Kim Jarvi is Senior Economist in the Policy Department at the Registered Nurses’ Association of Ontario (RNAO). His focus includes environmental, economic, and health policy. Kim sits on the advisory group of the City of Toronto and TAF project, TransformTO.  This is the fourth interview in our TransformTO Talks series with multi-sectoral experts.


TAF: Can you tell me about your current work and interest in the topic area of carbon and health?

Kim Jarvi: Our mandate is to speak up for nursing and to speak up for health. We interpret that mandate broadly to include all the determinants of health, including social and environmental health. In the latter case, carbon reduction has a lot of known health benefits and co-benefits. One part of our job is to enumerate and identify those benefits to make a political case. That’s the sort of work we do – we advocate for health and build the business case for tackling these issues by looking at preventative strategies. Preventing issues upstream is not only more humane, it’s actually a lot cheaper. It keeps people productive, out of the hospitals, and even out of the justice system.

TAF: You mentioned building the business case for environmental health – can you provide some examples of how climate action has potential to save on healthcare costs?

Kim Jarvi: Take for example promotion of more and safer active transportation. That reduces morbidity and mortality from inactivity and obesity, while reducing injury rates. It also reduces health effects by reducing automobile pollution. Similarly, more transit will increase activity level and reduce pollution. Quantification of impacts on health costs is challenging. But in the Greater Toronto and Hamilton Area, we could avoid conservatively $2.2 billion per year just in mortality costs associated with physical inactivity and traffic pollution by moderately increasing transit use and active transportation, according to the Medical Officers of Health. Another example is traffic, which costs Toronto alone $7 billion a year in congestion and which costs Canadians $4-7 billion related to the healthcare costs of air pollution. These are just some examples. They’re difficult to quantify and the real numbers are likely much higher. I see these as conservative estimates.

TAF: Why do you think it’s important to have an independent health voice at the table of climate change discussions?

Kim Jarvi: Nurses have the credibility, power, and responsibility to speak up on all health issues. We find that the RNAO voice is sought out by environmental groups because the health factor and the nursing voice is very compelling.  Politicians, decision-makers, and the media pay more heed to nurses than environmentalists, even if they are making exactly the same points.  There’s a lot of good will and collaboration between RNAO and environmentalists, which is absolutely necessary in order to get consistent messaging that will gain purchase with government and decision-makers.

TAF: Why did you personally agree to participate as an advisor in TransformTO?

Kim Jarvi: My first experience working in a collaborative with TAF was with Move the GTHA, which turned out to be a successful and effective use of resources. As with TransformTO, I felt that the focus on economy, health and social equity fit very well with our own mandate. It’s something we’d like to support and we’re hopeful that TransformTO will yield the same kind of progress that Move the GTHA has.

TAF: Where do you see the most significant overlap between deep carbon reductions and improved health?

Kim Jarvi: You can start by looking at short- and long-term policy strategies that tackle the major emissions sectors – transportation and buildings.  On transportation, we need to give more public space to transit and active transportation, as well as invest in transit infrastructure. We also need to create more compact sustainable communities where people don’t have to travel as far to get to work, shopping, and recreation. Our communities and lifestyles have shifted enormously in recent decades. It used to be possible for one person to work 40 hours a week and support a family – maybe spending five hours a week commuting. Now you’ve got two family members working, they’re working 80 hours a week, and they’re probably spending 20 hours commuting. They have no time for their kids and they’re super stressed. If they’re living far from their jobs, they’re going to fight attempts to make it harder to use their car for commuting. So you have to find some solution that addresses their challenges.

TAF: You also mentioned buildings. What are the major opportunities there?

Kim Jarvi: Buildings cause about 19% of Ontario’s emissions. Making buildings more energy efficient requires more stringent regulations for new buildings, as well as retrofits for old buildings. Building retrofits create a huge benefit through local employment. But you have to be very strategic about how you phase in these retrofits. You start with low-income and subsidized housing because that’s where the need is the greatest, where the living environments are the least healthy, so the retrofit can not only reduce energy waste, but can also make the building much healthier for the tenants. So the effort has not only a carbon reduction effect, but also a health effect and a local job creation effect.

TAF: And how do you recommend advancing these priorities? How do you phase them in so they’ll have support and longevity?

Kim Jarvi: My long term message is that the solutions are political and you have to address different groups with different concerns in a strategic way. You need to deliver solutions in ways that are credible, that support a strategy – and you need early wins to support a longer term vision. We need to create local jobs, but we can also question if we need to be working so much. And do we need to be working at the office or could people with desk jobs maybe work from home? Why, with all these technological advances do you need families to be working 80 hours per week?

TAF: What are some of the barriers to changing this?

Kim Jarvi: This comes to the question of skewed distribution of income. One family living downtown may be able to afford to have only one parent working – they can walk to work, have plenty of time for recreation, and a nanny looking after their kids. But those nannies don’t have time to take care of their own kids because they’re taking care of other families. The skewed income means that many people can’t afford to live in the city – they need to commute from further away and put their kids in daycare, which is expensive.  This is a market failure. What Brian De Pratto was talking about in your previous interview was about examples of market failure – negative and positive externalities. Negative externalities would be pollution, carbon, congestion, crowding. Positive externalities would be urban greenspace, trees, and so forth. The problem in a market situation is that there is no price on either of them. So you get way more pollution than if it were priced, and you get way less green space to enjoy because there’s no subsidy for them. The trees provide benefit to everyone, they’re absorbing carbon, they’re cutting down on heat, they’re absorbing pollutants, they’re providing great services, but there’s no private incentive to keep those things going. That’s one example of market failure, and the other is market failure of income distribution. The markets don’t always lead to equitable or fair distributions of income, which in turn drives some of these problems we have.

TAF: So by addressing some of these systemic economic failures, we could improve health and reduce emissions?

Kim Jarvi: Exactly. You can’t leave those things up to the market. You have to change things either by changing the pricing or using regulation; those are the two major available tools.

TAF: What are some of the ways we can encourage people to care about these issues? What are the stories that resonate most in the city that will encourage our politicians to take action?

Kim Jarvi: I’m hoping that this collaboration can help define some of the answers. Right now, there is a lot of media interest and public concern about pedestrian and cyclist fatalities, for example. This is something that hasn’t been quantified very much, but it’s now being reported more often. We’ve got more and more people competing for less and less space, and it makes less and less sense to have a bunch of single passenger cars out there. The more you can put a face on these problems, the better. Statistics are one thing –we do our best to quantify things, but we need better communications to translate those numbers into issues people care about.

TAF: What single piece of advice do you have for the TransformTO team to make this project successful?

Kim Jarvi: To see the path to a sustainable society, you need a strong vision. I would say, be as ambitious as you can, but make sure that this leads to a vision that gets from here to there. You also need to build political support by achieving early wins, and I think we should lead with health. We can quantify the health benefits and show that investing in these upstream solutions are not a trade-off but a cheaper way to make us healthier and more productive. Instead of fixing health problems that we cause, we want to stop them from happening in the first place.