Adapting to Climate Change in New Brunswick: Health Vulnerability and Adaptation Assessments with an Urban and Rural Perspective

The project, “Adapting to Climate Change in New Brunswick: Health Vulnerability and Adaptation Assessments with an Urban and Rural Perspective,” was funded by Health Canada’s HealthADAPT program until March 2022.

The project was led by Public Health New Brunswick (PHNB). Localized contexts in New Brunswick make some communities more vulnerable to the health impacts of climate change. The New Brunswick population generally suffers from higher rates of obesity, diabetes, and cardiovascular disease than other parts of Canada. Around 50% of the New Brunswick population is living in dispersed rural areas and are thus more isolated than urban areas and can lack access to services and resources.  Furthermore, nearly 60% of the New Brunswick population live along the coast, making them more vulnerable to sea-level rise. The aim of the project was to expand the evidence base on the links between climate change and health by developing climate change and health vulnerability assessments in two pilot communities in New Brunswick: the city of Moncton and the Chaleur Region.

The intention behind choosing two pilot communities was that the work being done in these communities would eventually lead to similar work in many more communities and possibly in the province as a whole. This work was done by creating New Brunswick-specific tools to carry out the assessments, conducting a literature scan to understand the nature of climate change-related health impacts in New Brunswick, and utilizing a number of frameworks to scope the issue and create the adaptation plan. An additional tool, an Adaptations Options Database, was created to implement the adaptation plan and monitor progress with a range of indicators. The main climate risks that were assessed for this project were extreme temperatures, extreme weather events, poor air quality, drinking and recreational water safety, food safety and security, vector-borne diseases, and UV radiation.

Understanding and Assessing Impacts

This project was intended to establish a link between climate change and health impacts in the New Brunswick context through creating a climate change and health vulnerability and adaptation assessment toolkit. The project was based in two pilot areas: the urban City of Moncton and the rural Region of Chaleur. The two areas were selected based on wanting to test the vulnerability and adaptation tools in the toolkit within an urban and rural setting. In addition, both of these areas had already done work on climate change adaptation.

The first stages of the project focused on establishing associations between health issues and climate change, as well as identifying province-specific climate change concerns. A healthy equity perspective was utilized by assessing for certain health conditions in the population (e.g. hypertension, chronic obstructive pulmonary disease (COPD), and asthma). Social determinants of health were also recognized, including visible minority status, elderly age, those living alone, low-income populations, and persons with disabilities. Both of these preliminary population assessments factored into identifying disproportionate risks in the pilot communities.

In the scoping stages of the project, an extensive literature review was conducted and the project team took advantage of several existing frameworks to inform their process. The frameworks utilized included World Health Organization’s Health Impact Assessment, Building Resilience against Climate Effects (BRACE), and Health Canada’s Guide to Climate Change and Health Vulnerability and Adaptation Assessments. Throughout the project, PHNB took a broader approach to data collection, data analysis, public engagement, and the sharing of results. This was mainly due to a lack of health data and a lack of population awareness of the health impacts of climate change, which necessitated establishing baseline information for the province to understand the impacts of climate change on health over the longer term.

Identifying Actions

For the two vulnerability and adaptation assessments, the team needed to define vulnerability to climate change health impacts, identify the most climate-sensitive populations in the city, and then establish baseline information for exposure to climate change risks. The project had seven main objectives to develop the New Brunswick-specific Climate Change and Health Vulnerability Assessment and Adaptation tools. They were:

  1. Improve understanding and the evidence based on the associations between climate change and health outcomes in New Brunswick (NB);
  2. *Provide health and emergency management officials, stakeholders and the public with more NB-specific information on the health risks associated with climate change, to help increase awareness and manage the impacts to human health and the health system;
  3. Provide guidance on mechanisms to reduce health impacts and inequities in the face of climate change with an urban and rural perspective.
  4. Serve as a baseline to monitor future changes in health impacts and the effect of policies and programs;
  5. Forge collaboration between key stakeholders;
  6. Develop and deliver bilingual communication materials to help inform the public and other stakeholders (e.g., healthcare workers, decision-makers, emergency management officials) on the potential NB-specific impacts to human health *and the health system associated with climate change and options to manage those risks.
  7. *Ignite the NB public’s interest in climate change and their mobilization around taking action at the local level.

       *Due to the COVID-19 pandemic, these objectives were not fully achieved. 

These objectives informed the framework for the project and its outputs. However, due to the COVID-19 pandemic, two of the objectives were not fully achieved. As part of the intended outcomes of the project, it was important to identify how climate change vulnerability differed in the urban and rural context. Much of these differences in context were understood from literature review and existing population data. For instance, the continued expansion of urban and suburban areas is associated with larger areas with intense heat island effects. However, rural areas have fewer concerns with heat islands, but are more at risk to the socioeconomic implications of an unpredictable climate, such as the spread of vector-borne diseases, wildfires, and water-related issues. It was therefore important for the project to develop indicators that differentiated between urban and rural contexts.

Other considerations that were important for the project were to employ an evidence-based approach to the study, to work with community-specific climate and health data for the pilot communities, ensure local realities were captured within data collection, and to engage key stakeholders from all sectors. The key stakeholders were identified as academics, local government, public works, urban and rural planners, those working in agriculture, those working in fisheries, and NGOs.


The project team was made up of staff from PHNB. Although qualified staff were secured to complete the project from the onset, due to the COVID-19 pandemic, there were time and personnel constraints, so the project team had to change the focus of the project towards community-based adaptation rather than an assessment of the health system. This pivot resulted in changes to proposed project deliverables but was necessary to ensure the project had the maximum impact under the circumstances. Although some dissemination materials could not be completed, the team completed two additional dissemination materials that were not part of the initial project plan. The two materials included an infographic and climate change sensitivity profiles for the province. The profiles were developed for each of New Brunswick’s 33 Health Council communities to identify benchmark indicators. An infographic was developed for public dissemination that showed the different ways that adaptive communities could mitigate climate change impacts on health. Both outputs had a health equity focus that presented how health challenges could result from social determinants of health, as well as from medical concerns, such as respiratory or cardiovascular issues. Aside from these additional materials, several planned activities were completed over the three-year timeline.

After the literature review and review of existing tools, the project team evaluated and refined the climate change and health vulnerability assessment and adaptation tools and piloted them in the two municipalities. In the final year of the project, climate change and health adaptation plans were developed for the pilot communities, the tools were adapted to be used in other municipalities, and an internal performance and evaluation was completed to monitor the progress of the project and to identify how adequately the project achieved its intended outcomes.

Outcomes and Monitoring Progress

Currently, the project has completed five of seven intended objectives. Despite project delays, data collection and analysis were largely completed as planned for the pilot communities, but was not completed for the health system review, as per the pivot to community-based adaptation. Nonetheless, the team acknowledged that there were data limitations due to the complex nature of climate change impacts, which present an element of uncertainty in ongoing data collection. Furthermore, it was acknowledged that there was a need to standardize data collection across the province and to ensure consistent health-related data was collected from health networks. The literature review from the project led to the development of an Adaptations Options database which was supplemented by qualitative data from focus group activities with a broad range of stakeholders such as academics, municipal representatives, nongovernmental organizations, and CAPE-NB (Canadian Association of Physicians for the Environment, New Brunswick).  This engagement was highly useful, but it was acknowledged that some segments of the population need to be better engaged, including youth and seniors.

Due to COVID-19 related delays, there were some limitations to engagement due to time constraints, but adaptation options reports were prepared for each pilot community. Rural data was stated to be more limited than the urban data collected but the team compensated for this by supplementing the rural data with data provided by the University of New Brunswick. The University of New Brunswick undertook a province-wide analysis of sensitivity factors to climate change, in order to create the sensitivity profiles of the 33 Health Council communities. Generally, throughout the project, while adjustments were made, the flexible approach to the project was an asset considering the need to reprioritize due to competing health emergencies, such as COVID-19. While not all intended activities were created, the project helped build the capacity of the PHNB to undertake future climate change and health adaptation assessments and resulted in more data collection relevant to urban and rural contexts in New Brunswick.

Next Steps

This project was highly informative in the sense that it provided baseline information to communities and expanded current knowledge related to climate change and health vulnerability assessments. Nonetheless, the next steps of the project will be heavily influenced by available funding and resources.  The project will continue to guide future research and data collection in the province and the New Brunswick Department of Health intends to include the full population through an expansion of the project in the future. This expansion will involve additional climate change and health vulnerability assessments for other communities and improvements to data sources, as data limitations within this project were shown to be a challenge for gathering baseline information on the pilot communities.

Currently, next steps are to disseminate results. For example, a website on health and climate change is being created and will be hosted on the new Ministry of Environment/Climate Change Secretariat’s website. As well, a webinar on the results of the New Brunswick HealthADAPT project, in collaboration with the work done by the Université du Québec à Rimouski on psychosocial impacts, will be presented to a wide range of partners within the New Brunswick government.