Overview & Summary: Planetary Health: A Call for Global Leadership in Healthcare

As a family nurse practitioner and an educator dedicated to caring for the health of patients and communities in New Mexico, I understand the importance of identifying and addressing the myriad factors that influence health. Like many of us, I have witnessed firsthand how health literacy and individual lifestyle behaviors shape health outcomes, and Ihave incorporated new science in   genetics, epigenetics, the resilience of the immune system, and the microbiome    to guide my care of patients.  I understand how the social determinants of health (World Health Organization [WHO], 2025b), including economic opportunity, stable housing, reliable access to transportation and healthcare, and a sense of dignity, belonging, and fairness/equityand how these impact overall health. Overtime I have also seen   how additional environmental forces, including pollution, drought, extreme weather, and biodiversity loss, impact the people and communities I care for. I know how wildfire smoke and poor air quality during our "fire season" affect myself and my patients, and I have cared for people impacted by exposures to contaminants in their water supply, volatile organic compounds in their homes and workplaces, heavy metals in their land and food, and a wide variety of air pollutants.

These experiences have shaped my identity as nurse and have informed my understanding of how our environment and the ecosystems in which we live shape our health. As Earth's natural systems are increasingly threatened, we are recognizing more clearly that human health is profoundly influenced by planetary-scale environmental determinants, including climate change, biodiversity loss, pollution, ecosystem degradation, and the cumulative environmental exposures people encounter throughout their lives. The WHO (2025a) has estimated that approximately 25% of the global burden of disease are attributable to unhealthy environments, most of which are preventable. Because human health cannot be separated from the health of our environments, the framework of Planetary Health provides guidance on how these environmental forces shape health. This concept informs me about how I can move in nursing to address these complex, wicked problems.

Planetary Health is a transdisciplinary field that examines the impacts of human activity on Earth's natural systems and the consequences for human health and well-being now and for future generations. It asks us to recognize broader global patterns and respond to emerging health threats, including extreme weather events, displacement and migration, changing infectious disease patterns, chronic illness burdens, food and water insecurity, mental health strain, nutrition deficits, and maternal and child health challenges. This framework centers the stability of Earth's life-support systems as essential for human flourishing and expands our understanding of health beyond the absence of disease toward the well-being of individuals, communities, and ecosystems together. Planetary Health encourages us to learn from Indigenous knowledge systems that have long understood reciprocal and sustainable relationships with land, water, and nonhuman life. It also calls us to listen to frontline communities who experience environmental harms first and most intensely. Through these skills and sensibilities, we can deepen our practice in ways that honor both local wisdom and global interdependence. This work also asks nurses to engage with humility, recognizing that scientific knowledge and lived experiences, along with deep caring and visionary solutions, offer essential pathways toward collective healing.

As nurses we are guided by the United Nations Sustainable Development Goals (n.d.), which recognize that human flourishing depends upon interconnected social, economic, and ecological conditions. These goals affirm access to food, water, housing, energy, healthcare, education, income, decent work, peace, justice, political voice, social equity, and gender equality as foundational conditions for health, while also respecting planetary boundaries such as climate stability, biodiversity, ocean health, freshwater availability, and air quality as ecological ceilings that cannot be exceeded without consequence. Nurses who incorporate these goals can shape the quality of care and how that care is equitably distributed across populations and generations. In practice, this translates to advocating for sustainable healthcare models, reducing food and healthcare waste, prioritizing disease prevention, and reducing transportation burden. It also involves supporting policies that protect clean air and water, resilience food systems, strengthening disaster preparedness, and engaging patients in conversations about how environmental changes impact their health and daily lives. By centering the concepts of fairness and equity throughout this work, and by recognizing that environmental harms disproportionately affect those who contribute least to their creation, nurses can model a path forward that is grounded, relational, and hopeful. In doing so, we can reaffirm our enduring commitment as nurses to protecting health not only for individuals in the present moment, but also for communities, ecosystems, and generations yet to come.

The articles in this OJIN topic are united by a singular purpose: to guide us as we integrate Planetary Health into our work in nursing. With this, we can move beyond reactive healthcare modules to proactive preventive health and ecological stewardship. In these pages, we are called to understand the full spectrum of all the determinants of health, and to use our trusted voices to lead the way in addressing the ecological crises that threaten our collective future. Planetary Health invites a fundamental shift in how we understand our role as healers in a changing world.

In "Nursing for Planetary Health: Changing our Paradigm to Ensure our Future," Teddie M. Potter introduces the modern field and framework of Planetary Health as a transformative lens through which nursing must reimagine its purpose and practice. Potter illustrates how the health of the planet and human health are fundamentally intertwined and asks nurses to recognize that the overlapping environmental crises, including climate change, biodiversity loss, and degradation of air, land, and water as important determinants of patient and community well-being. Drawing on the principle of interconnection, she advocates for a paradigm shift in nursing practice, urging us to reconceptualize communal care and ecosystem stewardship as essential prerequisites for health and the sustenance of all life. Potter brings our attention to the ethical guidelines recently published by the American Nurses Association, which affirm nurses' responsibility to protect human health and the environment, positioning our profession to lead systemic change. By embracing “Nursing for Planetary Health” as a new way of approaching our work, nurses can fulfill their ethical mandate to safeguard the well-being of current and future generations while advancing sustainable, equitable healthcare systems.

In "Integrating Sustainable Healthcare into UK Nursing and Midwifery Practice," Lucy Brown discusses how nurses and midwives, as the largest professional group within the global health workforce, are uniquely positioned to lead the transition toward sustainable healthcare in the face of climate change, biodiversity loss, and ecological degradation. Noting that healthcare systems are both responders to and contributors of these crises, Brown discusses the policy landscape in the United Kingdom, including NHS England's commitment to becoming the world's first net-zero national health system, and explores how sustainability principles can be embedded into everyday clinical practice. Brown calls for sustainability to be integrated into routine clinical decision-making, and for nurses and midwives to be empowered as leaders of change. Through education and healthcare leadership, they can achieve a whole-system approach that enables both individual clinicians and policymakers to reconcile healthcare's dual role as both protectors of health and contributors to environmental harm.

In "The Planetary Health Report Card for Nursing: Development, Implementation, and Global Impact," Ryne Wilson and colleagues describe the creation and early outcomes of the Planetary Health Report Card for Nursing (PHRC-N), a student-driven, metric-based evaluation tool adapted from the original 2019 PHRC for medical schools. Their work is rooted in the realization that nurses often feel underprepared to address climate-related health impacts due to gaps in formal education. The authors discuss how the PHRC-N empowers students to take an active role in shaping how nursing programs respond to the evolving understanding of health as inseparable from the health of natural systems. They describe how the PHRC-N aligns with evolving accreditation standards for nursing schools and offers a structured, student-led pathway to move planetary health from aspirational ideas to actionable accountability, preparing graduates to meet the urgent demands of a changing planet.

In the article, “Transforming Nursing Curricula to Address Planetary and Global Health: A Canadian Exemplar,” Barbara Astle shares insights for integrating the concepts of Planetary Health into nursing education through an approach that combines the Planetary Health Education Framework (PHEF) with the Consortium of Universities for Global Health (CUGH) Global Health Education Competencies Tool-Kit. Through a detailed exemplar, Astle provides education strategies that nurse educators can implement in their curricula. These strategies will equip the next generation of nurse leaders with knowledge and skills to co-create solutions across all areas of nursing to address the complex challenges inherent in planetary health and global health.

In this article, Terzioglu and colleagues provide a thoughtful review of the multifaceted impacts of climate change and ongoing environmental degradation on women's reproductive health. They share current research on how exposures to common environmental hazards such as air pollution, endocrine-disrupting chemicals, and extreme heat, directly contribute to myriad reproductive health issues, including infertility, menstrual irregularities, hypertensive disorders, preterm birth, and adverse neonatal outcomes. The authors offer their insights into limitations that exist in current global reproductive health policy frameworks and guide us on how these can be updated to incorporate both environmental and reproductive health indicators to promote a better understanding of the 'environment–health–gender relationship.' These authors present a strategic roadmap that recognizes nurses' unique role at the nexus of clinical care, community education, and policy, and guide us in addressing the reproductive health challenges posed by climate change and environmental degradation.

I hope this OJIN topic inspires each of you to use Planetary Health as a lens through which you move in your own work as nurses in practice, education, advocacy, research, leadership and personal and professional sustainability. The journal editors invite you to share your response to this OJIN topic either by writing a Letter to the Editor or by submitting a manuscript which will further the discussion of this topic which has been initiated by these introductory articles.

Disclosure: The author acknowledges the use of Lumo, an AI assistant by Proton, for editorial suggestions in the original work of this introduction.

Author

Heidi Honegger Rogers DNP, FNP, APHN
Email: hrogers1@salud.unm.edu

Heidi Honegger Rogers is an Associate Professor at the University of New Mexico (UNM) College of Nursing whose scholarship centers on Planetary Health, climate change and health, equity and justice, and interprofessional education. She co-leads Planetary Health projects with the UNM Center for Health Equity; Planetary Health and Preparedness and serves on the advisory team for UNM's Accelerating Resilience Innovations in Drylands (ARID) Institute. She co-leads the Planetary Health Task Force for the American Holistic Nurses Association and collaborates with the Alliance of Nurses for Healthy Environments and the Planetary Health Alliance. As an educator she is committed to integrating a Planetary Health Lens into nursing and healthcare education, preparing future health professionals to address the interconnected wellbeing of people and ecosystems. She is also a facilitator with the Work That Reconnects and a certified Nature and Forest Therapy Guide.