Mom Shaiyena Currie, right, with 3-day-old baby Octavia and her sister Chelsea Currie on their way home to Bella Coola from Williams Lake after three weeks of living in a tent waiting for the birth. PNG
Three weeks after the birth of her daughter Octavia, Bella Coola mom Shaiyena Currie, 23, is still recovering from the trauma of spending 14 days in a tent during the final stretch of her pregnancy.
Since 2008, when Vancouver Coastal Health cut maternity services at Bella Coola General Hospital, pregnant women in the community must travel to Williams Lake a month before their due date.
Pregnant women who travel for their deliveries in the VCH region are eligible for some discounts on ferries and airfares, and a medical discount of about 30 per cent at select hotels, but meals, accommodation, mileage, fuel and local transportation expenses are not included in the provincial Travel Assistance Program.
Currie estimates that the total cost to her and her family for the birth was around $10,000, in part because her sister had to take an unpaid leave from her job to accompany Currie.
“I was worried for my safety. I stayed up all night tossing and turning because of the fear that anybody could just walk into my tent,” said Currie who pitched her tent at the Stampede Campground, not far from Cariboo Memorial Hospital in Williams Lake.
When a busy horse riding competition started on the stampede grounds, Currie moved to the Stampeder Motel where the slightly discounted medical rate came to $90 a night, plus taxes and fees. The final insult was that she had to give birth alone, because her sister had to watch her son at the hospital while she was delivering. Her mother had planned to be there, but couldn’t make the six-hour drive in time.
Currie calls the whole situation “terrifying and traumatic,” and says people need to know the health and safety risks pregnant women face when travelling to give birth.
Katy Best is a Bella Coola Grade 5 teacher who is expecting her first child will moving back in with her mother in Richmond next week while she awaits her birth.
In a letter to health authorities advocating for change, Best wrote on Aug. 29, “The disruptions to these mothers’ lives are countless, including having to leave children behind or pull them out of school, feeling isolated from their communities and partners at a very vulnerable time, and missing out on nesting at home during their final month of pregnancy.”
Best said she was required to sign a waver stating that she understood childbirth was “inherently dangerous,” and that she would be required to leave the community to give birth.
“If leaving the community is deemed a medical necessity by health authorities, why aren’t the costs covered?”
“This is an equity issue,” says Best, who points out that pregnancy is not a “rare or unforeseeable condition.”
“Based on the fact that you give birth, you have to take on this enormous financial and emotional hardship.”
Best believes that Vancouver Coastal Health saved money by shutting down Bella Coola General’s maternity program, and “off-loaded those costs onto women and families.”
Adrian Dix, Minister of Health told Postmedia in an email, “Improving travel assistance supports, especially for expectant mothers and families, is an issue that I am looking into with the input of Ministry of Health staff and health authorities.”
Vancouver Coastal Health provided Postmedia with a written statement which read in part, “Vancouver Coastal Health recognizes the difficulties in providing health services to residents of remote and rural communities. This issue is not unique to British Columbia, or even to Canada for that matter. Bella Coola Hospital does not have full maternity service.”
A 2013 study published by the Canadian Institute for Health Information said 40 per cent of women living in rural Canada drive more than an hour to give birth; 17 per cent drive more than two hours.
A 2008 report from the Centre for Rural Health Research on Maternity Care in Bella Coola stated that cuts to rural maternity services tend to be driven by a trend toward centralization of health services and challenges in attracting nurse, general practitioner surgeons and specialists and lack of access to specialized services such as “access to epidural anesthesia, labour augmentation, or caesarean section backup.”
It’s not good enough for Currie.
“I don’t want another woman to have to sleep in a tent, or worse. Something needs to be arranged so mothers are safe and can give birth in their communities.”
When wildfire smoke enveloped Metro Vancouver last summer, Nikki Rogers noticed soot collecting on the walls of her White Rock condo and closed her windows to keep the bad air out.
“I tried to stay inside because I did not enjoy being outside,” recalled Rogers, who works in a hair salon. “I would never do any kind of exercising or jogging or walking outside because anything that promotes heavy breathing outdoors would be terrible.”
This summer she will take even greater precautions because she is pregnant. And this is the first year that Vancouver Coastal Health and Metro Vancouver have included pregnant women on their list of people especially vulnerable to wildfire smoke, along with asthmatics, the elderly, and people with chronic heart and lung conditions.
Rogers said she will research the best way to keep herself and her baby safe, but laments that wildfire smoke is one more thing expectant mothers will likely need to worry about this July and August.
“We shouldn’t have months of just smoke in the air. That’s just awful,” she said. “Every year it gets worse and worse. It is just getting out of hand.”
Experts believe British Columbians are about to experience another hot, smoke-filled summer, basing their prediction on the higher-than-average temperatures and drought so far in 2019 — a trend that is expected to continue.
“We expect increased wildfire and smoke risk, and that includes in the southwest where we are,” said a Metro Vancouver air-quality engineer, Francis Ries.
Just in the last week, a stubborn wildfire on steep terrain near Lions Bay snarled traffic on the busy Sea to Sky Highway for days, and a fire broke out Monday near Pender Harbour on the Sechelt Peninsula.
Fires started earlier in 2019
Hotter, drier conditions contributed to fires in early spring, far sooner than in other years. Since April 1, the B.C. Wildfire Service has recorded 377 fires that have burned more than 110 square kilometres.
The summers of 2017 and 2018 were the worst on record for smoky skies — a provincial state of emergency was declared both years over wildfires — and much of the haze in Metro Vancouver drifted in from big fires in other parts of B.C.
The smoke led officials to issue a record number of air-quality advisories, and give extensive advice on how residents should try to remain healthy.
This year, local health and municipal agencies added pregnant women to the list of those most vulnerable to the smoke after lobbying by Sarah Henderson, an environmental health scientist at the B.C. Centre for Disease Control.
She advocated the change based on an “evidence review” and academic research that showed mothers exposed to extreme wildfire smoke give birth to smaller babies.
A University of California, Berkeley study found that pregnant women breathing in wildfire smoke during their second trimester in 2003, a terrible fire season in Southern California, had babies that were about 10 grams lighter than women not exposed to smoke. The results were small but “significant,” researchers found, because they showed “climate change can affect health.”
Ten grams would be enough to “push some babies into a low-birth-weight category,” added Henderson, noting undersized infants can face challenges.
Based on pregnancy and population statistics, Henderson predicts a repeat of last summer’s smoky skies could lead to 20 babies in B.C. being born a bit smaller. It’s not a big number, but one that could hurt 20 families.
“And that is kind of the tip of the iceberg in some ways because nobody has looked at preterm birth or malformations, if that smoke exposure happens to pregnant women,” added Henderson, who is also an associate professor in the UBC school of population and public health.
She has applied for funding to do her own study of the outcome of women who were pregnant in B.C.’s Interior, where the smoke was the thickest during the last two summers.
Wildfire smoke is a toxic, chemical soup
Wildfire smoke contains many pollutants, but the most dangerous to human health is fine particulate matter, a mixture of solid particles and liquid droplets that are generally 2.5 micrometers or less in size — about one-30th the diameter on a strand of hair.
“The very small particles can be inhaled deeply into your lungs and then get into your blood stream, and irritate and lead to inflammation,” said Emily Peterson, a Vancouver Coastal Health environmental health scientist.
A typical summer day in Metro Vancouver would feature 10 or 15 micrograms a cubic metre of these fine particulates, but during the height of last summer’s smoky skies the quantity jumped tenfold.
Smoky air makes it harder for lungs to get oxygen into the blood stream, and it can irritate the respiratory system and cause inflammation in other parts of the body. Common symptoms include eye irritation, sore throat, coughing, wheezy breathing and headaches, and there is an increased risk of infections for some, such as pneumonia in older people and ear infections in children.
At-risk people — including those with chronic lung or heart conditions and now pregnant women — should “pay attention to the smoke much earlier” this summer, said the VCH medical health officer, Dr. James Lu.
“We do start with the vulnerable population, but if the smoke (concentration) is high enough we do encourage people who are normally healthy to take precautions as well,” Lu added.
Among the precautions backed by medical experts: Stay inside places with filtered air, such as most community centres, libraries or malls; drive with the windows up, the air conditioning on, and the recirculate-air button activated to reduce the amount of smoke getting into your car; and drink lots of water.
Because most people typically spend 90 per cent of their days indoors, Henderson highly recommends buying a portable air cleaner, which plugs into a wall socket and can be moved from room to room. These purifiers remove 40 to 80 per cent of the fine particles found in smoke, but people with respiratory conditions are encouraged to buy higher-performing HEPA (High Efficiency Particulate Air) filters, the Centre for Disease Control says.
If people are outside and want to wear a mask, Henderson said the best option is a well-fitted N95 respirator. A surgical mask can offer limited protection. A cloth mask is close to useless at keeping out the fine particles in smoke.
Doctors’ visits, asthma prescriptions skyrocket
Most people can manage irritations from smoke without medical attention, but those with severe symptoms should see a doctor.
Wildfire smoke caused a slight rise last summer in the number of people visiting Vancouver Coastal Health emergency rooms, although the increase wasn’t even across all communities: North Vancouver and Richmond had more hospital visits, while other cities did not, said Lu.
“What we did see were increased visits with respiratory symptoms, asthma and people short of breath,” the medical health officer told Postmedia.
The B.C. Health Ministry could not provide information about higher traffic in emergency rooms in other health regions, saying its data does not let it differentiate between treatment specifically for wildfire smoke and other respiratory issues.
However, Centre for Disease Control statistics suggest medical services across B.C. were harder hit when wildfire smoke was heavy. In the summers of 2017 and 2018, 45,000 extra doses of asthma medication were dispensed and there were 10,000 extra visits to doctors for asthma-related conditions in B.C., Henderson said.
“It does stack up, the impact is quite extreme,” she said. “On a very smoky day in Metro Vancouver, there were 350 extra doctor visits.”
The Centre for Disease Control tabulates this information daily in the B.C. Asthma Prediction System, which was launched after previous severe wildfire seasons. The surveillance system tracks asthma-related doctor visits and the prescriptions filled for lung conditions, and is used to warn health officials about the anticipated effects of wildfire smoke.
This summer is also expected to experience a boost in asthma treatments, given what happened in May after a significant wildfire near Fort St. John. “We had this one day of smoke in Fort St John, and the asthma visits skyrocketed,” Henderson said.
During the past few years, Vancouver Costal Health has sent reminders to family physicians to help their patients get ready for smoke expected in July and August — such as ensuring medications for patients with chronic heart or lung disease are up to date.
“I think what we are hoping for is to perhaps educate the public and primary-care physicians in helping people to be prepared so that they don’t really need to come to the emergency,” Lu said.
More than 3,000 ‘smoky skies’ bulletins issued
The provincial Environment Ministry issues “smoky skies” warning bulletins when wildfire smoke gets bad in all areas of the province except Metro Vancouver, which releases its own air quality advisories.
In 2017, 1,646 air-quality advisories were issued across B.C., and that jumped to 1,742 in 2018. There have been 69 warnings so far this year, but that number will likely increase as the majority of 2018 bulletins were issued between late July and late August.
The province monitors 63 regions, and six of those have had 100 or more smoky skies bulletins since 2017 due to bad fires nearby, including Quesnel, Penticton, Prince George, Williams Lake and Kamloops. Other communities in B.C.’s Interior and the Cariboo region have also been hard hit, with just under 100 bulletins issued in the last two years in Vernon, Kelowna, Cranbrook and 100 Mile House.
Only Haida Gwaii, off B.C.’s northwest coast, has had no smoke-related air quality warnings since 2017.
The Environment Ministry was unable to provide information about how many advisories it issued in years with far fewer forest fires than 2017 and 2018. But statistics from Metro Vancouver indicate those two years were off the charts.
There were 22 days in Metro Vancouver last summer with poor air quality due to forest fires, mainly between late July and late August. In 2017, it was 19 days of unhealthy amounts of smoke.
The region’s figures, dating back to 1996, showed no other years with near that number of hazy days, the closest being 10 days in 2009 and 2015, when there were also some forest fires. In several years, including 2011, 2013 and 2016, there were no days with poor air quality.
Metro Vancouver’s advisories show much of the air pollution came from forest fires in other parts of the province, but the air was also affected by some local blazes, such as a bog fire in Richmond and a barge blaze in Surrey.
No air quality advisories have been issued so far in 2019; Metro Vancouver said the smoke residents smelled earlier this week from the Lions Bay fire was “below advisory thresholds.”
Some smoke from the Strip Creek wildfire south of Lions Bay has reached western portions of Metro Vancouver. Air quality levels remain below advisory thresholds however concentrations may vary as winds and wildfire behaviour changes. https://t.co/qyfTAdCeW5
Metro Vancouver’s summer 2019 outlook warns of the potential for increased ozone due to higher temperatures and wildfires. Ozone is described as “good up high; bad nearby” — ozone in the atmosphere protects from UV radiation, but when lower to the ground it damages lungs and destroys ecosystems according to a Colorado State University academic paper, Ozone Levels Elevated in Presence of Wildfire Smoke.
“We’ve seen high ozone levels at monitoring stations which we never, under normal circumstances, expect to have high ozone,” said Metro Vancouver’s Ries. “We almost never have high ozone in the western part of the valley, downtown Vancouver and through into Burnaby,” he said, except in 2017 and 2018 when “the highest ozone levels we received were in that part of the region.”
Ries said more studies, including ones that focus on B.C., are making a strong link between climate change and the exacerbation of wildfire seasons.
In 2017, 65,000 British Columbians were evacuated and 509 buildings burned during wildfires that scorched 12,000 square km of land. The 2018 forest fires were even more destructive, consuming 13,500 sq. km — although fewer people were evacuated (6,000) and fewer structures lost (158).
Over the last two summers, the provincial government grossly outspent its wildfire budgets — by 10 times in 2017, when it cost more than $650 million to fight the fires. This year, the NDP is trying to be better prepared for the unknown by nearly doubling its wildfire budget, boosting it from $64 million in 2018 to $101 million.
Smoky summers in Vancouver may become “the new normal,” if not every year then at least every other year, VCH’s Lu predicted.
“We do not expect this to go away. This is going to be a way of life, unfortunately,” he said. “So I think the need to include that in your consideration of how to stay healthy is important.”
Plan ahead to ensure that you stay safe and healthy while travelling this summer. Getty Images
It wasn’t until monkeys started swarming our tuk tuk that I started to think about a rabies vaccine.
Fortunately the boldest topped short of landing on my lap, opting instead to plunder a bag of fruit left on the seat. The incident, while we were touring Siem Reap in Cambodia, underscores the scouts’ motto, ‘be prepared.’
With summer holidays upon us, it’s time to plan ahead. With help from Dr. Suni Boraston, travel clinic director for Vancouver Coastal Health and Sara Holland, senior communications director for the BCAA, here are 10 tips for a healthy holiday.
1. Travel Health Clinics
If you’ll need vaccinations for travel it’s best to visit a travel health clinic six weeks before you leave, but Boraston says even if you’ve left it to the last day, it’s better to get vaccinated then than not at all. Travel clinics’ services and products extend beyond vaccinations; they’re a good place to start regardless of where you’re travelling.
Online sources can give you recommendations on vaccinations and other medicines based on the area you are travelling in and the length of your stay but check with your travel clinic. Anyone born after 1970 who doesn’t have a documented second dose of measles vaccine should get one, said Boraston. Babies don’t get their first measles vaccine until age one, but Boraston said they can safely get the vaccine from six to 12 months, and she recommends that no matter where you’re travelling with a baby. Another must-have for every traveller is a Hepatitis A vaccine. Hep A is spread by food and water and it’s a global issue. Expect to pay for travel vaccinations, although some, like a tetanus booster, are free in British Columbia and others may be covered by extended benefits plans. It can add up: A rabies vaccination, for example, is $200 per dose and there are three doses, probably why I opted not to get that but useful if you’re spending an extended time in areas where rabies is still prevalent. Boraston said E. coli is the most common ailment for travellers. She suggests packing antibiotics prescribed by your doctor, only to be used if you have “think you’re going to die diarrhea”.
When shopping around for insurance, make sure you know what you need and what your policy covers. Holland recommends travel insurance that covers medical and/or hospital expenses, prescription drugs, ambulance service, emergency dental care and pre-existing conditions. Some extended benefits plans include travel so you don’t have to buy extra insurance or you can just top it up; check with your provider and check for age limitations. Read the fine print on travel coverage you may have through your credit card. Holland also reminds us that travel insurance isn’t just for travelling outside the country. Some medical expenses aren’t covered by the B.C. medical plan when you’re in other provinces.
4. Questions to ask before you buy travel health insurance
Does the insurance provider protect spouses or children? If not, can they be added?
Does it cover trips of any length? Some policies have a limit on trip length
What’s the limit on coverage for medical expenses?
What is the policy around pre-existing conditions? Are they covered and to what degree?
Did the travel have to be purchased on the credit card in order to be eligible for coverage?
5. Packing a first aid kit
When it comes to packing your first aid kit, your destination will help determine what’s on the list. Here is a list of basics that you can adapt depending on where you’re going.
Over-the-counter medication for pain and fever
Gravol, Boraston points out as well as being good for nausea it can serve as a sleeping pill.
Imodium and if you’re travelling in developing countries, an antibiotic to treat diarrhea.
Pads or moleskin for blisters are useful if you’re going to be doing a lot of walking
Consider compression socks for long flights
6. Prescriptions and other medication
Don’t pack just enough of your prescription medicine to cover your expected time away, carry extra in case you’re delayed. Make sure your medications are in your carry-on bag and take a copy of your prescription, including the generic name, in case your bag gets stolen or lost.
Spare cheater drugstore specs may be enough to get by if your glasses are lost or broken but if you’re totally dependent on you’re glasses to see, take spare prescription glasses or contacts and your prescription. Take a copy of your health insurance documents.
7. Area-specific additions for your packing list
Depending on where you are travelling, you may need extras such as antimalarial medication, or Diamox for altitude sickness
Carry repellent when you’re travelling where there are ticks and mosquitos, even in malaria-free countries. If you’re backpacking or sleeping in the open air, consider adding mosquito netting to your packing list.
Water purification tablets
8. Reduce your travel footprint
Boraston recommends taking your own water bottle when you travel and refilling it from taps. In developing countries or where you are unsure about water quality, use water purification tablets and leave the water for 30 minutes to kill organisms. Carry a reusable cup and avoid using plastic straws, another source of plastic waste, by carrying a reusable stainless steel straw.
9. What not to take
The legalization of cannabis in Canada doesn’t mean you can take it across the border. The Canadian government warns on its website that: “Taking cannabis or any product containing cannabis – even for medical use – across the Canadian border is illegal.” Plus cannabis is still illegal in most countries. Even if you’re travelling to a state in the United States where cannabis is legal, it is illegal under United States federal laws and it is illegal to cross the border with it.
Centers for Disease Control and Prevention: It has a lot of useful information and resources, including advice for travelers and clinicians that can be customized to your destination and type of travel. Along with recommended vaccinations and health advice, it has packing lists tailored to your travels.
All indications suggest British Columbians should prepare for another smoky summer this year, experts warned today.
B.C. Wildfire information shows the province has so far this year seen increased drought and higher-than-average temperatures, which are expected to continue. Experts are predicting a greater risk of wildfires and smoke in the province this summer, particularly in the southwest, which includes Metro Vancouver.
Metro Vancouver air quality engineer Francis Reis said more studies are making a strong link between climate change and the exacerbation of wildfire seasons.
“As we continue to see further warming, we can expect the patterns we are seeing now to continue or even get more extreme,” he said.
Residents are reminded to try to stay indoors when air quality bulletins are issued.
The summers of 2017 and 2018 were the worst on record for smoky skies in B.C., caused by wildfires. This led to warnings that people take caution when outside, especially those with asthma, lung conditions, the elderly and pregnant women.
The hot, dry spring has many worried that 2019 could also bring hazy skies that are bad for residents’ health.
A fentanyl check in progress. One red line on top is a positive result for the presence of fentanyl or one of its analogs. Two red lines is a negative result. Handout
Vancouver Coastal Health and B.C. Centre for Disease Control are collaborating on a pilot project that will provide substance users with take-home drug checking kits to determine if people can safely use them on their own.
Clients will receive five free test strips, with instructions, to take home so they can determine whether their drugs contain fentanyl, a highly potent synthetic opioid being cut into the illicit drug supply.
“We know that most people dying from overdoses die while using alone,” said Dr. Mark Lysyshyn, medical health officer with Vancouver Coastal Health. .“We’re hoping that giving people the opportunity to check their drugs for fentanyl on their own could help them make safer choices and save lives.”
The VCH says fentanyl was responsible for approximately 87 per cent of illicit drug overdose deaths in B.C. last year.
A record 1,489 British Columbians died of suspected drug overdoses in 2018.
Currently substance users voluntarily check their drugs at overdose prevention sites, supervised consumption sites and other community health sites an average of 500 times each month. But since many fatal illicit drug overdoses occur in private residences, and when the user is alone, health authorities believe take-home drug checking kits could help more people.
“We know using drugs alone presents a significant risk amidst a toxic, unpredictable and illegal drug supply that is taking three to four lives every single day,” said Judy Darcy, B.C.’s minister of mental health and addictions. “Drug checking is an important tool in our toolbox and through this research project we can learn more about how to keep people safer and help them find a pathway to hope.”
The test strips were originally developed to check urine for the presence of fentanyl but in July 2016 in light of the overdose crisis, VCH pioneered the use of the strips to check the drugs themselves for fentanyl. A small amount of a drug is mixed with a few drops of water, the test strip is inserted into the solution, and a positive or negative for fentanyl is revealed within seconds.
The research study will evaluate the fentanyl positivity rates from the take-home checks compared with rates that trained technicians get at VCH sites during the same time frame. The study will help determine whether take-home drug checking kits can be effectively used outside of a healthcare facility without staff oversight.
B.C. Health Minister Adrian Dix says MRI wait times have dropped significantly since the number of scans was ramped up. Francis Georgian / Postmedia News Files
VICTORIA — Wait times for MRIs across the province have fallen sharply during the past year after government boosted the number of scans, according to provincial data.
The median wait time for an MRI scan in the Northern Health Authority fell 66 per cent between April 2018 and March 2019, with a patient waiting roughly 24 days compared to the prior 71 days.
Vancouver Coastal Health saw wait times drop from 36 to 21 days, a 42-per-cent reduction, and Fraser Health saw a reduction to 48 days from 89 days, a 46-per-cent cut.
“I’m happy with the direction,” said Health Minister Adrian Dix. “This is what we intended to do.”
The data reflects elective or scheduled MRIs. Emergency scans are done immediately.
Last year, B.C. began running 10 of the province’s 33 MRI machines 24 hours a day, seven days a week and bought two privately owned MRI clinics in the Fraser Valley to expand capacity, at a cost of $11 million (plus an undisclosed amount for the clinics).
Dix announced last week a further expansion of MRI scans in the coming year, but did not have the data to prove wait times had reduced. He said the ministry was compiling the final figures and provided the data publicly Wednesday.
The longest wait times for certain patients — known as the 90th percentile measure — also dropped. Some MRI scans in Fraser Health had taken 346 days last year, but fell to 224 days once government expanded capacity, a reduction of 35 per cent, said Dix.
But that is still not good enough, he said.
“I obviously like the direction, I think we’re getting there,” he said. “We wanted to see everything under 26 weeks, and everything is under 26 weeks, except this.”
The longest wait times in Vancouver Coastal Health fell from 114 days to 99 days, a reduction of 13 per cent, and in Northern Health from 257 days to 55 days, a reduction of 79 per cent.
“The huge difference in the north is obviously significant,” said Dix.
Government is adding another $5.25 million to the MRI budget next year, which Dix said will fund 15,000 additional MRI scans. Dix said the wait times should drop even further.
People who live in walkable neighbourhoods and have access to parks in Metro Vancouver save the health-care system tens of millions of dollars each year, and have lower rates of chronic illness than those who don’t, according to a new study.
The report, called Where Matters, used data from two existing studies — the My Health, My Community Survey, and the B.C. Generations Project — and clearly shows the correlation between health and neighbourhood design, said study lead Lawrence Frank.
“That’s unusual. Then, we monetized all those results and showed wildly reduced health-care costs, relatively speaking, across the continuum of place types — from the most sprawling, exurban, car-dependent to the most walkable urban. That’s never been shown before, no one’s ever had that,” said Frank, who is a professor in sustainable transport and the director of the Health and Community Design Lab at the University of B.C.
Direct health-care costs — such as medication and hospital visits — for diabetes are 52-per-cent less for those living in walkable areas than in car-dependent areas. The cost for hypertension is 47-per-cent less, and for heart disease is 31-per-cent less.
Walkability is a measure of the physical characteristics of neighbourhoods that support walking, such as a higher concentration of housing units, a mix of land uses and smaller block sizes.
The direct health-care costs for those living near parks are also significantly lower. The spending on diabetes is 75-per-cent lower for people who live near six or more parks than those who live near zero to one park. The costs are 69-per-cent lower for hypertension and heart disease.
Dr. Patricia Daly, chief medical health officer for Vancouver Coastal Health, said at the report’s unveiling on Monday that containing costs is important in the health-care system, but it shouldn’t be the only reason to create healthy environments and improve the health of the population.
“We need to do this because our citizens value this. They value their good health, the good health of their family, their friends and their loved ones,” Daly said. “When municipal, provincial governments and other decision makers are thinking about what work needs to be done, they should be keeping this in mind.”
Daly said she hopes the report will give those decision makers good data to make healthy decisions.
The report also shows, unsurprisingly, that people who live in walkable areas and near parks get more exercise and are healthier.
Those living in a somewhat walkable area or a walkable area are 20- and 45-per-cent more likely, respectively, to walk for transportation than those living in car-dependent areas. They are also more likely to meet the weekly recommended level of physical activity.
People in walkable areas are 42-per-cent less likely to be obese and 39-per-cent less likely to have diabetes than car-dependent people. Those in moderately walkable areas are 17-per- cent less likely to have heart disease.
Living in a walkable area means people are 23-per-cent less likely to have stressful days. They are also 47-per-cent more likely to have a strong sense of community.
People living in an area with six or more parks are 20-per-cent more likely to walk for leisure or recreation, and 33-per-cent more likely to meet the weekly recommended level of physical activity than those living in an area with no parks.
They are 43-per-cent less likely to be obese, 37-per-cent less likely to have diabetes, 39-per-cent less likely to have heart disease and 19-per-cent less likely to have stressful days. Those living near six or more parks are also 23-per-cent more likely to have a strong sense of community belonging.
Frank said he hopes that the study will make those in power more comfortable acting on making investments in active transportation and developing policies around growth and development that support physical activity and active living.
Andrew Devlin, manager of policy development for TransLink, called the work “cutting edge” and said the onus will be on governments and agencies like TransLink to take the information and use it to create policy.
“I think what’s really unique to this piece of work, besides being a local data set for us to draw from to make decisions, is really the monetization element of it,” he said.
James Stiver, manager of growth management and transportation for Metro Vancouver, said the information will help with the future development of regional plans.
“This work is critically important to the work we do at Metro Vancouver and ties really nicely into the theme of the work we do connecting transportation to infrastructure to build complete communities,” said Stiver.
The project was a collaboration between Metro Vancouver, the Real Estate Foundation of B.C., the City of Vancouver, and TransLink, which contributed a total of $320,000 to the project, and the University of B.C.
“What makes it really cool is that all of these agencies are working together, and that’s what could make this region a better place,” said Frank.
There are now 17 cases of measles in B.C., the latest of which is located in the Fraser Valley and is linked to the Vancouver outbreak.
The most recent case was confirmed Wednesday in a Fraser Valley resident, according to Fraser Health medical health officer Aamir Bharmal. The individual had been exposed to one of the infected measles patients in the outbreak originating at two Vancouver schools.
“This individual was isolated since their exposure and there is no concern relating to public exposure at this time,” Bharmal said in an emailed statement.
He also confirmed there is no measles outbreak at any Fraser Health-area schools and no known measles exposure in Fraser Health’s coverage areas.
Not long ago, measles cases were far and few in between.
There were two cases in 2016 and just one in 2017. There were six cases confirmed in 2018.
The last outbreak of measles in B.C. was in 2014 when 343 cases were reported. Those cases were linked to an outbreak in a religious community that objects to vaccination.
Last week, Vancouver Coastal Health declared a measles outbreak in the city after as many as nine cases were reported in Vancouver.
Here’s how we got here and what you need to know.
January / February 2019: An individual who has been confirmed as having measles visited the emergency room at B.C. Children’s Hospital during the following times: • Jan. 21, 2019 – 10 a.m. to 6:10 p.m. • Jan. 23, 2019 – 4:45 p.m. to 11:10 p.m. • Jan. 24, 2019 – 8:13 a.m. to 11:40 a.m. • Feb. 1, 2019 – 2:05 p.m. to 6:55 p.m. If you also visited on those days during those times, contact your health care provider.
Jan. 25, 2019: Washington state declared a state of emergency due to the measles outbreak. As of Feb. 17, a total of 62 cases were confirmed, but there was no evidence the cases in Washington are linked to those in B.C.
Feb. 9, 2019: The first B.C. case of measles leading up to the current outbreak was confirmed. By the time this case was confirmed, it was past the point of being infectious.
Feb. 13, 2019: VCH announced a second case of measles was confirmed in the city; there are no indications it is linked to the first case. The patient was a school-aged child who was infected locally, not while travelling abroad.
Feb. 14, 2019: An online petition calling on the province to make vaccinations mandatory in B.C. schools has picked up traction. Just one day after the second case of measles was announced, the petition had already garnered more than 1,800 signatures. Another five days later, the petition now has nearly 27,000 signatures.
Feb. 15, 2019: Health officials confirmed there were several cases of measles at three French-language schools in Vancouver: École Jules‐Verne, École Anne‐Hébert and École Rose-Des-Vents. The cases are occurring in staff, students and family members linked to the schools.
More to come.
What’s the deal with measles and what should I know?
Measles is highly infectious. Highly. It can be spread through coughing, sneezing, breathing the same air as an infected person, sharing food or drinks, sharing a cigarette and yes, even through kissing a person with measles.
The measles virus can survive for several hours in small droplets in the air.
Most people will recover but those with a weak immune system or infants could experience serious complications. Those could include encephalitis (an infection and swelling of the brain), meningitis, pneumonia, deafness and infection of the liver.
Measles in B.C. is usually rare and linked to cases of unvaccinated residents returning from overseas travel.
How do I know if I have measles?
The incubation period is about 10 days and the symptoms include fever, cough, runny nose and red eyes, followed by a rash that starts on the body and spreads to the limbs. The rash lasts at least three days. You may also have small white spots inside your mouth.
The symptoms can begin as early as a week after being infected.
Some people may have measles, be infectious and not even know it. Those who are infected can spread the virus anywhere from four days before to four days after a rash appears.
How do I protect against measles? How do I know whether I’ve been vaccinated?
Health officials recommend two doses of the MMR (measles-mumps-rubella) vaccine to be fully protected against measles. The first immunization is usually received at the age of one, while the second usually comes before starting kindergarten.
If you’re unsure if you’ve been vaccinated, the first stop is to check your health records.
Born in or after 1994 here in B.C.? You’re likely to be immune because those born in or after 1994 here in B.C. will have had two doses of the MMR (measles-mumps-rubella) vaccine, the first dose when they turn a year old and a second before starting kindergarten, as part of routine vaccinations.
Born between 1970 and 1994? Grew up outside of B.C.? You may have only received one dose of the MMR vaccine. You’ll need a second dose to be protected.
Born before 1970? Or you’ve already had measles in the past? You’re likely to be immune.
Can’t remember if you’ve had one or two doses of the vaccine? The Canadian Centre for Disease Control says adults who do not have evidence of immunity should get at least one dose of MMR. It’s entirely safe to get the vaccine again.
I’m not vaccinated and I’ve been exposed to measles. What now? How do I treat it?
If you’ve been exposed to measles and you’re not vaccinated, you’ll need to get a dose of the MMR vaccine within 72 hours of exposure to prevent the illness.
But wait – don’t go to the emergency room or a doctor’s office without calling first. You’ll be highly contagious and the last thing you want is to spread it even further. Calling ahead will allow doctors make arrangements for your arrival and to ensure you’re isolated from other vulnerable patients.
Students at Fleetwood Park Secondary School in Surrey are being told to stay away from class if their measles immunization is not up to date. Sean Gallup / Getty Images
A second case of measles has been confirmed in the Vancouver area.
It was transmitted locally, meaning the patient was not infected while travelling abroad, Dr. Althea Hayden of the Vancouver Coastal Health Authority said at a news conference on Wednesday. She would not give details about the patient but said they are a school-age minor.
The other case, acquired abroad, was confirmed on Saturday but past the point of being infectious. Hayden said there is no clear link between the two cases. Her health authority’s region includes Vancouver, Richmond, the North Shore and the Sunshine Coast.
“We are working very hard to find out how measles may have been introduced into our community,” she said. “We would be much less concerned about it if we knew exactly where it came from.”
The health authority last released a public measles alert in September, after an infected person attended the Skookum Festival.
Spokespeople at the Fraser, Interior, Island and Northern health authorities said Wednesday that they had not heard of any suspected or confirmed cases of the disease in their regions.
In the State of Washington, a surge in measles cases prompted Gov. Jay Inslee to declare a state of emergency on Jan. 25. As of Wednesday, 54 cases had been confirmed. Health officials are urging residents to get immunized. Four more cases have been confirmed in Oregon.
Measles spreads through the air when an infected person coughs or sneezes, according to Vancouver Coastal Health. Complications can include inflammation of the brain, convulsions, deafness, brain damage and even death.
Infection does not require close contact and measles can survive in close areas, such as a bathroom, for up to two hours after an infected person has left. It causes fever, red eyes, coughing, a runny nose and a rash. Most people recover within a week or two.
Measles is easily prevented through vaccination, which Vancouver Coastal Health recommends. People who have previously had the infection do not need immunization.
B.C. children born in or after 1994 routinely get two doses of the measles, mumps and rubella (MMR) vaccine, one dose when they turn a year old and another before they start kindergarten.
People born before 1994 or who grew up outside of B.C. may need a second dose. People born before 1970 are likely immune; but if they aren’t sure whether they have had the infection, they can safely get the MMR vaccine.
The World Health Organization named “vaccine hesitancy” one of its top 10 threats to global health in 2019. Measles saw a 30 per cent increase in cases globally between 2016 and 2017, and a resurgence in some countries that were close to eliminating it, according to the organization.
“The reluctance or refusal to vaccinate despite the availability of vaccines – threatens to reverse progress made in tackling vaccine-preventable diseases,” according to the WHO. “Vaccination is one of the most cost-effective ways of avoiding disease – it currently prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved.”
In Canada, immunizations are not mandatory. But Ontario and New Brunswick require proof of immunization for children and adolescents to attend school, according to Immunize Canada.
In the U.S., all 50 states and the District of Columbia have laws that require children entering childcare or public schools to have certain vaccinations. All state laws provide medical exemptions, 17 states allow religious or medical exemptions only, and five states expressly exclude philosophical exemptions, according to the Centers for Disease Control and Prevention.
The B.C. Centre for Disease Control tracks child immunization and reports that 82.1 per cent of children aged seven had been immunized for measles in 2018, compared to 88.4 per cent in 2017 and 90.2 per cent in 2016.
Across Canada, only a single new case of laboratory-confirmed measles was reported between Dec. 30, 2018, and Jan. 26, 2019, according to Health Canada’s most recent measles and rubella monitoring reports.
The agency said there have been large measles outbreaks reported across Europe which have affected many countries.
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