American tariffs and fears of a prolonged recession have increased calls to expand resource development and infrastructure projects in Canada. The pace and scope of expansion projects like these have major implications for Canada on many levels, including: commitments to environmental sustainability, relations with Indigenous Peoples and the quality of local health services.
In a study that I conducted with environmental health researcher Barbara Oke in northern British Columbia, we found that major resource projects can strain local health-care services in rural and remote regions. In particular, the influx of workers connected with development projects puts significant pressures on health-care providers. This is especially concerning as local health-care services are already experiencing funding, infrastructure and staff shortages.
Therefore, it’s critical that government and industry actively consider these pressures when planning new projects.
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Health-care services under pressure
(Barbara Oke), Author provided (no reuse)
In recent years, northern British Columbia has been home to some of the biggest capital investment projects in Canada, including a major hydroelectric dam, liquefied natural gas (LNG) facilities, pipelines and mines.
Our interviews with leaders from Northern Health, the region’s main health-care provider, have highlighted the link between major development projects and the pressures experienced by their health-care system.
Pressures on the local health-care system mainly stem from the influx of a non-local workforce when compared to the size of the nearest community, and local contexts. The smaller the community, the more vulnerable its health-care system is to additional pressures, especially if capacity challenges already exist.
How well a project manages its health service impacts clearly matters. When project workers resided in well-managed camps supported by competent onsite medical service providers, the pressures on the local system were less than when workforces did not have adequate accommodation and health supports.
An older workforce
Contrary to some popular assumptions that itinerant project workforces consist mainly of young, risk-taking individuals, most workers seeking health-care services were older and managing multiple chronic illnesses or disease risk factors.
Therefore, most of the pressure on health-care services did not come from what one would consider typical “workplace injuries” but, rather, from workers experiencing injuries and illnesses common within any population.
One health-care interviewee said: “It’s not that [project workers] are asking for special services, but just having more people needing health care adds to [the] pressure.”
Emergency departments
Impacts to the health-care system were felt primarily in the emergency departments of local hospitals and health-care centres.
Many communities in northern B.C. do not have walk-in clinics and most doctor’s offices are already at patient capacity.
So if a project does not provide its own on-site medical supports, the only option for workers is to seek care at a local emergency department, which are supposed to respond to urgent issues.
When staff have to deal with non-urgent needs, such as prescription renewals, sick notes or to manage regular ailments, it compounds the challenges and congestion faced by emergency departments.
(Barbara Oke), Author provided (no reuse)
Cumulative impacts on health services
Beyond emergency departments, industry pressures have cascaded throughout the system, affecting services such as primary care, infectious disease, diagnostic and lab services, and administrative and ambulance transfer services.
Rising workloads, combined with higher private-sector wages and an industry-driven increase in the cost of living, have made it harder to retain and recruit staff — especially in housekeeping, food services, laundry, administration, ambulance services and care aide roles.
Several people interviewed noted the consistent and cumulative pressures of projects on the health-care system.
While the pressures from a single project may seem inconsequential, the impacts from multiple projects in the same area pose a significant challenge to health-care services.
Balancing resource development and health care
The strategic and economic value of resource development is difficult to ignore.
Major infrastructure projects contribute to both local and provincial economies. When managed well, the economic benefits of such projects can positively contribute to community health.
But when not managed properly, the pressures that major infrastructure projects place on local health-care services can be significant. Therefore, we strongly urge governments and businesses to consider their impacts on overburdened and hard-working health-care providers in rural and remote communities.
Barbara Oke contributed to this article. She recently completed her Master’s of Arts in Political Science at UNBC.
