Editorial from Dean Eileen Sullivan-Marx: Climate change, global health, and nursing scholarship

According to the World Health Organization (2014), global climate has significant effects on the social and environmental determinants of health through threats to clean air, safe drinking water, sufficient food, rising temperatures, and secure shelter. Threats to health as a result of climate change are a worldwide phenomenon having global repercussions for individuals and populations, including infectious and chronic disease, mental health, entomology, food security, disaster planning, and social disparities. 

Nursing’s international organizations, the International Council of Nursing and Sigma Theta Tau International (STTI), recognize the importance of the United Nations Sustainable Development Goals including climate change, particularly in relation to healthcare workforce development and health improvement of vulnerable groups (International Council of Nursing, 2017; STTI, 2005). In 2008, the American Nurses Association (ANA) published a resolution regarding climate change, stating that challenges faced as a result of global climate change are unprecedented in human history. Therefore, per ANA, nurses should support local public policies endorsing sustainable energy sources and reduce greenhouse gas emissions. The ANA also resolved support for initiatives to decrease the contribution to global warming by the healthcare industry. The American Association of Colleges of Nursing (AACN, 2011) has identified ways that institutions of learning and schools of nursing could address sustainability in buildings, classrooms, and embed sustainability within the practice of nursing. Issues of social and environmental justice along with disparities related to social determinants of health are all intertwined with climate change and health. Such complexity requires the development of theoretical frameworks for nursing that can guide nursing’s approach to climate change and health. 

In June 2015, President Barack Obama convened a White House Summit on Climate Change and Health, inviting deans of U.S. schools of nursing, public health, and medicine to commit to the development of curricula and research addressing climate change and health. Somewhat due to crowded content in curricula and lack of dedicated research funding for climate change and health, development of health professionals who are experts on this topic is lacking. Recognizing this need, the deans attending the summit agreed upon a commitment to improving this situation by promoting curricular changes and supporting research related to climate change.

Scientists are clear that the planet is experiencing extremes in climate change, but political debate lingers regarding the cause, human or otherwise, for climate change. Calls for commissions to address this debate are seen as both a way to address the divide but also as a lack of willingness to accept scientific evidence (Koonin, 2017). Regardless, it is clear that climate is changing, and nursing needs to rise above this debate to address the issue as part of our scope of a discipline that focuses on health promotion, disease prevention, and environmental measures within the interrelated concepts of person, environment, health, and nursing (ANA, 2010; Fawcett & DeSanto-Madeya, 2013). Nursing organizations are developing climate change guidelines and principles especially focused on teaching health professionals about climate change, vulnerability, and prevention of illness due to exposures to extreme weather events including heat, air pollution, and exposure to solar radiation. Downstream issues of responding to disasters associated with climate change and health is historically the most common way that nursing is visible in climate change issues, yet it is increasingly important for nursing and nursing science to address not only mitigation of climate change health issues but also engagement in the prevention of climate change through environmental sustainability. Worldwide, movement of populations due to drought, civil unrest, and food insecurity can give way to epidemics and health deterioration, particularly in underdeveloped countries and among vulnerable groups, including the aged, children under 5 years of age, and women of childbearing age.

Climate change is believed to be one of the largest threats to human health that the planet has ever experienced. The potential impact on human health is highly variable, depending on where one lives and works and the resources or social support available to communities. A recent paper in Lancet described that tackling climate change could be the greatest global health opportunity of the 21st century (Watts et al., 2015). The investigators pointed out that the effects of climate change are being felt today with severe weather events across our globe, but more importantly, the future projections represent an unacceptably high and potentially catastrophic risk to human health. Under the Obama administration, the U.S. Global Change Research Program produced a large report summarizing the impacts of climate change on human health in the United States (Crimmins et al., 2016). In this special issue of the Journal of Nursing Scholarship, nursing scholars present papers addressing the multitude of challenges that health providers face related to climate change and address compelling issues in the United States and globally.

The U.S. health sector is a leading emitter of greenhouse gas and non-greenhouse gas pollution. Watts et al. (2015) reported that the U.S. healthcare sector produces 10% of all greenhouse gas emissions, more than many countries throughout the world. These emissions are associated with increases that are being observed in conditions related to climate change, including respiratory and cardiac morbidity and mortality. The nursing profession has been engaged for many years advocating for the healthcare industry to reduce its carbon footprint through the adoption of practices to increase efficiency and decrease the impact on the environment. In this issue, Kurth (2017) presents a broad perspective on the importance of nursing in protecting planetary health and the significance of the contribution the healthcare industry can make in reducing greenhouse emissions.

Nursing has historically addressed the health needs and care of the nation’s most vulnerable individuals. Climate change will have the capacity to affect all of the earth’s inhabitants, but groups particularly vulnerable include those with low income, some communities of color, immigrant groups, indigenous peoples, children and pregnant women, older adults, vulnerable occupational groups, persons with disabilities, and persons with preexisting or chronic medical conditions. Several papers in this issue address these vulnerable populations and the important role that nursing can play in protecting their health.

This issue also highlights the important role that nursing educators can play in preparing the workforce of the future to care for populations experiencing uncertain climate change. Nursing’s role in addressing climate change cannot be done in a silo, but is dependent on interprofessional collaboration. Universities are working together to address the climate change challenge. The Global Consortium on Climate and Health Education funded by the Rockefeller Foundation and housed in the Columbia University’s Mailman School of Public Health is designed to bring educators together to share best scientific and educational practices and to design model curricula on the health impacts of climate change for academic and nonacademic audiences. This initiative began at the 2015 COP-21 conference in Paris, followed by the World Health Organization’s 2016 Second Global Conference on Health and Climate and addresses the need to mainstream climate change and health topics into medical, nursing, and public health training. With this initiative, 115 medical, nursing, and public health schools across the world have signed a pledge to add climate and health to their curricula in order to equip their students to face the climate change issues of the future. This will ensure a cadre of well-trained health professionals to serve as leaders for nations and businesses to address the challenges that we face. In addition, the Consortium will support the development of academic partnerships to assist under-resourced countries that face a disproportionate share of the burden of climate-related illness. We present in this special issue several papers that discuss curricular maps or frameworks for integrating climate change content into health professional education, nursing’s role in disaster preparedness, and prevention of illness related to climate change. Hopefully, the papers in this issue will serve to lay a beginning foundation for future engagement of nursing scholarship in addressing climate change globally.

Acknowledgments

The Guest Editors thank Jin Jun, MSN, RN, Melissa Ojemeni, MS, RN, and Billy Caceres, PhD, RN, for their support in the generation of context, background, and literature review for this special issue.

Eileen Sullivan-Marx, Guest Editor

Linda McCauley, Guest Editor

References

For a full list of references and PDF version of the article, click here.