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The Role of Nursing in Climate Change and Public Health

Gayle Morris, BSN, MSN
Updated February 20, 2023
    Nurses must be prepared to adapt and provide care in the face of challenges rising from climate change. Discover how your skill and influence can help direct policy.
    Credit: Maskot / Getty Images
    • Climate change triggers extreme weather events that impact access to healthcare, often disproportionately affecting populations of Black, indigenous, and people of color.
    • Nurses must also address care during extreme weather events to other vulnerable populations, such as the elderly, pregnant individuals, and children.
    • Climate change can lower air quality, increase food insecurity, and raise the incidence of allergies and respiratory conditions.

    Since 1981, the Earth’s temperature has risen 0.32°F each decade. This warming trend represents a significant amount of accumulated heat since the oceans have a tremendous capacity to absorb and disperse heat.

    These climate changes have resulted in temperature extremes, heavy rainfall in some areas and drought in others, changing habitats, and rising temperatures at the polar ice caps. In turn, the environmental challenges have resulted in public health problems that impact nurses and their patients.

    Our nurse contributors answered questions about how climate change has impacted nursing care and public health. Explore how nurses can get involved to protect patient care and public policy.

    How Does Climate Change Impact Nursing?

    Patrice K. Nicholas, DNSc, is the director of the Center for Climate Change, Climate Justice, and Health at the MGH Institute of Health Professions and codirector for Policy and Advocacy at the Massachusetts General Hospital Center for the Environment and Health.

    She knows that the adverse effects of climate change are critical to patients, families, communities, and populations. While they impact all individuals, they are particularly important to the elderly, pregnant individuals, and pediatric populations. One of the effects of climate change is an increase in natural disasters and extreme weather events.

    These can disrupt the delivery of healthcare and require the evacuation of patients. It can also cause the displacement of healthcare providers. In addition to making it more difficult for people to access medical care, it also places additional stress on healthcare workers.

    “As the largest group of health professionals worldwide, the nursing profession has a key responsibility in assessment, planning, intervention, and evaluation regarding impacts on health in a climate-changing world,” she says.

    With higher ambient heat, Nicholas notes that nurses must assess all populations for heat-related illnesses, particularly those who are most vulnerable. Poor air quality requires an in-depth assessment of adults and children with asthma and other chronic health issues who may experience heart and respiratory exacerbations when exposed to poor-quality air.

    “In addition, pregnant women who experience heat exposure and poor air quality are disproportionately affected by negative pregnancy outcomes including neonates with low birth weight, preterm birth, stillbirth, intrauterine growth restriction, and cardiac anomalies,” she says.

    Patients and Their Community

    Milagros Elia, MA, APRN, ANP-BC, is an oncology nurse practitioner with experience in clinical and community settings. She’s certified as a climate for health ambassador and has been appointed as a member of the ANA Innovation Advisory Committee for Planetary Health.

    She notes that according to the Lancet Countdown on Health and Climate, climate events have “the potential to disrupt core public health infrastructure and overwhelm health services.” She believes it’s vital for nurses to play a strong role within the healthcare system by advocating for the reduction of their institution’s carbon footprint, transitioning to clean renewable energy, and building climate-resistant facilities.

    “Nurses have a tremendous opportunity to protect their patients from the impacts of climate change by working to create sustainable, climate-smart hospitals and health systems,” she says.

    She goes on to say that nurses are well-positioned to connect the dots between patients and their local community’s decisions on environmental health. By extension, this also impacts the community’s health and well-being.

    In addition, climate change has an impact on changing patterns of disease transmission. This puts an added strain on healthcare and can increase the risk of outbreaks of diseases, such as malaria and dengue fever.

    These stressors have an impact on the mental health of both the patient and the nursing staff. The consequences of climate change can increase the risk of anxiety, depression, and other issues following natural disasters, extreme weather events, and other climate-related disruptions.

    Climate change has a significant impact on nurses, and more broadly, the healthcare system. It’s crucial that healthcare providers are prepared to adapt and find ways of continuing to provide quality care in the face of these challenges.

    9 Ways Climate Change Impacts Public Health

    The impact of climate change highlights health disparities across socioeconomic statuses as it affects the social and environmental determinants of health. People have different availability to clean air, safe drinking water, secure shelter, and food.

    Natural disasters are increasingly frequent occurrences; these contaminate the water supply and create food instability. Natural disasters also displace people from their homes and increase the potential risk of vector-borne diseases.

    “Chronic long-term environmental impacts of climate change like droughts, heatwaves, and air pollution, to name a few, cause short and long-term public health issues and disruption across health system factors that support prevention, screenings, diagnosis, and medical treatments,” says Elia.

    Unfortunately, the consequences to overall health inevitably harm some populations more than others. Black, indigenous, and people of color, as well as low-income communities, are disproportionately affected and experience systematically higher exposure to health-threatening climate conditions.

    The following are nine examples of how climate change has an impact on public health.

    1. 1

      Extreme weather events

      Even small degrees of warming cause more frequent and severe heat waves, droughts, and storms. These can lead to dehydration, heat stroke, and other heat-related illnesses.

      Other extreme weather events cut off healthcare to vulnerable and marginalized populations. It may affect the quality of drinking water and air quality. It could also increase food insecurity.

    2. 2

      Air pollution

      Rising temperatures can contribute to increases in air pollution. These have a serious impact on cardiovascular and respiratory diseases.

    3. 3

      Waterborne diseases

      Changes in precipitation patterns, flooding, and temperature can lead to the spread of waterborne diseases, such as cholera and vibriosis. Agricultural and industrial runoff during frequent storm conditions increases the risk of pathogenic contamination of bodies of water by bacteria, viruses, protozoan, and toxins.

    4. 4

      Vector-borne diseases

      Temperature changes affect the distribution and transmission of diseases, such as dengue fever, West Nile virus, and malaria.

    5. 5

      Food insecurity

      1816 was “the year without a summer.” The weather was unprecedented as cold temperatures returned throughout the summer months and farmers lost their crops.

      Ireland, the U.S., France, and England experienced food shortages. It was 100 years before scientists understood that a volcanic eruption in the Indian Ocean one year earlier had forced volcanic ash into the upper atmosphere, blocking the sun during the summer of 1816.

    6. 6

      Mental health

      People experience higher levels of anxiety, stress, and other issues as a result of extreme weather events and other disruptions to their life, such as food insecurity and higher levels of disease.

    7. 7

      Allergies and respiratory conditions

      Increased pollen production and air pollution have led to a higher level of allergies and respiratory issues. Data shows that climate change has triggered the pollen season to start 20 days earlier and last 10 days longer than in 1990.

    8. 8


      Climate change increases the risk that drought and monsoon seasons can last longer, impacting the ability of local people to grow food. Extreme weather events and other factors also increase the potential that individuals leave their communities and never return.

    9. 9

      Skin cancer

      Depletion of the ozone layer is one effect of high carbon emissions. This increases exposure to ultraviolet radiation, which in turn can increase the risk of skin cancer.

    Elia wants nurses to understand that they can make a difference as individuals and as a collective voice. Nurses can join well-established nursing organizations that specialize in the environmental health impact of climate change.

    They can also find an avenue for public advocacy by working within their own practice and supporting collaboration between disciplines to examine pathways in their institution to lower the carbon footprint. It is important for nurses to be at the table making decisions that help support the integration of evidence-based clinical practice to care for individuals who have been impacted by climate change.

    The Nurse’s Role in Climate Change and Public Health

    Nurses play a crucial role in addressing the impact of climate change on public health. They are frontline healthcare professionals who are positioned to identify and address the impact climate change has on individuals and communities.

    Nicholas believes that one of the primary ways that nurses can prepare themselves for the impact on public health for their patient populations is to be well-read.

    “Most nursing and health professions journals are increasingly addressing the health consequences of climate change in their professional publications. Nurses must commit to gaining further knowledge about the looming public health threat of climate change,” she says.

    For example, nurses can educate their patients about the risks of heat stroke or how to stay hydrated during heat waves. It’s crucial that patients understand the importance of protection against mosquito bites to reduce the risk of vector-borne diseases.

    Additionally, nurses can advocate for policy change at the local, regional, national, and global levels by supporting clean energy, protecting natural resources, and supporting the effort to reduce greenhouse gas emissions.

    Elia notes that the Alliance of Nurses for Healthy Environments is a nursing-led online resource that focuses solely on the intersection of health and the environment. Nurses can join the organization and participate in the vision to prepare nurses to overcome environmental health disparities and help ensure the environmental health of all people.

    Nurses can also focus on their workplace and communities by advocating for the use of green cleaning products, encouraging public transportation or carpooling, and supporting waste reduction and recycling efforts.

    Nurses can also participate by providing information and support within their local healthcare system that allows better responses to the healthcare challenges posed by a change in the climate.

    The role that nurses play in addressing climate change and its impact on public health is critical. Nurses have the knowledge, skills, and influence to make a real difference in the health of individuals and communities.

    Meet Our Contributors

    Portrait of Milagros R. Elia, MA, APRN, ANP-BC

    Milagros R. Elia, MA, APRN, ANP-BC

    Milagros Elia has been a nurse practitioner in oncology within both the clinical and community setting for more than 25 years. Elia has been a very active member of the Oncology Nurses Society for several years and in 2019 was appointed her chapter’s health policy liaison. In 2021, she became certified as a climate for health ambassador through ecoAmerica and since then has gone on to help initiate a new ONS environmental health focus group. This past year, she received the great honor of being appointed as a member of the ANA Innovation Advisory Committee for Planetary Health and was inducted into the Sigma Theta Tau International Honor Society of Nursing in recognition of her nursing leadership. Elia also privately owns and operates an educational programming service, M. Elia Nature-Based Healthcare Solutions, where she offers organizational workshops and presentations on environmental health, climate change, and healthcare system sustainability.


    Portrait of Patrice Nicholas, DNSc

    Patrice Nicholas, DNSc

    Patrice K. Nicholas is a distinguished teaching professor and director of the Center for Climate Change, Climate Justice, and Health at the MGH Institute of Health Professions and codirector for Policy and Advocacy at the Massachusetts General Hospital Center for the Environment and Health. She earned a bachelor of science degree in nursing at Fitchburg State University and both a master of science in nursing and doctor of nursing science degree at Boston University. From 1996-1999, she was a postdoctoral fellow at the Harvard T. H. Chan School of Public Health. Nicholas received a doctor of humane letters degree honoris causa from Fitchburg State University. She has authored/co-authored over 100 peer-reviewed manuscripts, two texts, and many presentations including several manuscripts on climate change, climate justice, and climate-related health consequences.