Nurse Leader Raises Awareness About the Environment’s Impact on Health

    • September 4, 2013

Problem: Research suggests that global climate change is having a dramatic—and negative—effect on public health. But nurse education programs and health professional schools do not teach students about the considerable effects of the changing environment on health, and there is little awareness about the subject in the health care system.

Background: Laura Anderko, a nationally recognized nurse leader who is known for her pioneering work at the intersection of health and the environment, never took a nursing course in what became her specialty. She didn’t learn about it in nursing school, and she hadn’t given it much thought when she started her career in the late 1970s—a time when the environmental movement was gaining momentum but hadn’t penetrated nursing education programs.

It wasn’t until about five years into her career, in fact, that she began to contemplate the effect of the environment on her patients’ health. It was a kind of awakening that came about during a disturbing visit to the home of a teen mother who had given birth to a baby with a grisly defect: He had been born without a brain. Anderko, then the director of a visiting nurse association in an industrial town outside of Chicago, sought to help the young mom grieve the loss of her child, but she was also curious about what might have had led to the baby’s life-ending abnormality.

At first, the case confounded her. The mother lived in poverty but was otherwise healthy. She had taken good care of her body during pregnancy; she had eaten well; she had taken her prenatal vitamins regularly; and she had avoided drugs and alcohol.

Then Anderko looked around the woman’s neighborhood, and what she saw disturbed her: a murky river polluted by industrial waste.

When Anderko returned to her office, she began to research the neurological effects of the kind of toxic chemicals that might be found in the river near the woman’s house. She couldn’t prove that the pollution caused the baby’s demise, but she suspected that he might have had a better chance had his mother had the good fortune to live in a cleaner, safer environment. “It opened up a whole new world for me as a nurse,” she recalls.

Anderko began to seek out more information on the effects of the environment on health and found relatively little research on the subject. At the time, most environmental scientists weren’t exploring the impact of their findings on public health, she says. And health professionals, on the other hand, weren’t studying the effects of the environment on patients.

Solution: Anderko became determined to change that. She sought out other environmentally-conscious nurses and helped found the Alliance of Nurses for Healthy Environments, an international network of nurses who are working to call more attention to the effects of the environment on health.

“Nurses are in an excellent position” to address the environment’s impact on health because we practice in a wide range of settings, including health care facilities, schools, and workplaces, she says. “We really are everywhere. We’re the most trusted health professionals. We sit in a perfect place to make a difference, not only to help people adapt to environmental changes but also to drive policy change.”

Anderko also decided to earn a master’s in nursing and a doctorate in public health, which marked the beginning of her teaching career. She began incorporating environmental subjects into her nursing classes, conducting research about the effects of the environment on health, and advocating for a cleaner, healthier planet.

In 2005, she was selected to be a Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow. During the three-year program, she conducted a project exploring nursing interventions related to methylmercury toxicity in people who consumed fish contaminated by coal-fired power plants. That led to a line of inquiry into the effects of global climate change on health.

What she found dismayed her. Studies show that climate change is already having a profound effect on public health, and those effects are likely to intensify. The changing climate is contributing to higher rates of vector-borne diseases such as malaria and dengue fever, due to milder winters that aren’t killing off mosquito and other insect populations; higher rates of heat exhaustion due to longer, hotter summers; and higher rates of asthma associated with increased ozone levels caused by rising temperatures and increased particulate matter. More extreme weather events, meanwhile, are leading to displacement and disease around the world and contributing to mental health conditions such as anxiety and depression.

After concluding the RWJF fellowship, Anderko began looking for a position that would enable her to focus on social justice issues and health, in particular environmental health. She found the perfect fit at the Georgetown University School of Nursing & Health Studies, where she is the Robert and Kathleen Scanlon Endowed Chair in Values-Based Health Care, a position she has held for almost five years.

At Georgetown, she teaches courses on health disparities, environmental justice, and epidemiology, conducts research on public health and environmental health issues, and works for policy change on Capitol Hill and in other venues. She has partnered with advocacy groups including the American Lung Association, the Climate Reality Project, and the U.S. Climate Action Network, and she has worked with government organizations such as the Environmental Protection Agency and the U.S. Department of Health and Human Services.

For her work in Climate Change and Public Health, she was recently recognized by the White House as a “Champion of Change”—an award that honors individuals, businesses, and organizations that “are doing extraordinary things to empower and inspire members of their communities.”

Because of the award, she was invited to discuss her work with top government officials and other “champions” at the White House—a day that helped her achieve her mission of raising awareness about the link between climate change and public health in the United States and around that world.

RWJF Perspective: Through its Executive Nurse Fellows (ENF) program, RWJF supports nurses, like Anderko, who are leaders and innovators in health and health care. The ENF program, she said, had a “huge impact” on her career and helped her to “think big” and “consider unusual and unlikely partners….It allowed me to really immerse myself in environmental health.”

RWJF also has a deep and long-standing commitment to narrowing disparities in health and health care. Anderko’s work supports this mission, as it focuses on social determinants of health—the conditions in which people live, work, and play—and the effects they have on underserved and low-income populations.