevity Centre Canada
Linda Garcia, Director, uOttawa LIFE Research Institute
cc: The Right Honourable Justin Trudeau Prime Minister of Canada
The Honourable Filomena Tassi Minister of Seniors
The Honourable Jean Yves Duclos
Minister for Families, Children and Social Development
Ambassador Marc-Andre Blanchard
Permanent Representative to Canada at the United Nations
The Honourable Ginette Petitpas Taylor
International Longevity Centre Canada
Dr. Kiran Rabheru
Chair of the Board, International Longevity Centre Canada
Linda Garcia, PhD
LIFE Research Institute
Dr. Laurent Marcoux
Canadian Medical Association
Andrew Padmos, BA, MD, FRCPC, FACP
Chief Executive Officer
Dani Prud’Homme Directeur général FADOQ
Peter Lukasiewicz Chief Executive Officer Gowling WLG
Dr. Dallas Seitz, MD, FRCPC
Dr. Frank Molnar
President, Canadian Geriatrics Society
Dr. David Conn
Canadian Coalition for Senior’s Mental Health
Director - Canadian Coalition for Seniors’ Mental Health
Chief Executive Officer, Speech-Language & Audiology Canada
President Canadian Nurses Association
Janice Christianson-Wood, MSW, RSW Title/Organization: President, Canadian Association of Social Workers / Présidente, l’Association canadienne des travail-
Chief Executive Officer/Chef de la direction
Ondina Love, CAE
Chief Executive Officer Canadian Dental Hygienists Association
National Association of Federal Retirees /Association nationale
des retraités fédéraux
Laura Tamblyn Watts
National Initiative for the Care of the Elderly
Dr. Keri-Leigh Cassidy
Founder Fountain of Health
Dr. Beverley Cassidy Geriatric Psychiatris Seniors Mental Health
Dalhousie University Dept of Psychiatry
Jenny Neal and Janet Siddall
CO Chairs, Leadership Team Grandmothers Advocacy Network (GRAN)
President and CEO
Dr. Becky Temple, MD, CCFP, CCPE
Medical Director Northeast, Northern Health Medical Lead Privilege Dictionary Review, BCMQI
J. Van Aerde, MD, MA, PhD, FRCPC
Clinical Professor of Pediatrics - Universities of Alberta & British Columbia, Canada
Associate Faculty - Leadership Studies - Royal Roads Univ, Victo- ria, BC, Canada
Past-President - Canadian Society of Physician Leaders Editor-in-Chief / Canadian Journal of Physician Leadership
Dr. Rollie Nichol, MD, MBA, CCFP, CCPE
Associate Chief Medical Officer, Alberta Health Services
Dr. Shannon Fraser, MSc, FRCSC, FACS
Secretary / Treasurer, CSPL Chief General Surgery Jewish General Hospital
Linda Gobessi MD FRCPC
Geriatric Psychiatry Community Services of Ottawa Ottawa
Executive Director / Directrice générale
Services communautaires de géronto- psychiatrie d’ Ottawa Geriatric Psychiatry Community Services of Ottawa
Ging-Yuek Robin Hsiung, MD MHSc FRCPC FACP FAAN
Ralph Fisher and Alzheimer Society of BC Professor Director of Clinical Research
Director of Fellowship in Behavioural Neurology UBC Hospital Clinic for Alzheimer and Related Disorders
Division of Neurology, Department of Medicine University of British Columbia
Senior Social Worker Baycrest Health Sciences
Harinder Sandhu, D.D.S., Ph.D
Professor and Past Director
Schulich Dentistry & Vice Dean, Schulich School of Medicine & Dentistry
Dr. Christopher Frank,
Chair of Geriatric Education and Recruitment Initiative
Jennie Wells, MD
Associate Professor, University of Western Ontario Department of Medicine
Chair/Chief Division of Geriatric Medicine Parkwood Institute
Laura Diachun, MD
Program Director, Undergrad Geriatric Education University of Western Ontario
Department of Medicine, Division of Geriatric Medicine Parkwood Institute
Sheri-Lynn Kane, MD Program Director Internal Medicine Dept of Medicine Education Office
Niamh O’Regan, MB ChB,
Assistant Professor, University of Western Ontario Parkwood Institute
Michael Borrie, MB ChB, FRCPC
Professor, University of Western Ontario Department of Medicine, Division of Geriatric Medicine
Jenny Thain, MRCP (Geriatrics)
Assistant Professor, University of Western Ontario Department of Medicine, Division of Geriatric Medicine Victoria Hospital
Peter R. Butt MD CCFP FCFP
Assoc. Professor, Department of Family Medicine, College of Medicine,
University of Saskatchewan
Mamta Gautam, MD, MBA, FRCPC, CCPE Dept of Psychiatry, University of Ottawa Psychiatrist, Psychosocial Oncology Program, The Ottawa Hospital
President and CEO, PEAK MD Inc.
Dr. Shabbir Amanullah
Arun V. Ravindran, MBBS, MSc, PhD, FRCPC, FRCPsych
Professor and Director, Global Mental Health and the Office of Fellowship Training, Department of Psychiatry,
Graduate Faculty, Department of Psychology and Institute of Medical Sciences, University of Toronto
Sarah Thompson, MD, FRCPC Geriatric Psychiatrist Seniors’ Mental Health Team
Addictions and Mental Health Program
Louise Plouffe, Ph.D.
Director of Research, ILC Canada (retired)
Kimberley Wilson, PhD, MSW
Assistant Professor, Adult Development & Aging, Department of Family Relations & Applied Nutrition, University of Guelph
Andrew R. Frank M.D. B.Sc.H. F.R.C.P.(C)
Cognitive and Behavioural Neurologist Medical Director, Bruyère Memory Program Bruyère Continuing Care
Diane Hawthorne Family Physician BSc, MD, CCFP, FCFP
Dr. Ken Le Clair
Prof Emeritus Queens University and. Lead Policy Physician Consultant to Ontario. Seniors Behavioral Support Initative Queens University