Climate and the nursing profession

The health and well-being of people, indeed their survival, depends
fundamentally on a healthy environment: clean atmosphere and water,
fertile soils, pollution-free oceans and biological diversity.
Nurses believe that everyone has an obligation to protect and preserve
the environment for the benefit of human health.
Nurses have a shared responsibility to sustain and protect the
environment, whilst fulfilling their role of promoting, restoring and
maintaining health in people.
Nurses have a role in protecting the health of individuals by:
• Seeking to preserve a healthy environment which is fundamental to
the health of all communities and future generations;
• Utilising expertise and providing leadership to assist communities
to apply the principles of public health in building healthy
• Participating in partnerships to lobby and advocate for actions to
reduce impacts on health through environmental changes.
The interdependence and the interconnectedness of human health
with the health of the natural environment is a relationship formally
acknowledged by the World Health Organization (WHO) as interrelated
with the conditions and resources needed for health. The Ottawa
Charter for Health Promotion states that; “The fundamental conditions
and resources for health are peace, shelter, food, income, a stable
ecosystem, sustainable resources, social justice and equity” (World
Health Organization 1986, Prerequisites for Health, para. 4).
In 2012, 12.6 million deaths, representing 23% of all deaths and 22% of
the disease burden were attributable to modifiable environmental risks
(World Health Organization 2016a).
The WHO has identified that changes in climatic conditions can have
three types of health impacts:

  1. direct impacts e.g. heat waves
  2. health consequences of changes to ecosystems and biological
    processes e.g. mosquito borne infections, agricultural food yields
  3. health consequences of populations who are disrupted or
    The threat from environmental degradation to human health and survival
    has been recognised and expressed by the scientific community
    (Union of Concerned Scientist) and by the United Nations Environment
    Programme (UNEP). Human activity is the main cause of environmental
    Changing landscape patterns and biodiversity may be a key contributor
    to the outbreak of disease. Human-induced land use changes are
    primary drivers of a range of infections, and land use changes, food
    production and agricultural changes account for almost half of all global
    infectious disease emergencies that are transmitted from animals to
    people (World Health Organization 2016a). Stable ecosystems are
    vital to sustaining human life. The loss of biodiversity and changes to
    ecosystems can result in outbreaks of infectious diseases, risk food and
    nutrition security as well as protection from natural disasters (Romanelli
    et al. 2015).
    Described as the biggest reserve of biodiversity on the planet, oceans
    and other waterways provide food, medicines, biofuels and other
    products. They support the breakdown and removal of waste, support
    climate change mitigation and are valuable resources for tourism and
    recreation. The Food and Agriculture Organization stated, “the health of
    our planet as well as our own health and future food security all hinge on
    how we treat the blue world” (Food and Agriculture Organization of the
    United Nations 2014, Foreward, para. 4).
    Just as humans impact the environment, the environment impacts
    humans. Human activity influences the physical environment with
    resultant impact on peoples’ health. Higher temperatures increase both
    mortality and morbidity (Australian Institute of Health and Welfare 2011).
    Australia is already the driest inhabited continent on Earth and drought
    is an important feature of its highly variable climate (Steffen 2015). The
    relative risk of suicide can increase by up to 15 percent for rural males
    aged 30–49 as the severity of drought increases (Steffen 2015). The
    number of weather related natural disasters has tripled since the 1960s
    and these disasters claim 60,000 deaths each year (World Health
    Organization 2016b). The environmental influences on the determinants
    of health include the natural environment, the built environment and the
    individual’s responses to environmental influences (Veitch 2009).
    The design and structure of the built environment is an important
    determinant of lifestyle and health. There are direct associations with
    illness and mortality, such as motor vehicle accidents, as well as
    indirect associations, such as encouraging physical activity. The built
    environment may also affect mental health and child development
    through a lack of green space, overcrowding and environmental noise
    (Australian Institute of Health and Welfare 2011).
    That humans impact the environment is undeniable. This impact can
    be both positive and negative. We have a responsibility to affect the
    environment in a positive way when possible and reduce our negative
    impact at every opportunity.
    Health in All Policies (HiAP) is an approach to public policies across
    sectors to improve population health and health equity that takes into
    account the health implications of decisions, seeks synergies, and
    avoids harmful health impacts. It provides a means for considering the
    impact of policies on people’s health and health equity regardless of the
    primary aim of the policy in concern. Good health enhances the quality
    of life, improves workforce productivity, increases capacity for learning
    and strengthens families and communities. In an HiAP approach,
    the aim is that health is an outcome of all policies (World Health
    Organization 2013).
    The link between increasing air pollution and mortality has been
    well-documented (Cohen et al 2005; Xu et al. 1994). Air pollution is an
    important global risk factor for disease, with ambient particulate matter
    ranking 5th on the global ranking of risk factors for total deaths from
    all causes in 2015 (Health Effects Institute 2017). The United Nations
    Sustainable Development Goal 3 refers to improving health through
    improving environmental conditions. Specifically, target 3.9 states “By
    2030, substantially reduce the number of deaths and illnesses from
    hazardous chemicals and air, water and soil pollution and contamination”
    (United Nations Statistics Division n.d., p. 4).