Food Safety and Security

This chapter is guided by a framework (Schnitter & Berry, 2019) that conceptualizes the breadth and complexity of climate change impacts on food systems and hence on human health (Figure 8.1). The framework describes the dynamic relationship among food systems, primary dimensions and determinants of food security and safety, and human health outcomes in a changing climate.

Within this framework, food systems consist of activities and elements spanning multiple sectors related to food production, processing, distribution, preparation, and consumption (Gregory et al., 2005; Ericksen, 2008; Anand et al., 2015; HLPE, 2017). These food system components include non-commercial and commercial production, transportation, washing, cooking, preparation, storage, consumption, and use of food (Ingram, 2009; Friel, 2019) and are often interconnected, with the activities of one component affecting the operations of others.

Food systems underpin the primary dimensions of food security by supporting the stability and strength of its pillars: food availability, accessibility, and use (Table 8.1) (Pinstrup-Andersen, 2013; Friel & Ford, 2015; Nelson et al., 2016). Food security exists when “all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food which meets their dietary needs and food preferences for an active and healthy life” (FAO, 1996). In contrast, food insecurity exists whenever any of these pillars are unfulfilled. Influenced by political, economic, social, and environmental factors (Ericksen, 2008), food security can be measured at different spatial and temporal scales (Gregory et al., 2005) and occurs on a spectrum (e.g., food secure, marginally food insecure, moderately food insecure, severely food insecure) (Health Canada, 2020). Food security or insecurity affects health and well-being and, thus, is a public health issue.

Food security cannot exist without food safety. The safety of food for human consumption can be compromised at any point in food systems, and the ingestion of contaminated food can result in adverse health effects and, in severe cases, death. Food safety systems are critical for ensuring that the food consumed by Canadians is safe to eat, and that pathogens or contaminants are not present in foods at levels that can cause harm. Two elements of food safety and their relationship to climate change are explored in this chapter: food-borne pathogens and chemical contaminants.

A rigorous, systematic, and flexible approach was used to identify literature and evidence relevant to climate change, food systems, and health. The approach comprised three elements: building from previous assessments; conducting a comprehensive search of peer-reviewed and grey literature; and learning from public consultations and engagement.

This chapter built on international (IPCC, 2018; IPCC 2019a; IPCC, 2019b), national (Lemmen et al., 2008; Warren & Lemmen, 2014), and human health-specific assessments that summarized literature on the impacts of climate change on food-related health (Séguin, 2008; USGCRP, 2016). The chapter draws particularly on two chapters from the health-specific assessments The Impacts of Climate Change on Water-, Food-, Vector- and Rodent-Borne Diseases (Charron et al., 2008) and Food Safety, Nutrition, and Distribution (Ziska et al., 2016).

Literature published since the previous Canadian National Climate Change and Health Assessment in 2008 (Séguin, 2008) was identified and assessed using two separate literature searches, focusing on climate change impacts on food security and food safety in Canada. Five databases (PubMed, Web of Science, Scopus, Embase via Ovid, and MEDLINE via Ovid) were searched using search strings developed in consultation with a research librarian. The reference lists of all relevant literature were examined to identify articles not captured in the database search. Websites of key government and international agencies (e.g., provincial and territorial government websites, Public Health Agency of Canada, Health Canada, Canadianood Inspection Agency, Food and Agriculture Organization of the United Nations, World Health Organization, US Centers for Disease Control and Prevention, World Food Programme) were examined to identify relevant grey literature. No language restrictions were placed on either search. Citations identified through these searches went through two levels of screening conducted by two independent reviewers. First, the titles and abstracts were screened for relevance, then, the full texts of articles were screened for relevance. Literature that discussed food security and/or food safety in the context of human health and climate change was included in this assessment. While Canadian research was prioritized, international research with results relevant to the Canadian context was also included.

The existing literature on climate change impacts on Indigenous food security primarily focuses on Inuit and First Nations peoples, with very limited Métis-specific literature (Halseth, 2015; Beaudin-Reimer, 2020). Wherever possible, specific Indigenous Peoples are distinguished in this chapter to reflect the diverse perspectives and experiences among First Nations, Inuit, and Métis peoples and communities. However, some generalizations are made, depending on the number and nature of citations used (e.g., Indigenous Peoples reflect more than one Indigenous group being referenced) and in instances where there may be shared experiences.

The baseline level of food security contributes to the vulnerability of households to the food-related health impacts of climate change. Therefore, it is important to understand the baseline prevalence, distribution, determinants, and magnitude of food security in Canada. Approximately 12.7% of Canadian households experience some level of household food insecurity (Tarasuk & Mitchell, 2020). This prevalence is likely an underestimate, as the survey does not capture those living in First Nations communities (on-reserve), full-time members of the Canadian Forces, individuals in prisons, those living in some remote Northern communities, or individuals who are under-housed or homeless (Jessiman-Perreault & McIntyre, 2017).

Inequities exist with respect to how food security is distributed and experienced across Canada. Such inequities contribute to ongoing health disparities across the country (see Chapter 9: Climate Change and Health Equity). Household food insecurity is most prevalent in the territories and the Maritime provinces (Figure 8.2), and urban households experience food insecurity to a slightly greater degree (13%) than rural households (11%) (Tarasuk et al., 2016; Tarasuk & Mitchell, 2020). Household food insecurity is more common in households with children and those with lone parents, with lone female-headed households being most vulnerable (Tarasuk & Mitchell, 2020). The likelihood of severe food insecurity increases with decreasing household income (Statistics Canada, 2012). In 2017–2018, approximately 60% of Canadian households whose primary income source was social assistance reported experiencing food insecurity (Tarasuk & Mitchell, 2020). Household food insecurity is significantly higher among households where the respondent identified as Indigenous (28.2%) or Black (28.9%) (Tarasuk & Mitchell, 2020). Unemployment, lower education (less than a high school diploma), recent immigration (within five years), and self-identification as 2SLGBTQQIA+ (two-spirit, lesbian, gay, bisexual, transgender, queer, questioning, intersex and asexual) also increase the risk of household food insecurity (PHAC, 2018).

Indigenous households, in remote and Northern communities in particular, are often significantly challenged by food insecurity, which is often rooted in ongoing colonial legacies (Box 8.1). Indeed, the prevalence of food insecurity is 3.7 times higher among Inuit adults, 2.7 times higher among First Nations adults (living off reserve), and 2.2 times higher among Métis adults than among non-Indigenous adults (PHAC, 2018) (see Chapter 2: Climate Change and Indigenous Peoples’ Health in Canada). On-reserve data indicates that just over half (50.8%) of First Nations adults live in food insecure households, and 43.2% of households with children were classified as food insecure (FNIGC, 2018). With over 68% of households experiencing some level of food insecurity (Rosol et al., 2011; Huet et al., 2012; Fillion et al., 2014), Inuit living in Nunavut have a higher prevalence of food insecurity than any other Indigenous Peoples living in a high-income country (CCA, 2014).

While some individual and household characteristics are associated with food insecurity trends (e.g., socio-economic status, household living arrangement, Indigenous identity), it is important to note that population groups are not homogeneous and that food security status is not static. Each individual uniquely experiences a range of intersecting social, political, economic, and environmental factors that contribute to differential food security status over time (Kapilashrami & Hankivsky, 2018), and therefore different and changing vulnerability to climate change impacts on food systems. In some cases, these factors may intersect in ways that compound vulnerability to food insecurity in the context of climate change, creating disproportionate impacts on some population groups. Food insecurity has close linkages to other indicators of material and social disadvantage (Tarasuk & Mitchell, 2020). In many cases, disadvantage can further enhance vulnerability to climate-related health risks by creating difficulties that hinder individuals from taking measures to protect themselves and adapt (see Chapter 9: Climate Change and Health Equity).

Food security is an important public health challenge that will be affected, mediated, and modified by climate change. Household food insecurity is associated with many adverse physical and mental health outcomes, including nutritional deficiencies, cardiovascular disease, diabetes, oral health issues, and depression (Table 8.3) (McLeod & Veall, 2006; Muldoon et al., 2013; Tarasuk et al., 2016; Jessiman-Perreault & McIntyre, 2017). Malnutrition due to food insecurity can increase the body’s susceptibility to disease, which can, in turn, limit an individual’s ability to access and use food. This can further exacerbate food insecurity and malnutrition and establish a vicious cycle of food insecurity and poor health (Aberman & Tirado, 2014). Furthermore, one study in Ontario demonstrated that food insecurity can indirectly stress the health care system, as adults experiencing food insecurity require more health care services and are more likely to become high-cost health care users compared to adults who are food secure (Figure 8.3) (Tarasuk et al., 2015; Li et al., 2016; Tarasuk et al., 2016). Given these implications for the health sector, food security in a changing climate is an important public health challenge.

Climate change poses risks to food systems (see section 8.3 Climate Change Impacts on Food Systems in Canada) through complex interactions that influence the pillars of food security — availability, accessibility, utilization, and stability — which can lead to negative health outcomes among Canadians. Threats to these pillars are discussed below.

8.4.3.1 Climate Change Impacts on Food Availability

There are three primary elements associated with food availability: production, distribution, and exchange of food (Ericksen, 2008). Climate change can disrupt each of these elements (Figure 8.1). For example, crop yields are highly sensitive to changes in temperature and water availability. Air temperatures higher than 30°C are associated with reduced yields for rain-fed crops (Myers et al., 2017). Temperature variability and extremes can also damage crops, especially if these events occur during critical stages of crop development (Easterling et al., 2007; Gornall et al., 2010). In 2012, for example, following a summer of extreme heat and drought, fruit trees in Ontario bloomed earlier than seasonal norms. Temperatures then dropped, causing a frost event that resulted in an 80% loss of apple crops and a 50% loss of strawberry crops in Ontario (ECCC, 2017). It is projected that, in Eastern and Central Canada, there will be an increase in the frequency of winter bud kill and late killing-frost events (Campbell et al., 2014), which will negatively affect agricultural food production.

Canada is also expected to experience an increase in frequency and severity of extreme weather events (Bush & Lemmen, 2019), which can hinder agriculture and livestock production and also disrupt food distribution and exchange. For example, a powerful winter storm in January 2020 caused the City of St. John’s, Newfoundland and Labrador, to declare a state of emergency, ordering all businesses, including grocery stores, to close. Grocery stores re-opened after four days; however, high consumer demand, combined with a disrupted regional food supply chain, resulted in many stores selling out of food and turning away customers who had been waiting for hours to purchase basic food staples (Roberts & Cooke, 2020).

Climate change is expected to affect the diversity of available food globally, which has important health implications. Springmann et al. (2016) determined that a total of 529,000 deaths worldwide (78 per million, base year: 2010) could occur between 2010 and 2050 due to climate-related reductions in food availability and changes in fruit, vegetable, and red meat consumption. In this model, climate-related changes in diet (i.e., decreased fruit and vegetable consumption) were projected to result in twice as many deaths as climate-related reductions in caloric intake. For Canada, the study projected that between 25 and 33 deaths per million will occur in 2050 due to climate-related changes in diet and weight, almost all of which are attributable to reductions in fruit and vegetable consumption (Springmann et al., 2016). Should Canada’s population grow to a projected 44 million inhabitants (Statistics Canada, 2020), an additional 1100 to 1450 deaths might be expected in 2050. The adoption of GHG mitigation strategies could decrease the number of deaths worldwide due to climate-related changes in food availability in 2050 by 29% to 71%; however, excess deaths would remain even under negative emissions scenarios (Springmann et al., 2016).

8.4.3.2 Climate Change Impacts on Food Accessibility

Food accessibility relates to the affordability, allocation, and socio-cultural preferences for food (Figure 8.1) (Ericksen, 2008), and can be affected by climate change through indirect, but well-known, pathways. Several studies have projected the impact of climate change on world food prices (Easterling et al., 2007; Lake et al., 2012). For example, global models project that, under the Representative Concentration Pathway (RCP) 6.0 emission scenario, cereal prices will increase by 1% to 29% by 2050 (Mbow et al., 2019). Other staples, such as rice and sugar, are projected to increase in price by as much as 80% compared to their reference levels without climate change (Schmidhuber & Tubiello, 2007). Canada’s Food Price Report identified climate change as a significant driver of food price increases since 2016. Climate change impacts, including changing weather patterns, droughts, wildfires, reduced access to fresh water, and rising sea levels, are projected to affect Canadian food systems and contribute to a 3% to 5% increase in overall food prices in 2021 (Charlebois et al., 2020; Charlebois et al., 2021).

As food prices rise, households may lack the economic means to purchase adequate, healthy, and preferred foods. Indeed, increased food prices can force consumers, especially those living on low incomes who are already at risk of food insecurity, to purchase lower-cost energy-dense processed foods, which contribute to excess sodium, sugar, and saturated fat intake and may have negative nutrition and health consequences (Lock et al., 2009; Lake et al., 2012). Substituting nutritious foods with inexpensive energy-dense processed foods can lead to an increased incidence of nutrient deficiencies and non-communicable diseases, such as obesity and type 2 diabetes (Gibson et al., 2004; Lake et al., 2012; Marushka et al., 2017; Kenny et al., 2018).

Food accessibility is also a function of physical access to food, which can be affected by climate change and extreme weather events, in particular (Palko & Lemmen, 2017). For instance, high winds, extreme precipitation, flooding, and extreme heat events can disrupt public transportation systems, which many urban dwellers rely on to access retail food distribution sites (Palko & Lemmen, 2017). These effects may be particularly pronounced for those with disabilities and those living in neighbourhoods categorized as “food deserts,” where households are primarily relying on a low income and have little or no nearby access to stores or restaurants that provide healthy and affordable foods (Biehl et al., 2018).

8.4.3.3 Climate Change Impacts on Food Utilization

Food security extends beyond the supply and demand dynamics of markets to the use of food (Figure 8.1), including important aspects related to food safety (see section 8.5 Climate Change Impacts on Food Safety in Canada) and the nutritional and socio-cultural value of food (see section 8.4.3.3.1 Climate Change Impacts on Nutrient Availability) (Ericksen, 2008; Myers et al., 2017).

Climate change will influence the nutritional value and nutrient composition of diets through its influence on the pillars of food security, as well as its impact on the conditions under which food is produced, distributed, and individually chosen (The Royal Society, 2009; Lake et al., 2012). As discussed below, such changes have implications for overall human health and nutrition through possible effects on nutrient availability, biodiversity-related impacts on nutrient access, and dietary transitions and substitutions.

8.4.3.3.1 Climate Change Impacts on Nutrient Availability

Globally, increasing carbon dioxide (CO₂) concentrations associated with climate change are projected to alter the nutrient content and density of agricultural and seafood products, which can affect food security (Macdiarmid & Whybrow, 2019). Experiments growing crops (e.g., wheat, rice, legumes) in controlled environments have found that zinc, iron, and protein concentrations are reduced by 3% to 15% when grown in conditions with elevated CO₂ (550 to 690 ppm) (Myers et al., 2014; Myers et al., 2017). Phytate content was also reduced, which could offset some of the zinc and iron losses, as phytates typically reduce micronutrient bioavailability (Myers et al., 2014; Myers et al., 2017). Nevertheless, when these nutrient changes are applied to contemporary diets globally, it is projected that hundreds of millions of people will be placed at risk of zinc, iron, and/or protein deficiencies, and the existing deficiencies of an estimated two billion people will be exacerbated (Myers et al., 2017).

Increasing CO₂ concentrations are also changing the nutritional value of important forage for pollinator species (Myers et al., 2017). Although the net effect of climate change on pollinators remains unclear, studies indicate that a reduction in animal pollination would decrease yields of numerous pollinator-dependent food crops that provide important macro- and micronutrients to humans (Myers et al., 2017). Pollinator declines over the long term could reduce dietary intake of fruits, vegetables, nuts, and seeds in many countries, leading to increased child mortality and birth defects from vitamins A, E, and B6 (folate) deficiencies, and increased risks of heart disease, stroke, type 2 diabetes, and certain cancers (Myers et al., 2017). Varying soils and growing conditions, as well as methods of harvesting, processing, and storing food crops, can also influence nutrient composition. For example, selenium content varies by geography according to the soil mineral content (Lake et al., 2012).

The health impacts of reduced nutrient densities on food security, however, will depend on overall dietary diversity, as well as country-specific enrichment and fortification policies (CFIA, 2014). Similar to impacts in other higher-income countries, the impact will likely be lower in Canada, where many staple foods, including wheat flour, are fortified with essential micronutrients such as iron and folic acid (CFIA, 2014). Nevertheless, health impacts may be more pronounced in specific regions of Canada, such as Northern communities, where challenges accessing a diverse diet including fruits, vegetables, and whole grains already exist. Further research is therefore needed to understand how climate-related changes in nutrient availability will affect food security in Canada.

8.4.3.3.2 Impacts of Climate-Related Biodiversity Loss on Nutrient Access

The impacts of climate change on biodiversity loss will increase risks to food and nutrient access (Rose et al., 2001; Romero-Lankao et al., 2014). Biodiversity reflects the number and variety of living organisms and plays a key role in boosting ecosystem productivity, resilience, and sustainability — in turn, offering many benefits to humans and animals, such as soil formation and retention, pollination, climate regulation, and resources for foods and pharmaceuticals (IPBES, 2018).

While agriculture products provide the majority of dietary energy (i.e., calories), seafood is an important source of nutrients, such as protein, fat, minerals, and vitamins, for many populations, including Canadians (Myers et al., 2017; Marushka et al., 2019). Global estimates suggest that climate-related declining fish harvests (IPCC, 2019a) will leave 845 million people vulnerable to deficiencies in iron, zinc, and vitamin A, and 1.4 billion people vulnerable to deficiencies of vitamin B12 and omega-3 long-chain polyunsaturated fatty acids by 2050 (Golden et al., 2016). Those who are in low-resource settings will be at greater risk of nutrient deficiencies because of their limited access to alternatives, such as other sources of animal protein, supplements, and nutritionally fortified or enriched foods (Myers et al., 2017).

The impacts of biodiversity loss are inequitably distributed among human populations. In Canada, Indigenous Peoples who depend on the land for sustenance are particularly vulnerable to climate-related biodiversity loss (Rose et al., 2001; Richmond & Ross, 2009; Anderson et al., 2018; Kenny et al., 2018; Boulanger-Lapointe et al., 2019). For instance, drawing on observations of declining food species in 36 Indigenous communities spanning Nunavut, the Inuvialuit Settlement Region, and Nunatsiavut, Rosol et al. (2016) explored the likely nutritional impact of possible future diet substitutions. In some cases, substitutions resulted in similar nutrient intake, while other alternatives were of lower nutritional value. For example, if Inuit in the region of Kivalliq replaced 50% of their fish intake with duck (gram-for-gram), vitamin D intake would decrease by 94%, while iron and zinc intake would both increase (Rosol et al., 2016). Similarly, the diets of several First Nations in British Columbia rely on locally harvested seafood, meaning that their nutritional health is highly vulnerable to potential climate-related declines in seafood abundance (Box 8.2) (Rosol et al., 2016; Marushka et al., 2017; Watts et al., 2017; Rapinski et al., 2018). Indigenous Peoples may respond to these changes by purchasing more retail food; however, this response may increase health risks, as shifts from locally harvested to retail food often result in increased consumption of processed foods that are higher in fat, refined sugar, and sodium (Marushka et al., 2019). Furthermore, in many remote Indigenous communities, retail foods are expensive and limited in quantity, quality, and diversity — and do not support cultural continuity, which is a critical determinant of Indigenous Peoples’ health — thus complicating effective options for adaptation response (Marushka et al., 2019). Along with the effects on diet quality, these declines in locally harvested food also have detrimental impacts on mental health outcomes, cultural practices, language, self-determination, and social cohesion (Batal et al., 2017; Marushka et al., 2019) (see Chapter 2: Climate Change and Indigenous Peoples’ Health in Canada and Chapter 4: Mental Health and Well-Being).

8.4.3.3.3 Impacts of Dietary Transitions and Substitutions on Nutrient Use

Climate change can exacerbate existing and emerging nutritional stresses, including the current nutrition transition affecting populations in and outside of Canada. The nutrition transition, which is linked to globalization and urbanization, is a shift from traditional diets toward foods higher in calories, fats, and sugars, accompanied by a rise in sedentary lifestyles (Wheeler & Von Braun, 2013; Breewood, 2018). A diet high in energy-dense processed foods rich in calories, salt, sugar, and saturated fat, and low in whole grains, nuts, seeds, legumes, fruits, and vegetables, is a leading risk factor for death and disability in Canada (IHME, 2016; Bacon et al., 2019).

Globally, the nutrition transition is contributing to a dual burden of overnutrition (e.g., obesity) and undernutrition, along with increased risks of non-communicable and infectious disease (FAO et al., 2018). Some of these health effects may be more pronounced for specific population subgroups. Monitoring of, and support for, populations that are disproportionately affected is needed, particularly for lower-income households that are most affected by rising food prices; those already at nutritional risk, such as women, children, and seniors; and those in remote geographical areas, including many Indigenous Peoples (Ford & Beaumier, 2011; Lake et al., 2012; Bunce et al., 2016; Collings et al., 2016). More research is also needed on the nature, extent, and magnitude of climate change impacts on the nutrition transition.

8.4.3.4 Climate Change Impacts on Food Stability

Longer-term food security requires that food be available, accessible, and used by people in a sustained and stable manner over time (FAO, 2008). Climate change can decrease the stability of food systems, which has a direct impact on all pillars of food security (Figure 8.1). For example, climate change increases the spatial and temporal variability in food production patterns, which affects food availability. Food prices may also fluctuate to a greater degree, which will have implications for accessibility. Many knowledge gaps exist in terms of how climate change will influence the volatility and stability of global food systems and food security, especially with respect to food access and use (Myers et al., 2017).

Food safety can be compromised at any point along food system pathways (Figure 8.1). Given the estimated four million cases of food-borne illness per year, microbial food safety is an important public health concern in Canada (Thomas et al., 2013). Food-borne illnesses are acquired through the ingestion of contaminated food, and symptoms can range from diarrhea and vomiting to more severe illness (e.g., Guillain-Barré syndrome, hemolytic uremic syndrome) and death. In Canada, five pathogens (norovirus, Clostridium perfrigenns, Campylobacter spp., Salmonella spp., and Bacillus cereus) account for over 90% of food-borne illnesses for which the causative agent is known (Table 8.5) (Thomas et al., 2013). At least four of these pathogens are known to be climate sensitive (Kovats et al., 2004; Fleury et al., 2006; Lake et al., 2009; Valcour et al., 2016; Wu et al., 2016; Lake, 2017; Park et al., 2018).

Indeed, in many cases, climatic conditions are directly linked to food-borne illness, as pathogen occurrence in foods is affected in the short and long term by climate variables, including temperature, precipitation, extreme weather events, and ocean warming and acidification (Semenza et al., 2012a; Liu et al., 2013; Hellberg & Chu, 2015; Lake, 2017; Lake & Barker, 2018). Increasing temperature and extreme weather events rank in the top three of 19 economic, environmental, and social factors influencing food safety in Canada (Charlebois & Summan, 2015). The precise magnitude of climate change impacts on the burden of food-borne disease in Canada is uncertain, due to a paucity of research; however, given that many food-borne pathogens are climate sensitive (Lake et al., 2009; Tirado et al., 2010; Semenza et al., 2012a; Semenza et al., 2012b; Liu et al., 2013; Hellberg & Chu, 2015; Wu et al., 2016; Lake, 2017; Lake & Barker, 2018), the overall food-borne disease burden both current and emerging (previously rare) pathogens is expected to increase. For instance, mathematical models suggest that climate change will increase the burden of specific pathogens in food in Canada (e.g., V. parahaemolyticus in oysters) (Smith et al., 2015) (Box 8.4).

The relationship between climate change and food-borne illness can be estimated using short-term seasonal trends as a proxy. Many studies in temperate regions similar to Canada have linked food-borne contamination and disease incidence with seasonal trends (Semenza et al., 2012a; Semenza et al., 2012c). A review analyzing studies of food-borne illness in temperate countries identified consistent summer peaks for disease caused by Campylobacter spp., Salmonella spp., verotoxigenic Escherichia coli infection, Cryptosporidium (bi-modal peak with spring and summer highs), and giardiasis (Lal et al., 2012). In New Brunswick, the incidence of Campylobacter, E. coli, Giardia, and Salmonella infections were greater in the spring and/or summer months (Valcour et al., 2016). In Alberta and Newfoundland and Labrador, ambient air temperatures were positively associated with Campylobacter spp., pathogenic E. coli, and Salmonella spp. infections (Fleury et al., 2006). Non-cholera Vibrio spp. infections have been associated with rising air and water temperatures and prolonged summer seasons (Semenza, et al., 2012a; Semenza et al., 2012c). Recently, it has been proposed that non-cholera Vibrio spp. can act as an indicator of climate change in marine systems due to their climate sensitivity (Baker-Austin et al., 2017).

Risks of climate-related food-borne illness are expected to vary across Canada, due in part to regional and local consumption preferences; for example, risks from seafood-associated pathogens will likely be greater in regions with high seafood consumption (e.g., coastal regions). Inuit are at increased risk of climate-related impacts on food safety, due in part to climate-sensitive traditional food practices, such as the consumption of raw meats, which are sensitive to even slight changes in food storage and transport temperatures (Pardhan-Ali et al., 2012a; King & Furgal, 2014; Harper et al., 2015a; Harper et al., 2015b; Jung & Skinner, 2017; Rapinski et al., 2018; Harper et al., 2019). Furthermore, climate change may introduce new microbial contamination into Northern regions through changes to wildlife ranges (Jenkins et al., 2013), permafrost thaw, and other environmental changes (Harper et al., 2015a). Additional research is needed on climate-related food safety risks that are unique to First Nations, Inuit, and Métis peoples, as well as Northern communities (Hedlund et al., 2014).

8.5.1.1 Food System Pathways Through Which Climate Change Affects Food Safety

Climate change affects the growth, survival, abundance, and range of pathogens throughout food systems, including during food production, processing, distribution, preparation, and consumption (Semenza et al., 2012a; Semenza et al., 2012c). An overview of how climate change can affect microbial food safety at each step of food systems, using E. coli in lettuce as an example, is provided in Box 8.3.

The relationship between climate variables and lettuce contamination is complex; therefore, uncertainty exists about projected health risks due to climate change. For example, flooding and irrigation are two factors that may increase lettuce contamination, yet they are influenced by precipitation in opposite ways: increased rainfall could increase risks of contamination due to flooding or reduce risks due to less irrigation. More detailed analyses that capture the system’s complexity in a particular context or location are required to understand how changes in precipitation will ultimately affect public health risks. Such analyses could include mathematical models, which could quantify the relative impacts of each risk driver on public health in the studied location and identify points throughout food systems where climate change adaptation measures could be most effective. By integrating climate change projections, the model could also allow various adaptation options to be tested (Romero-Lankao et al., 2014; ECCC, 2018).

8.5.1.1.1 Climate Change Impacts on Food Safety via Food Production

Food production (e.g., farming, aquaculture) is the stage of food systems where pathogens are most likely to be introduced and propagated through to food products. Climate change will create both challenges and opportunities for Canadian food production (Warren & Lemmen, 2014) and, therefore, may increase risks to food safety. For example, growing seasons may be extended and suitable land for agriculture may expand northward as temperatures rise (Schmidhuber & Tubiello, 2007; Gornall et al., 2010; Butler, 2014a; Warren & Lemmen, 2014; AAFC, 2015). At the same time, however, as climate conditions warm, pathogens can be introduced and become established in these new production regions via increased food production activity, range expansion of wildlife and insect vectors, and improved pathogen growth conditions (Séguin, 2008; Smith & Fazil, 2019).

Climate change can affect the release of pathogens from livestock into the environment (Smith & Fazil, 2019). Some livestock animals are known, or suspected to, carry and shed greater numbers of enteric pathogens during periods of elevated air temperatures (Venegas-Vargas et al., 2016). Increased temperatures expected with climate change may result in increased pathogen shedding (Keen et al., 2003; Pangloli et al., 2008), thus affecting pathogen abundance in the surrounding environment, crops, and, consequently, food. Increased temperature stress or alterations in livestock housing conditions (e.g., indoor versus outdoor environments) as a result of climate change could also drive increased antimicrobial use in food-producing animals, which could increase antimicrobial-resistant food-borne illnesses in humans (WHO, 2017; MacFadden et al., 2018).

Pathogens released into the environment can be transported via precipitation and directly contaminate food sources, such as crops or livestock facilities. The frequency and intensity of precipitation events is expected to increase for many regions in Canada as temperatures rise (Bush & Lemmen, 2019), increasing concerns about contamination. Without intervention, this contamination could work its way through all stages of food systems, ultimately contributing to the burden of food-borne illness. One study in Ontario, for example, found temporal associations between human giardiasis incidence and pathogen presence in manure in livestock reservoirs, river water level and flow rate, and precipitation (Brunn et al., 2019). As the climate continues to change, combinations of drought followed by extreme precipitation could increase these contamination events, as dry, compact soil has an increased runoff potential (Yusa et al., 2015).

Many wildlife and insect vectors, such as rodents, deer, flies, and beetles, contribute to food-borne pathogen transmission and therefore can affect food safety. Climate conditions can directly affect these vectors (Agunos et al., 2014). For example, climatic variables are known to affect fly population density (Goulson et al., 2005; Ngoen-Klan et al., 2011), and flies can be carriers of Campylobacter (Hald et al., 2008). In Ontario, a 28% to 30% increase in incidence of illness due to Campylobacter in humans is projected by 2050 due to climate-related changes in fly population size and activity (Cousins et al., 2019).

Warming water temperatures have been linked to seafood contamination and incidence of food-borne diseases. For example, modelling studies suggest that risks from V. parahaemolyticus in British Columbia could increase by 41% to 45% by the 2060s (Box 8.4) (Smith et al., 2015). In addition to V. parahaemolyticus, the abundance of V. cholerae detected along Canadian coasts has increased significantly over time (Banerjee et al., 2018). V. cholerae is a highly lethal pathogen (causing cholera) previously restricted to tropical regions, but its abundance could increase in Canadian waters with climate change.

8.5.1.1.2 Climate Change Impacts on Food Safety via Food Processing and Distribution

Climate variables also affect the occurrence, growth, and survival of pathogens throughout food processing and distribution. Any pre-existing contamination can proliferate if food is mishandled during these steps (e.g., inappropriate food storage temperature, cross-contamination), and additional contamination can be introduced through, for example, the use of contaminated water during processing (see Chapter 7: Water Quality, Quantity, and Security). Extreme weather events associated with climate change, such as flooding, high winds, or precipitation can result in power outages that disrupt temperature controls (e.g., refrigeration), creating opportunities for pathogen growth and resulting in impacts on food safety and food-borne illnesses.

Air temperature is a key food safety risk during food processing and distribution. The prevalence of poultry contaminated with Campylobacter in Canadian processing and retail environments has been positively correlated with air temperatures (Smith & Fazil, 2019). Humidity and precipitation also affect the occurrence of pathogens throughout processing and distribution. For example, some micro-organisms, such as fungi, can produce mycotoxins that cause adverse human health effects, and these micro-organisms can proliferate under certain temperature and humidity conditions during the processing of corn and cereal grain products (Duarte et al., 2010). In Canada, warmer and wetter conditions due to climate change could encourage fungi growth and mycotoxin production (Patriarca & Fernández Pinto, 2017).

Nearly 30% of retail food consumed in Canada is imported from other countries (Statistics Canada, 2009); therefore, any climate-related changes to the occurrence or growth of pathogens during food production in other countries, or during food distribution to Canada, could affect the health of Canadians. Cases of food-borne illness caused by pathogens previously exotic or rare to Canada could increase in incidence with climate change (Smith & Fazil, 2019). Canadian food importers, along with federal, provincial, and local public health agencies, should enhance the monitoring of global trends and incidence of food-borne illness to anticipate potential new threats to Canadian food systems. Environmental scanning platforms, such as the Canadian Food Safety Information Network, may assist with such monitoring, as they include tools to identify local or global food safety issues (CFIA, 2018). Additionally, international initiatives, such as the European Food Safety Authority’s Climate Change and Emerging Risks for Food Safety project, which lists climate-related emerging risks in European food systems (EFSA et al., 2020), may be helpful in informing and monitoring existing and emerging food safety risks relevant to Canada. Given the interconnected nature of the global food system, and the complex effects climate change has on food systems, monitoring may become increasingly challenging and may need to expand in order to appropriately capture the diverse impacts of climate change on food safety in Canada.

8.5.1.1.3 Climate Change Impacts on Food Safety via Food Preparation and Consumption

Climate change impacts on food-borne illnesses at the preparation and consumption stages fall into three categories: climate-related behavioural changes by individuals that increase pathogen exposure via food; increased pathogen survival and growth on foods during transport or storage; and potential indirect climate-related changes to human susceptibility and/or exposure to food-borne illness.

Human behaviour, such as food mishandling events, can lead to cross-contamination or undercooking of food products, thus increasing the risk of food-borne illness. Seasonal increases in food mishandling by consumers are attributable to higher-risk cooking methods (e.g., barbeque used in the summer may increase risk of cross-contamination if the same utensils are used for raw and cooked meats) and consumption patterns (e.g., picnics in warm temperatures where foods are less likely to be stored at safe temperatures) (Ravel et al., 2010; Liu et al., 2013; Milazzo et al., 2017). In Canada, the contamination of meat products with Salmonella spp. does not increase in the summer season, compared to the rest of the year (Smith & Fazil, 2019); however, human cases of illness caused by Salmonella do increase in the summer (Fleury et al., 2006; Ravel et al., 2010; Valcour et al., 2016), suggesting that behavioural factors and/or susceptibility could drive the seasonality of illness rates (Ravel et al., 2010). Climate change could also influence food preferences and consumption patterns, which may have implications for human health. For example, an extended growing season, due to climate change, could provide longer access to fresh produce, which is at increased risk for pathogen contamination due to higher temperatures and changes to precipitation, thus increasing the risk of food-borne illness. In fact, the rate of E. coli outbreaks linked to raw produce (e.g., lettuce) has increased over the last several decades (Rangel et al., 2005; Heiman et al., 2015).

Storing foods at cold temperatures at which pathogens cannot grow is one of the main strategies to maintain food safety. Even a 1°C increase in average ambient temperatures, which has already been surpassed in Canada due to climate change (see Chapter 1: Climate Change and Health Linkages), can result in significant food safety concerns (Smith et al., 2015). Furthermore, the projected increase in extreme weather events and resulting power transmission disruptions due to climate change (Warren & Lemmen, 2014) will introduce potential disruptions in the cold chain at the consumer level with subsequent increases in food safety risk. In Northern Canada, safe food storage in ground freezers used by some Indigenous Peoples is threatened by increasing temperatures and permafrost thaw (CCA, 2014).

Finally, other adverse health effects caused or exacerbated by climate change can increase an individual’s susceptibility to food-borne illnesses. For example, immunocompromised individuals are at increased risk of an infectious illness, including from food-borne pathogens (Pouillot et al., 2015). Furthermore, malnutrition arising from food insecurity, extreme weather events (e.g., extreme heat events, flooding), and poor air quality can cause adverse health impacts on Canadians, which could compound vulnerability to food-borne illness (Kipp et al., 2019).

Food-related chemical hazards occur when chemicals are present in foods at levels that negatively affect human health when consumed (CFIA, 2014). Chemical contaminants include a wide range of compounds, such as persistent organic pollutants (POPs) (e.g., industrial chemicals, pesticides), heavy metals (e.g., arsenic, copper, cadmium, lead, mercury, tin), and polycyclic aromatic hydrocarbons (PAHs). These chemical contaminants are introduced into plants and animals through environmentally mediated pathways, such as atmospheric deposition and uptake from contaminated soil, water, or other organisms. For example, when chemical contaminants are deposited at or near sites of food production or harvesting, such as fish breeding grounds, livestock pastures, or agricultural lands, they can be introduced into food systems via contaminated water or soil (Thomson & Rose, 2011). Levels of chemical contaminants in commercial foods are monitored through regular surveillance activities by Health Canada and the Canadian Food Inspection Agency. Chemical contaminants may be detected in commercial foods; however, concentrations are generally low and not associated with adverse health impacts. Canada’s national food chemical safety program has various tools (e.g., monitoring and surveillance programs, guidance on maximum safe concentration levels, and consumption advice) to help ensure exposure to food chemical contaminants is as low as possible.

There is growing evidence that climate change could increase human exposure to chemical contaminants, as climate variables, such as temperature, precipitation, wind, hydrological systems, ice and snow coverage, and extreme weather events can affect the transport, distribution, concentration, persistence, and bioaccumulation of chemical contaminants (Dewailly et al., 2000; Jaykus et al., 2008; Rose et al., 2011; Marvin et al., 2013; CCA, 2014; Manciocco et al., 2014; Government of Canada, 2016; Ziska et al., 2016).

8.5.2.1 Climate Change Impacts on Contaminants Throughout Food Systems

Environmental contaminants are chemicals that accidentally or deliberately enter the environment, often, but not always, as a result of human activities. Some of these contaminants may have been manufactured for industrial use and, because they are very stable, they do not break down easily. If released into the environment, these contaminants may enter the food chain. Other environmental contaminants are naturally occurring chemicals, but industrial activity may increase their mobility or increase the amount available to circulate in the environment, allowing them to enter the food chain at higher levels than would otherwise occur. Levels detected in food sold in Canada are generally low. These contaminants have varying toxicity and health effects (Government of Canada, 2016). For example, food-borne exposure to POPs has been linked to cancer, negative effects on the immune system, and developmental and reproductive problems (Schecter & Gasiewicz, 2003; Pardue et al., 2005; Government of Canada, 2016; Weihe et al., 2016). Exposure to food-borne heavy metals, such as lead and mercury, can affect the nervous system and cause cognitive, behavioural, and motor impairments (ATSDR, 1999; Thomson & Rose, 2011; Boucher et al., 2012; ATSDR, 2020; Dewailly et al., 2000; USEPA, 2021). More than 80% of fish consumption advisories in Canada and the United States are at least partially attributed to methylmercury (Eagles-Smith et al., 2016), which bioaccumulates in aquatic organisms and can cause severe health effects when consumed by humans in sufficiently high quantities or over prolonged periods of time (Alava et al., 2018). Biotoxins in the food system that can cause health risks to Canadians, and that are linked to climate change, are discussed in more detail in Chapter 7: Water Quality, Quantity, and Security.

Multiple factors contribute to the potential risk and severity of illness resulting from chemical contaminant exposure, including an individual’s genetic predisposition and other health conditions, the contaminant type and concentration, and the extent of exposure over time (Ziska et al., 2016). Risks are increased in children and seniors, since their organ systems have a reduced ability to process and eliminate contaminants (Lopez & Goldoftas, 2009; Ferguson et al., 2017).

8.5.2.1.1 Climate Change Impacts on Food Safety via Chemical Contamination During Food Production

In Canada, the impact climate change has on food safety via chemical contamination is not well understood, and the extent of increased risk has not been quantified. For example, additional research is required to monitor whether climate change will increase concentrations of contaminants to levels that may be associated with adverse health effects. International evidence suggests that climate change is likely to increase the risk of chemical contamination during food production through several pathways (Thomson & Rose, 2011) (Table 8.7).

Increasing temperatures associated with climate change are expected to exacerbate the risks posed by POPs, which are already of concern due to their negative health effects (WHO, 2008). Projected warming will enhance the transfer of POPs from oceans, lakes, and rivers to air, which will subsequently extend the potential for long-range transport of POPs (Ma et al., 2011). Climate change is also expected to influence soil properties and thereby increase the bioavailability of POPs and heavy metals and increase their bioaccumulation in food chains (Boxall et al., 2009; Manciocco et al., 2014). Similar trends are anticipated for PAHs in a changing climate (Miraglia et al., 2009).

Increasing extreme weather events associated with climate change will also affect the distribution of chemical hazards in the environment. Heavy precipitation and flooding can transport chemicals from direct sources (e.g., mines and tailing ponds), as well as contaminated soils, to new locations where food is produced (Lake et al., 2005; Boxall et al., 2009; Miraglia et al., 2009; Umlauf et al., 2011; Lake et al., 2015). European studies have found that regular flooding of industrial river catchments increase polychlorinated dibenzo-p-dioxins dibenzofurans (PCDD/Fs) and polychlorinated biphenyl (PCB) levels in soil and grass, which can then be transferred to food (Umlauf et al., 2011; Lake et al., 2015). Similarly, researchers found high levels of POPs in soil from flooded pastureland and in the milk of animals that grazed on the land (Umlauf et al., 2005), as well as high levels of cadmium and lead in wheat, lettuce, and potatoes (Lake et al., 2005). Wildfires have also been identified as a pathway for food source contamination, as they release PAHs and other contaminants (e.g., dioxins, cadmium, and mercury) into the air, which can then travel long distances before they are deposited (Armitage et al., 2011). If these chemicals are deposited into water bodies or on agricultural or pastureland, they could be introduced into food systems. Additional research on the impact of wildfires on chemical contamination of food is needed.

Rising water temperatures also exacerbate levels of seafood contaminants (e.g., nickel, copper, cadmium, lead, and zinc) and risks to aquatic organisms (Ma et al., 2011; Manciocco et al., 2014). For example, rising water temperatures can increase PCB metabolites and copper toxicity in rainbow trout (Boeckman & Bidwell, 2006; Khan et al., 2006; Buckman et al., 2007; Manciocco et al., 2014). Increasing water temperatures also affect concentrations of methylmercury in fish and mammals (Carrie et al., 2010) as a result of increased metabolic rates and mercury uptake (Booth & Zeller, 2005; Ziska et al., 2016).

Climate change is projected to increase the incidence of livestock and aquatic pests, parasites, and microbes (Lafferty et al., 2004; Ziska et al., 2016), which could encourage greater use of pesticides, herbicides, veterinary treatments, and aquaculture drugs (Boxall et al., 2009; Tirado et al., 2010; AAFC, 2015; Ziska et al., 2016). This increased incidence is projected to be exacerbated as chemicals used for pest management, such as pesticides and herbicides, become less effective as concentrations of CO₂ increase (Ziska et al., 2016). Such changes could lead to increased chemicals from pesticides, herbicides, and veterinary drugs entering food systems, with negative implications for human health (Boxall et al., 2009; Miraglia et al., 2009; Manciocco et al., 2014; Delcour et al., 2015).

Greater demand for water resources to maintain agricultural activities is expected as a result of changing precipitation patterns and the projected increase in droughts in many regions of the world (Jiménez Cisneros et al., 2014). Indeed, some regions are already experiencing stress on water resources and increasingly turning to wastewater reuse to meet irrigation needs. Wastewater can contain chemicals, such as PAHs and PCBs, which can therefore enter the food chain when used to irrigate agricultural crops (Al Nasir & Batarseh, 2008; Rose et al., 2011). Although wastewater is not commonly used in Canada for crop irrigation, stressed water resources and response measures could lead to food safety risks in the future and should be monitored. Further, policies and regulations for wastewater use and other water management practices vary by country, which has implications for the safety of foods being imported into Canada (Lake et al., 2012).

8.5.2.1.2 Climate Change Impacts on Food Safety via Chemical Contamination During Food Preparation and Consumption

While there is limited research examining how climate change could affect chemical contamination during food preparation and consumption, human behaviours may change in response to climate change in ways that could increase chemical exposures. For example, processing foods (e.g., drying, smoking) and cooking foods at high temperatures (e.g., grilling, frying, roasting, baking) are common sources of food contamination by PAHs and heterocyclic amines (Sugimura et al., 2004; Zelinkova & Wenzl, 2015). Consequently, the potential increase in barbequing associated with more frequent and prolonged warm days could increase exposure to chemicals from barbequed foods (Séguin, 2008).

Some Indigenous communities in Canada have developed alternative gardening and food preservation measures in an effort to adapt to climate change. Such activities may be necessary to support individual and community food security and sovereignty but may have unintended implications for human health. A study of food-related climate adaptation activities implemented, or planned to be implemented, across three First Nations communities in British Columbia and one Inuit community in Nunavut, revealed several food safety concerns (Steiner & Neathway, 2019). These included PAH contamination from food smoking, chemical contamination from the use of tires or treated wood as planters, and chemical and microbial risks from the use of greywater for crop irrigation (Steiner & Neathway, 2019). More research is needed to understand how such climate change adaptation measures may affect food safety and human health.

8.5.2.2 Climate Change Challenges Related to Chemical Hazards in Foods in the Arctic and Sub-Arctic

Persistent contaminants are found throughout Northern ecosystems, largely from transport from lower latitudes through air, water, and terrestrial routes (Kuhnlein & Chan, 2000; Rigét et al., 2016; Brown et al., 2018), and from local sources (e.g., mining sites). For example, accelerated temperature rise and the consequent melting of glaciers, snow, and sea ice can enhance POP transfer between trophic levels, and increase food safety risks for Arctic populations (Ma et al., 2011; Manciocco et al., 2014). Chemical contaminants deposited and trapped in glaciers via airborne transportation may be deposited in glacier-fed lakes and water bodies as glaciers melt, increasing exposure to humans and wildlife (Bogdal et al., 2009).

In Northern regions, locally harvested foods can be a significant route of contaminant exposure (Ratelle et al., 2018), particularly for Indigenous Peoples, as Indigenous food systems in the Arctic and sub-Arctic often include large quantities of locally harvested fish, birds, and marine mammals. Fish and marine mammals are primary sources of mercury and PCBs (NCP, 2013; Rigét et al., 2016; Brown et al., 2018; Chukmasov et al., 2019). Similarly, POPs and heavy metals have been found in all components of the Arctic ecosystem (Fillion et al., 2014). Once an organism absorbs a contaminant, the contaminant can bioaccumulate in the organism or be transferred to other organisms, posing potential health risks to those who consume the organism in significant quantities or over an extended period of time (Dewailly et al., 2000; NCP, 2013).

Variations in contaminant body burdens commonly reflect differences in dietary habits and traditional lifestyles (AMAP, 2015; Government of Canada, 2017). For example, POP and metal levels in Inuit women are generally higher for those in coastal communities in Nunavik and Nunavut, where there is a higher consumption of marine mammals, compared with Inuit women from Nunatsiavut (in Northern Labrador) and the Inuvialuit Settlement Region (in the Northwest Territories) (Government of Canada, 2017). Results of the Inuit Health Survey (2007–2008) suggest that Inuit men tend to eat traditional foods more frequently and in larger quantities than Inuit women (Egeland, 2010). The body burden of POPs and metals were therefore often higher in Inuit men than women, sometimes as much as two-or three-fold. Likewise, older adults typically consume more traditional foods than younger adults, and generally have higher contaminant body burdens of POPs and metals (Government of Canada, 2017). Globally, coastal Indigenous Peoples consume on average 15 times more seafood per capita than non-Indigenous people (Cisneros-Montemayor et al., 2016), and thus may be at increased risk of climate-related alterations in contaminant concentrations in food systems.

With warmer temperatures leading to earlier sea ice breakup, the toxicity of some contaminants in the water column may increase (Gaden et al., 2012). High levels of mercury and PCBs in Arctic fish have been linked to enhanced algal growth from warmer water temperatures (Carrie et al., 2010). Climate-related shifts in prey type and abundance could also affect contaminant exposure in marine mammals, by affecting foraging times and success. Earlier spring sea ice breakup can allow marine animals to forage earlier and for longer periods and allow access to foraging areas that were inaccessible under previous breakup regimes (Gaden et al., 2012).

Exposure to PCBs and mercury in top predatory species may increase with climate change, as Arctic sea ice retreats and releases accumulated chemicals to marine environments (Gaden et al., 2012; Alava et al., 2018). One study projected that the concentration of methylmercury and PCBs in animals at high trophic levels could increase by 8% and 3% by 2100 under a high emissions scenario (RCP8.5) and a no climate change scenario, respectively (Alava et al., 2018). Another study found a 3% to 5% increase in methylmercury uptake in marine organisms for each 1°C rise in water temperature (Booth & Zeller, 2005). In addition to food safety risks, the nutritional value of fish (e.g., omega-3 fatty acids) may also change due to interactions between climate change and contaminants and effects on fish metabolism (Alava et al., 2017). Climate change may, therefore, increase exposure to chemical contaminants in, and change the nutritional quality of, important food sources harvested by Indigenous Peoples (Undeman et al., 2010). Consumption of traditional foods have significant importance for the health and well-being of Indigenous Peoples (see Chapter 2: Climate Change and Indigenous Peoples’ Health in Canada). Guidance from the Government of Canada’s Canadian Arctic Contaminants Assessment Report and the Arctic Monitoring and Assessment Programme suggest that the nutritional benefits from consumption of traditional foods outweigh potential risks associated with chemical contamination, with few exceptions (Chukmasov et al., 2019). As the climate changes, it will be important to enhance research efforts and increase understanding of the impacts of climate change on food safety via chemical contamination.

8.6.1.1 Climate Change and Health Vulnerability and Adaptation Assessments

Vulnerability and adaptation assessments (V&As) concerning climate change and health provide an evidence-based assessment of the key health risks posed by climate change, identify high-risk populations and regions, evaluate the effectiveness of existing interventions, and outline adaptation opportunities (Berry et al., 2014a; Buse, 2018). These assessments are critical to building public health preparedness for climate change (Charron et al., 2008; Hansen & Hoffman, 2011; Berry et al., 2014a; PHAC, 2017; Berry et al., 2018). Regional and local health authorities across Canada are increasingly conducting V&As; however, the degree to which climate-related impacts on food security and food safety are assessed varies.

Provincially and territorially, responsibility for completion of V&As reflects mandates for climate change adaptation and the jurisdictional landscape for health services. Under the Ontario Public Health Standards, for example, health units are required to assess the health impacts of climate change. Several health units have, therefore, completed V&As, including Grey Bruce Health Unit (Grey Bruce Health Unit, 2017), Middlesex-London Health Unit (Berry et al., 2014b), and Simcoe Muskoka District Health Unit (Levison et al., 2017), all of which address risks of food-borne illness. Both assessments from Middlesex-London Health Unit and Simcoe Muskoka District Health Unit also explicitly consider the multiple dimensions of food security. The City of Toronto’s report, Exploring Health and Social Impacts of Climate Change in Toronto (Medical Officer of Health, 2013) considers food security and food safety in the context of power outages during extreme weather events and insufficiency of food storage standards as temperatures warm. In 2017, Toronto Public Health launched a Food Vulnerability Assessment (Zeuli et al., 2018a) to assess the resilience of Toronto’s food system under three extreme weather scenarios. Although food security risks were relatively low, they were associated with extreme weather events. The city identified a need to develop food resilience plans for neighbourhoods already experiencing food insecurity, which could be exacerbated by climate change. The report included recommendations to develop poverty-reduction strategies that address unequal food access (Zeuli et al., 2018a).

There are challenges in developing robust, actionable food-related V&As. Climate change and health V&As rely on surveillance data to assess associations between health outcomes and climatic conditions. While surveillance systems are in place to identify food-borne illnesses, the majority of cases of food-borne illness are undiagnosed or unreported (Berry et al., 2014a; Harper et al., 2015c; Thomas et al., 2015). Furthermore, while there have been advances in climate projections and impact analysis, particularly in localized downscaled projections, uncertainty regarding projections of food-borne disease in Canada due to climate change remains high. As a result, many V&As do not quantify how climate change may affect food-related risks, and, where future trends are examined, they involve only general extrapolations indicating the potential direction of change (Ebi et al., 2018). Furthermore, links among climate change, food quality, and water quality remain understudied (PHAC, 2017). Therefore, there is a need for future studies to examine how projected climate changes will affect food security and food safety (Smith & Fazil, 2019), and how future demographic and socio-economic factors will affect the distribution and incidence of such risks in Canada.

Several programs have been initiated in response to these gaps. For instance, the Public Health Agency of Canada’s Preventative Public Health Systems and Adaptation to a Changing Climate Program is focused on working with public health stakeholders to expand research on climate change impacts and to support adaptations, including surveillance and response to emerging food-borne diseases. In addition, Health Canada’s climate change and health adaptation capacity-building program, HealthADAPT, has funded 10 projects across Canada that aim to improve the knowledge base about the health impacts of climate change and develop strategic adaptation plans to address risks by conducting V&As. Partners in these projects include provincial and territorial health ministries, local health units, and the First Nations Health Authority in British Columbia. Several of these projects will examine climate change impacts on food-borne diseases.

8.6.1.2 Adaptation Planning

Climate change adaptation strategies and action plans play important roles in linking evidence to decision-making, articulating policy goals and objectives, and establishing pathways for adaptation action (Olazabal et al., 2019). Adaptation plans are a key component in laying the groundwork for adaptation action in all levels of government in Canada, minimizing climate-related impacts on food security and food safety, and maximizing resilience-building efforts. However, achieving tangible benefits from these groundwork efforts necessitates effective and timely implementation (Lesnikowski et al., 2011; Lesnikowski et al., 2016).

Discussions about intersections among climate change, food security, and health are often better developed in strategic adaptation plans for Indigenous communities, where changing environmental conditions are affecting Indigenous food systems (Box 8.5). For example, Newfoundland and Labrador’s climate change plan highlights the links between temperature and sea ice changes, on one hand, and decreased access to Inuit hunting areas, on the other, and implications for Inuit food security, safety, and mental health outcomes (Municipal Affairs and Environment, 2019). Food is also a key priority in territorial adaptation planning, where cross-sectoral adaptation actions are being designed to integrate health, conservation, economy, and culture. In many provincial climate change adaptation strategies, however, climate-related impacts on agricultural production are framed as an economic, rather than a public health, issue. In Nova Scotia, for example, adaptation activities in the Department of Agriculture focus on crop diversification, soil and water management, pest control, and flood risk management, but do not make explicit linkages with public health risks related to food security and food safety (Nova Scotia Environment, 2014).

Despite its importance, municipal climate change planning is highly uneven across Canada (Guyadeen et al., 2019). Examples of municipal adaptation plans that address growing climate change risks to food include Toronto’s Climate Change and Health Strategy, which sets out several actions that build on the Toronto Food Strategy, including identifying the need for infrastructure to support food system sustainability, encouraging low-carbon diets, and assessing climate change impacts on food security and food safety (TPH, 2015). The City of Surrey, in British Columbia’s agriculturally productive lower mainland, has examined how changing temperatures and precipitation will affect agricultural losses and increase the risk of food-borne illness. The city’s Agricultural Plan was updated in 2013 to reflect changing climatic conditions (Planning and Development Department, 2013). Surrey’s Climate Adaptation Strategy aims to improve local resilience to climate-related disruptions in global food prices and supply chains by encouraging crop diversification and supporting local research on climate-resilient agricultural practices. The strategy also draws linkages with long-term flood risk management and land-use planning mechanisms to improve food production in urban spaces. At the regional level, Metro Vancouver’s Food Action Plan Task Force is working to identify how municipalities throughout the region are contributing to a resilient regional food system, and how local food-production capacity can be increased (Metro Vancouver, 2016). Some small towns and rural areas are also examining how local food systems will be affected by climate change. The City of Castlegar, British Columbia, conducted a Sensitivity Assessment for Food and Agriculture that examined how climate change will stress local food production (City of Castlegar, 2010). The assessment proposed several actions to improve the adaptive capacity of Castlegar’s food system to climate change, including citizen-based monitoring of crop production and awareness-raising about food storage techniques.

In Quebec, the city of Montréal is conducting a study on the potential for urban commercial agriculture on the island of Montréal that supports food system resilience, with the goal of developing a commercial urban agriculture strategy and action plan (Ville de Montréal, 2018). However, in the general context of climate change planning, municipal policies regarding food production and consumption have commonly been adopted with the goal of reducing GHG emissions, and only recently are Canadian cities beginning to integrate food production and consumption into adaptation planning. For instance, some local adaptation strategies now recognize that higher summer temperatures and power outages due to extreme weather events pose a threat to food safety by increasing the risk of food-borne illness (Halifax Regional Municipality, 2010; City of Windsor, 2012; City of Montréal, 2015; City of Toronto, 2019). Municipal strategies that consider food security in the context of climate change often focus on increasing the self-sufficiency of local and regional food systems; food systems can be a nexus that provides opportunities to achieve synergies between adaptation and GHG mitigation policies (City of Toronto Environment Office, 2008; City of Surrey, 2013; Zeuli et al., 2018b).

To support adaptation by Indigenous communities, the First Nations Adapt Program and the Climate Change Preparedness in the North Program, administered by Crown-Indigenous Relations and Northern Affairs Canada, funds Indigenous-led climate change risk assessments and supports the development of adaptation options (CIRNAC, 2018; CIRNAC, 2019). Many of the funded projects have focused on climate-related impacts on health and/or food security. Examples include projects led by the Blood Band in Alberta to increase awareness about the impact of climate change on community food security; in British Columbia, the Splatsin First Nation’s risk assessment on the impact of flooding on food resources; the Government of Yukon Department of Environment’s research on the relationships among climate change, traditional foods, and Yukoners’ diets; and a permafrost vulnerability assessment and map of traditional harvest areas conducted by the Jean Marie River First Nation with Yukon College. The Climate Change and Health Adaptation Program, administered by Indigenous Services Canada, also funds community-driven projects to build adaptive capacity for the health impacts of climate change, including a number of projects on food security.

Efforts are underway at all governmental levels to address climate-related impacts on food production and security. Opportunities exist to learn from leading projects and partners that explicitly address risks to health and that expand protection of Canadians from future climate change impacts. These actions would encourage collaborative partnerships across sectors and inform more effective adaptation action, contributing to greater resilience in the population.

8.6.1.2.1 Adaptation Leadership in Northern Canada to Address Risks to Food Security and Safety

In Northern Canada, adaptation planning is taking place at regional to community levels. Formal planning efforts share a common perspective on climate-related health impacts as a cross-cutting challenge and emphasize the need to understand and respect relationships among health, conservation, culture, and the economy. The integration of Western science and Indigenous knowledge is a key principle found across planning documents, although a dominance of scientific framings and government planning approaches has been noted (see Chapter 2: Climate Change and Indigenous Peoples’ Health in Canada) (Bates, 2007; Cameron et al., 2015; Labbé et al., 2017; Flynn et al., 2018). Key food-related impacts of climate change addressed in many Northern adaptation plans include changes in the availability and accessibility of traditional foods, increased contaminants, more unpredictable weather and sea ice conditions, and impacts on mental health outcomes from challenges in preserving Indigenous practices and skills embedded in land-based activities.

At the regional level, the Pan-Territorial Adaptation Strategy (Government of Nunavut et al., 2011) has encouraged cooperation among the territorial governments to understand climate change risks and propose appropriate policy response measures. Inuit Tapiriit Kanatami’s National Inuit Climate Change Strategy (ITK, 2019) aims to enhance coordination of Inuit regional adaptation planning efforts and develop strong linkages between global advocacy and participation in local efforts. The plan identifies five priority action areas: knowledge and capacity development; health, well-being, and the environment; food systems; energy; and infrastructure. Additionally, the National Inuit Committee on Health convenes an Inuit Food Security Working Group, which coordinates efforts around nutrition, food security, and health in Inuit regions.

Strategic frameworks and action plans have also been adopted or are currently being developed at territorial and local levels. For example, the Northwest Territories Climate Change Strategic Framework and its associated Action Plan (2019 to 2023) detail several adaptation actions that specifically target food security and health, such as monitoring Indigenous food sources, conducting surveillance of species distribution, geo-mapping food system contamination, monitoring drinking water quality, developing a health advisory alert system, and exploring the potential for cultivation of new crops in community gardens as the growing season lengthens (Government of Northwest Territories, 2018). The Framework and Action Plan highlight that Indigenous knowledge should be used to obtain baseline data to monitor environmental and health trends and to identify future research needs. Both the Government of the Northwest Territories Sustainable Livelihoods Action Plan for 2019 to 2023 and the Nunavut Food Security Strategy and Action Plan for 2014 to 2016 also recognize that climate change poses a key risk to food accessibility in the region and state the importance of ensuring access to country foods to achieve community food security.

The Government of Nunavut’s strategic document Upagiaqtavut – Setting the Course: Climate Change Impacts and Adaptation in Nunavut emphasizes community involvement, decision-making by consensus, collaboration, resourcefulness, and respect for the environment. The document proposes several outreach and research activities, including planning toolkits, incorporating climate change topics into school curricula, and encouraging knowledge-sharing from Elders to youth. A number of community-specific actions to increase food access were developed through community adaptation planning exercises with federal and territorial government support, including delivering hunter apprenticeship programs, repairing or replacing dangerous trails to provide access to hunting and fishing areas, improving access to navigation technology and equipment, establishing community freezers, and creating awareness programs for safe food storage. Based on the results of these projects, a Local Adaptation Planning in Nunavut Toolkit was released in 2011 to support communities preparing their own adaptation plans (Bowron & Davidson, 2011).

The Government of Yukon is developing a territorial adaptation strategy that builds on past adaptation work. The Climate Change and Public Health Project (2013–2014) identified current and projected climate change health impacts in Yukon, along with priorities and gaps in knowledge and resources (Government of Yukon, 2014). Regarding food policy more broadly, the territory established an Interdepartmental Food Security Working Group to propose pathways forward for addressing food security across the portfolios of the Departments of Environment; Health and Social Services; Economic Development; Community Services; Energy, Mines and Resources; and Education. The territory is also developing a local food strategy, intended to encourage regional production and consumption of food and to reduce reliance on food transported from outside of Yukon. Various actions have been proposed to increase Yukon’s food system resilience, including the expansion of community markets, funding for irrigation system upgrades and specialized farming equipment, and the design of school programs to engage students on issues of food sustainability in Yukon, all of which will also enhance climate change adaptive capacity.

8.6.1.3 Surveillance

Surveillance systems are critical components of adaptation to the health impacts of climate change (Ebi & Semenza, 2008; Lam et al., 2019), as they provide ongoing monitoring of health outcomes through the collection, analysis, and interpretation of data. While most surveillance systems in Canada related to food safety do not currently include climate variables and were not implemented to support climate change adaptation, it is possible to use climate information and surveillance results to better understand risks to health and evaluate adaptation options (Box 8.5). For example, Smith et al. (2019) used national surveillance data from the Canadian Integrated Program for Antimicrobial Resistance Surveillance to show a correlation between air temperature and precipitation, on one hand, and microbial food-borne contamination, on the other. Similar studies have used surveillance data to identify associations between enteric infections and temperature (Ravel et al., 2010; David et al., 2017). New opportunities to enhance existing surveillance systems exist. For example, there are opportunities to integrate climate variables into the FoodNet Canada Surveillance System that tracks enteric disease risks throughout the farm-to-fork continuum in regions of urban–rural interface (e.g., retail foods, farm, water) (PHAC, 2017). Nevertheless, challenges for surveillance remain. For example, the proportion of enteric infections attributable to food consumption versus water and other sources of infection remains unknown (Butler et al., 2016), and the true burden of food-borne illness is underestimated due to under-diagnosis and under-reporting (Harper et al., 2015c; Thomas et al., 2015).

The ability of surveillance systems to provide early warning of the emergence of new or existing climate-sensitive diseases needs to be further investigated and strengthened (Ford et al., 2014), particularly for high emissions scenarios (e.g., RCP 8.5) (Costello et al., 2009; Ebi et al., 2018) and for risks that may emerge from outside food systems (e.g., via trade) (Lake, 2017). Climate change could make current food-related surveillance systems inadequate, underpinning the importance of horizon scanning to anticipate new threats (Lake, 2017).

National household food insecurity data are collected in the Canadian Community Health Survey, so that temporal changes in the prevalence of household food insecurity can be detected. However, the survey’s results provide an incomplete picture of the state of food security in Canada with each survey cycle, as some provinces and territories can opt out of its food security component, and several population groups, including First Nations living on reserves and those living in long-term care homes and prisons, are excluded (PROOF, 2018). Furthermore, the ability to examine fine-scale demographic, temporal, and spatial details with these data is limited (PROOF, 2018). Such data have not been used to examine the impacts of climate and climate change on food security in Canada (Ebi et al., 2017; Ford et al., 2019; Lam et al., 2019). Because the survey has limited ability to capture the multi-dimensional nature of food security among First Nations, Inuit, and Métis Peoples, alternative food security measurement approaches must be developed, rooted in cultural values and Indigenous knowledge, and focusing on consumption of traditional and retail foods and on the role of sharing networks in underpinning food access (Ready, 2016; Ford et al., 2019).

Existing surveillance systems are insufficient to detect the occurrence and spread of climate-related health risks for many Indigenous Peoples in Canada (Harper et al., 2015b; Sawatzky et al., 2018; Lam et al., 2019), thus increasing their vulnerability to future impacts (Ford et al., 2010; Harper et al., 2015a). Gaps in surveillance have been documented in Indigenous communities, and these gaps exist for a range of reasons, such as missing data, differing interactions with health care systems, and high costs of patient follow-up needed to provide data (Ford et al., 2010; Harper et al., 2011; Pardhan-Ali et al., 2012a; Pardhan-Ali et al., 2012b; Pardhan-Ali et al., 2013; Ford et al., 2014; Harper et al., 2015a; Harper et al., 2015b; Harper et al., 2015c). Indigenous knowledge is critical for robust climate change and health surveillance efforts (see Chapter 2: Climate Change and Indigenous Peoples’ Health in Canada). Several studies demonstrate the effectiveness of Indigenous knowledge for community-based monitoring and surveillance systems to monitor and respond to climate-related changes in access to Indigenous land-based activities, species distribution, food safety, and associated health impacts (e.g., food security, nutrition, personal safety and injury, food-borne pathogens, and new and re-emerging infectious diseases) (Berner et al., 2016; Blangy et al., 2018; Sawatzky et al., 2018; Kipp et al., 2019; Lam et al., 2019).

8.6.1.4 Risk Communication and Education

Awareness of climate change risks has a powerful influence on the initiation and development of adaptation programs and the adoption of adaptive behaviours (Grothmann & Patt, 2005; Moser, 2014; Ford & King, 2015). There are a number of examples in which health authorities have undertaken activities to increase education and awareness of climate change impacts on food and to promote individual behavioural change. In Quebec, the Mon climat, ma santé website was designed to increase public awareness of climate-related health impacts. The website provides an introduction to the concept of food insecurity and discusses various ways that climate change will affect food production and consumption in Canada and globally. The website promotes food security in a changing climate, emphasizing buying local foods, community gardening, and holding events such as cooking workshops to teach citizens how to reduce food waste (INSPQ, n.d.). At a city level, in Montréal, a 2017 pilot project in the neighbourhood of Notre-Dame-de-Grâce aimed to improve emergency preparedness through community resilience workshops. Citizens were encouraged to assemble 72-hour emergency kits that included recipes suited to emergency situations and food (City of Montreal, 2018). Additionally, the federal government has funded many projects through First Nations Adapt, Climate Change Preparedness in the North, and HealthADAPT programs that include risk communication and community-based education. The Young Hunters Program in Arviat, Nunavut, for example, uses SmartIce technology to monitor sea ice thickness and keep the community informed about travel conditions. By including youth in data collection, young community members simultaneously learn about sea ice and wildlife safety. The First Nation of Nacho Nyak Dun in Yukon provides information to the community on climate change and food security by conducting knowledge-gathering activities, and then developing and translating information into the Northern Tutchone language.

8.6.2.1 Tackling the Root Causes of Vulnerability

The people who are disproportionately affected by climate change impacts on food security and food safety are those who are socio-economically disadvantaged and who already experience high burdens of ill health, such as people living on a low income, seniors, members of racialized communities, households headed by single women, and persons with disabilities (Smith et al., 2014; FAO, 2016). Adaptation actions that address societal conditions underlying climate-health vulnerability can enhance food security and food safety, as well as contributing to health equity and overall community resilience (see Chapter 9: Climate Change and Health Equity). For instance, for Indigenous Peoples, this includes supporting and promoting Indigenous food sovereignty (Box 8.6). Opportunities for action discussed in existing literature are diverse and commonly examined in the context of Indigenous food systems; they include investing in social safety nets to respond to food emergencies (e.g., soup kitchens), poverty alleviation, truth and reconciliation, education, inclusive governance, and cultural promotion (Ford et al., 2013; Skinner et al., 2013; Fillion et al., 2014; Ford et al., 2014; Organ et al., 2014; Ford et al., 2016; Rosol et al., 2016). These actions have multiple health co-benefits and can strengthen important determinants of health, including food security.

Mainstreaming or integrating climate change considerations and information on risks to food security and food safety into existing policies and programs can also help to address underlying causes of vulnerability. Some jurisdictions are taking such actions already. The Government of Nunavut’s Food Security Strategy and Action Plan, developed in collaboration with the Nunavut Tunngavik Inc., Inuit organizations, non-governmental organizations, and the private sector, accounts for climate change impacts on food accessibility and promotes food-related skills important for adaptation (NFSC, 2014). Similarly, other territorial adaptation plans emphasize the importance of supporting health and wellness activities to build community resilience to multiple stresses, including climate change. Other measures to address food insecurity focus on increasing the self-sufficiency of local and regional food systems, which, in turn, can increase climate resilience (Sonnino, 2016; Dorward et al., 2017). Calgary’s Food System Assessment and Action Plan incorporates local climate projections, addresses adaptation challenges and opportunities throughout food systems, and showcases local examples of urban farming (City of Calgary, 2012). Municipalities across Canada are increasingly encouraging the creation of community gardens, permitting the keeping of chickens within city boundaries, supporting farmer’s markets and community agriculture programs, and growing urban food forests.³ Such actions can contribute to community climate resilience and have many health co-benefits.

8.6.2.2 Strengthening Health Systems

Strengthening health systems to improve the management of current and future risks from climate change is central to adaptation (Ford et al., 2014; Watts et al., 2015) (see Chapter 10: Adaptation and Health System Resilience). Public health authorities play a critical role in maintaining health and well-being, through health protection, promotion, screening, and surveillance related to food safety (Charron et al., 2008). There is limited knowledge of the effectiveness of current measures to reduce health risks from the potential food-related impacts of climate change (Yusa et al., 2015).

Given the interdependent relationships among food systems, health, and climate change, food can be an important intervention point for climate action and health equity within the health care system. For example, Nourish: The Future of Food in Health Care, a collaborative initiative led by the McConnell Foundation with partners across Canada, has worked to empower health care leaders to take greater actions on climate change and health equity issues through interventions with food (Nourish, n.d.). The Nourish Innovator Program, which ran from December 2016 to May 2019, brought innovators from 25 Canadian hospitals and health authorities together to collaborate on a series of projects that leveraged the power of food to achieve impact in three cross-cutting areas: climate, equity, and community well-being. National collaborative projects included initiatives related to traditional and cultural food programs, sustainable menus, value-based and local food procurement in health care, and measuring patient food experiences.

Adaptation efforts are underway at federal, provincial, territorial, municipal, community, household, and individual levels to respond to the food-related impacts of climate change, although analysis in this chapter indicates more action is needed. Continued monitoring and evaluation of adaptation will be essential for tracking progress in responding to risks and learning from actions, necessitating the development of new methods, approaches, and datasets (Ford et al., 2016; ECCC, 2018; Berrang-Ford et al., 2019; Lesnikowski et al., 2019).

Barriers impeding efforts to reduce risks to health from climate change impacts on food security and safety include uncertainty of climate change impacts; lack of financial resources; insufficient social capital; prioritization of more immediate public health challenges; fragmented institutional arrangements; and jurisdictional challenges (Huang et al., 2011; Clarke & Berry, 2012; Paterson et al., 2012; Yusa et al., 2015; Roser-Renouf et al., 2016; Austin et al., 2018; Austin et al., 2019). There are also potential limits to adaptation, although little scholarship has assessed these limits in a climate–health context in general (Ebi & Hess, 2017; de Coninck et al., 2018) or for food security and food safety in particular. Associated debates around loss, damage, and compensation are relevant in Canada, particularly for Indigenous Peoples, who face an unequal and inequitable burden of impact, but have not yet been examined (Ford, 2009; Landauer & Juhola, 2019).

Another challenge to adaptation is that, in climate change policy planning, food security tends to be framed as primarily an economic and/or GHG emissions mitigation issue, rather than as a social, cultural, or public health challenge that needs to be addressed. Food policies and programs in response to climate change are, therefore, being developed primarily under sustainability, mitigation, or resilience policy initiatives and often lack strong linkages to public health issues and concerns.

The existing literature on climate change and food security generally focuses on food availability, and research generally places a disproportionately large emphasis on climate change impacts on food production, rather than other components of the food system (Nelson et al., 2016). As a result, there is limited understanding of the impacts climate change will have on non-production components of food systems (i.e., food processing, distribution, preparation, and consumption) (Porter et al., 2014), and on human health. Further, studies have tended to concentrate on single-factor changes that might affect food systems, rather than delving into the more complex and multi-layered features of food security that require integration of environmental, political, economic, and social factors. As a result, a number of knowledge gaps exist, particularly regarding food system components most vulnerable to climate change, the consequences for human health, and the most effective adaptation strategies (Schnitter & Berry, 2019).

The severity and significance of climate change effects on food security, as well as the capacity to adapt, will vary across the country. Although a number of studies have explored climate change impacts on food security in Northern Canada, knowledge gaps persist in that region. Further, improving understanding of the main risks and vulnerabilities facing populations in regions south of 60 degrees north latitude, including rural and remote communities as well as urban centres, requires targeted analysis. Regional and local food system assessments and analyses are needed to identify unique vulnerabilities and inform appropriate adaptation strategies, with particular consideration for individuals who will face disproportionate impacts and may already face nutritional risk and food insecurity (e.g., low-income households, Indigenous Peoples, households headed by single women).

Given the integrated nature of food systems, disruption of one component of the food system can disrupt critical operations of other components. Consequently, future research examining the climate change, food security, and human health nexus from a food system perspective would help identify critical vulnerabilities and points of adaptation intervention. A food system perspective also encourages the collaboration of all food system actors. Indeed, many adaptation actions that contribute to a resilient food system fall outside of the jurisdiction of the health sector and will require a multi-sectoral response (Schnitter & Berry, 2019).

To understand risks to food security from climate change, specific knowledge is needed, including research to:

• identify processing and distribution facilities in Canada that are most vulnerable to disruption from extreme weather events and prioritize the most vulnerable sites for resilience-building activities;
• map food transportation and distribution networks across Canada and identify important facilities to assess climate change risks and implement adaptation actions;
• investigate how food distribution systems might adapt to short-term disruptions and longer-term challenges caused by climate change;
• examine climate change impacts on nutrition in a Canadian context, including examining the impact elevated CO₂ concentrations will have on nutritional content of key crops and studying potential climate-related diet shifts and implications for Canadians, and analyzing potential food substitutions and implications for dietary guidelines;
• evaluate and monitor the effectiveness of current measures to reduce health risks from impacts of climate change on food insecurity;
• enhance research and understanding of key factors that contribute to food insecurity, including analysis of compounding, intersecting vulnerability factors and the impact climate change will have on this relationship; and
• increase research and understanding of the impacts climate change may have on food security specifically for First Nations, Inuit, and Métis peoples.

Several Canadian and international studies have used surveillance data to link climate variables and/or climate change to incidence of enteric diseases. Fewer studies have directly associated climate change with food safety by, for example, linking climate to the occurrence of pathogens in foods or to illness directly attributed to food consumption. It is difficult to estimate the precise effect of climate change on food safety, as many food-borne pathogens can also be acquired via contaminated water consumption, direct contact with animals, and human-to-human transmission. Enhanced and integrated monitoring and surveillance of animals, the environment (including water), and foods for pathogens would help to address important knowledge gaps. Several food safety surveillance systems are established in Canada to monitor food-borne diseases; nevertheless, most of these surveillance systems do not currently include climate variables. An opportunity exists to integrate climate variables into food safety surveillance systems to be able to monitor trends in climate-related food-borne illness.

Food safety-related issues are under-represented in the climate-health literature relative to other health indicators (Springmann et al., 2016). More studies are needed to project the impacts of climate change and adaptation measures on food safety in Canada. Risk modelling work conducted thus far indicates that food-borne disease risks are projected to increase with climate change for several combinations of foods, pathogens, and regions (Smith et al., 2015). These types of mathematical models can be populated with data from enhanced surveillance programs that include climate variables, as well as new primary research on the evidence for pathogen behaviours under simulated climate scenarios, to derive risk projections for more food safety issues. Diseases previously considered exotic or rare to Canada should be reconsidered in light of climate changes expected in Canada (Greer et al., 2008). Cross-disciplinary research using various methodological tools can provide useful insights and forecast disease transmission patterns under specific climatic conditions (Greer et al., 2008).

More research is also required to fully understand the impact of climate change and variability on the fate of chemical contaminants in the environment. While ocean warming and acidification will affect the bioaccumulation of contaminants in aquatic species and the structure and distribution of food webs, additional research is needed to understand the changing physical biochemical basis and the changing geographical distribution of aquatic species. Furthermore, to address climate-related environmental changes, integrated surveillance of water, soils, and foods for contaminants and chemical residues; crops for pesticide residues; animal products for veterinary residues; and emerging animal and human diseases is essential (WHO, 2008; Tirado et al., 2010). The data generated from this research can be used to identify emerging problems and food contamination trends and to contribute to risk assessments (Moulton & Schramm, 2017).

To understand risks to food safety from climate change, specific knowledge is needed, including research to:

• regularly review Canadian food inspection regulations and policies to ensure that they are robust enough to cover emerging food safety issues, both in Canada and in countries from which food is imported;
• investigate how climate change adaptation measures may affect food safety and human health — for example, examine potential food safety issues and associated adaptations related to traditional preparation and storage methods used by Indigenous Peoples and how climate change may influence these practices;
• enhance and expand existing food safety surveillance systems to include climate variables and to integrate monitoring of animals and the environment;
• enhance models and derive risk projections for food-borne illnesses in the context of climate change; and
• examine the impact of climate change on the fate of chemical contaminants in the environment.