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BackgroundSimilar to the social determinants of health, physical environment has a significant influence on health outcomes and well-being. The environment surrounding an individual can impact health outcomes in a variety of ways, whether it be from the built environment or the natural environment. Environmental influences on health can include factors such as air quality or waste disposal within the home, road safety, crime and violence within the community and natural hazards and insect borne disease within our ambient environment.
While everyone is at risk of being exposed to environmental hazards, those who are marginalized are typically at higher risk. Specifically, populations such as the elderly and children are more susceptible to harms associated with environmental hazards such as air pollution, lead exposure, and heat waves because of age and weaker immune systems. Further, many First Nations communities are at an increased risk to being exposed to environmental hazards, such as unsafe drinking water as evident by the that exist in many First Nations communities across B.C.
While nursing's contributions to environmental health dates back to influential nursing leaders such as Florence Nightingale, who recognized that the environment was a tool that could be manipulated to improve health outcomes,as well as Lillian Ward and Mary Breckenridge,who addressed issues of sanitation and clean water, many nurses are often unaware of nursing's role in environmental health. With emerging issues such as greenhouse gas emissions, use of toxic substances within daily care and cleaning products and incineration of medical waste many British Columbians continue to be exposed to a variety of environmental hazards that may cause adverse health outcomes. Further, nurses are presented with patients on a daily basis whose health conditions have been highly impacted by environmental exposures.
The precautionary principle, which is based on the a duty to prevent harm, indicates that preventive measures must be taken when there is a threat of serious damage, even if scientific evidence is not conclusive. While the precautionary principle has been used as a form of prevention, this principle is not always adhered to. Nurses across B.C need to utilize their position and voice to advocate for policies that protect British Columbians from hazardous environmental exposures that threaten their health and well-being.
- Environmental factors play a significant role in contributing to both positive and negative health outcomes.
- Various environmental exposures exist throughout B.C. All British Columbians, especially those who are marginalized, are at risk for experiencing adverse health outcomes as a result of these exposures.
- Addressing external physical and social contributors to health is a part of a comprehensive nursing assessment.
- Nurses are well positioned to identify the factors that contribute to both good and poor health, and advocate for healthy environmental policies.
- As stated in the CNA Code of Ethics for Registered Nurses, "nurses should endeavor as much as possible, individually and collectively to advocate for and work towards eliminating social inequities by supporting environmental preservation and restoration and advocating for initiatives that reduce environmentally harmful practices in order to promote health and well-being" (p.20).
- When an environmental exposure poses a serious threat, but scientific evidence is not conclusive, preventive measures must still be taken to protect the health and well-being of society.
Questions for Nurses
- Canadian Nurses Association. (2016). Nursing and Environmental Health.