Public Health Nurses Demand a Seat at the Climate Policy Table

Climate change is no longer a distant environmental problem—it is a full-blown public health emergency, and the nurses who stand on the front lines of community care say they have been sidelined for too long. At the 7th Global Network of Public Health Nursing (GNPHN) Conference held in Calgary, Canada, in July 2025, public health nurses from around the world gathered to confront a stark gap: while nurses routinely manage the health consequences of heat waves, floods, and infectious disease outbreaks, their collective voice in climate policy remains strikingly underleveraged. The outcome was a coordinated call to action, published as a policy brief in Public Health Reviews, that aims to transform scattered awareness into organized global advocacy.

The scientific case for urgency is well documented. Rising temperatures, extreme weather events, air pollution, environmental degradation, and the shifting geography of infectious diseases are already producing measurable adverse health outcomes while deepening inequities between and within nations. The World Health Organization has highlighted that climate hazards are associated with adverse maternal and newborn outcomes, including gestational diabetes, hypertensive disorders of pregnancy, preterm birth, low birth weight, and stillbirth. Climate exposure also weighs on mental health, contributing to stress, anxiety, and depression. Heat waves, floods, and storms are increasing not only mortality and morbidity but also health inequities, hampering and even reversing global efforts to reduce disparities among populations.

The burden falls disproportionately on low- and middle-income countries, yet most climate-related research and advocacy efforts have been conducted in high-income settings. This asymmetry was a central theme of the Calgary session. Participants emphasized that low- and middle-income countries are home to Indigenous Peoples whose traditional knowledge, lived experiences, and leadership are essential for developing culturally responsive and locally relevant climate and health policies. Meaningful engagement of these communities, the nurses argued, should be treated as an integral component of equitable climate governance rather than an afterthought.

The policy brief, authored by Salimah R. Walani of Aga Khan University, Shahin Kassam of the University of British Columbia Okanagan, Zahra Shajani of the University of Calgary, and Aliyah Dosani of Mount Royal University, traces the institutional history of nursing’s climate engagement. The International Council of Nurses released its first position statement on nursing practice and climate change in 2008, revised it in 2018, and updated it again in 2024. The 2024 statement declared climate change the single greatest health threat and called on nurses to engage in global climate policy dialogue in support of evidence-informed, action-oriented strategies.

Despite that high-level endorsement, organized nurse-led climate advocacy remains scarce and geographically concentrated. The brief points to only a handful of collective advocacy groups, chiefly the Canadian Association of Nurses and the Environment (CANE) and the Alliance of Nurses for Healthy Environments (ANHE), both based in North America. CANE promotes planetary health and advocates for revisions to the Canadian Environmental Protection Act and a right to a healthy environment, while ANHE runs monthly transdisciplinary webinars, partners with environmental health coalitions, and provides input on policy guidelines. Both organizations have limited or no engagement with nurses from the low- and middle-income countries that bear the heaviest climate burden.

To probe this gap directly, the authors convened a 90-minute interactive think tank session titled

The think tank session itself offers a revealing snapshot of how the nursing profession is distributed across the global climate debate. Of the 28 participants, the first 20 minutes were devoted to structured discussion of climate-related research, practice, and policy, drawing on the perspectives of nurses working in health systems as different as Norway’s universal model and Liberia’s post-conflict rebuilding infrastructure. That such a session had to be deliberately convened at a conference—rather than emerging organically from standing professional structures—underscores the authors’ central diagnosis: the infrastructure for organized nursing climate advocacy simply does not yet exist at a global scale.

The four calls to action that emerged from the discussion deserve closer examination, because each addresses a distinct failure mode in how the health community has approached climate change. The first, building inclusive research through transdisciplinary collaboration, responds to a well-recognized problem in climate-health scholarship: the evidence base is heavily skewed toward high-income countries, leaving policymakers in the most vulnerable regions without locally relevant data. Public health nurses, who typically work embedded in communities rather than in laboratories, can generate grounded observations of how climate stressors manifest in daily clinical practice—patterns that may never surface in remote-sensing data or hospital admission statistics alone. Transdisciplinary collaboration, in this framing, means pairing nurses with climatologists, epidemiologists, and social scientists so that community-level realities inform research questions from the outset.

The second call, dismantling inequities by integrating gender and race into climate governance, reflects a growing body of evidence that climate impacts are not distributed randomly across populations. WHO analyses and broader public health literature consistently show that women, particularly pregnant women in low-resource settings, face heightened risks from heat exposure and climate-driven food and water insecurity, while racialized and Indigenous communities frequently occupy the most hazard-prone environments with the least adaptive capacity. The nurses’ argument is that governance structures—which allocate adaptation funding, shape evacuation planning, and determine health system preparedness—will reproduce these disparities unless gender and race are explicitly accounted for in policy design.

The third call, promoting language consistency through intersectional and equity-oriented frameworks, may sound procedural but carries substantial practical weight. When international bodies, national governments, and professional organizations use divergent terminology for climate vulnerability, resilience, and health equity, it becomes difficult to align research findings, compare interventions across borders, or hold institutions accountable to shared commitments. A common conceptual vocabulary grounded in intersectionality—the recognition that overlapping identities such as gender, race, class, and geography compound disadvantage—would allow nursing coalitions to coordinate advocacy across the very different political contexts represented in the GNPHN network.

The fourth call, integrating climate change content into nursing education, targets the pipeline. Most nursing curricula worldwide were designed before climate change was understood as a clinical and public health issue, and practicing nurses frequently report feeling unprepared to counsel patients on heat-related illness, vector-borne disease shifts, or the mental health consequences of displacement. Embedding planetary health into undergraduate and continuing education would equip the profession’s roughly 29 million members globally—by most estimates the largest segment of the health workforce—with a baseline literacy that no other single professional group can match in terms of community reach.

The decision by conference participants to form a global coalition is significant because it addresses the structural weakness identified throughout the brief. Existing nurse-led environmental organizations like CANE and ANHE have demonstrated that collective advocacy is feasible, but their North American base limits their reach precisely where climate-related health burdens are accelerating fastest. A coalition convened under the GNPHN umbrella, with members from countries including Pakistan, Kenya, Nigeria, Haiti, and Rwanda, could redistribute advocacy capacity toward the regions where policy engagement is most urgently needed—and where nurses’ firsthand accounts of climate impacts carry particular moral authority in international forums.

The timing of this mobilization aligns with broader momentum in the health sector’s climate engagement. The World Health Organization has established climate change and health as a priority program area, and successive United Nations climate conferences have featured dedicated health days, signaling growing recognition that health systems are both victims of and responders to climate disruption. What has often been missing from these discussions is the voice of frontline community health workers, and public health nurses are arguably the largest and most trusted constituency within that group. Their daily contact with populations experiencing climate impacts firsthand positions them to translate abstract policy targets into concrete accounts of what rising temperatures and intensifying storms actually do to pregnancies, chronic disease management, and community mental health.

The policy brief’s framing of climate change as a determinant-of-health issue rather than a purely environmental one is also analytically important. By situating climate within the same conceptual architecture that public health nursing applies to housing, income, and food security, the authors make the case that climate response belongs within core nursing practice rather than being treated as a specialist concern. This reframing matters for resource allocation: when climate is understood as a structural determinant shaping every community health interaction, investments in nursing workforce preparedness become as fundamental as investments in meteorological monitoring or emergency response infrastructure.

What remains to be seen is whether the coalition formed in Calgary can sustain momentum between conferences and secure the institutional funding that advocacy work requires. The history of professional mobilization on environmental health suggests that durable influence depends on sustained presence in policy processes—comment periods, national adaptation plan consultations, and international negotiations—rather than episodic statements. The four calls to action provide a roadmap, but their realization will depend on whether public health nurses across income settings can build the organizational muscle that their counterparts in medicine and public health advocacy have spent decades developing.

Subject of Research: Public health nurse advocacy as essential for addressing the health impacts of climate change

Article Title: Public health nurse advocacy as essential for addressing the health impacts of climate change

Article References: Walani, S. R., Kassam, S., Shajani, Z., & Dosani, A. (2026). Public health nurse advocacy as essential for addressing the health impacts of climate change. Public Health Reviews, 47, Article 1609391. https://doi.org/10.3389/phrs.2026.1609391

Image Credits: AI Generated

DOI: 10.3389/phrs.2026.1609391

Keywords: Public, health, nurse, advocacy, essential, addressing, impacts, climate, change, scientific research