The impact of globalization and environmental change on health: challenges for nurse education.

The environment is an established domain of nursing knowledge, but some authors argue that the traditional perspective is too narrowly focused on the immediate environment to appreciate the relevance of the global environment. This article explores how human activities are bringing about global changes through their impact on biogeochemical cycles, land use and mobility of organisms, altering biodiversity and climate, and ultimately compromising the ecosystems services that sustain our planet. The consequences of global change for population health are examined, including the emergence of drug-resistant diseases, and the implications of climate warming and pollution for health. Addressing these issues presents a considerable challenge for nursing at all levels, in promoting sustainable policies, integrating environmental considerations into clinical practice, and in the nursing role as health educators. The greatest challenge is to education, to raise awareness of the relevance and importance of the global environment to health, and to empower nurses with sufficient understanding of the issues to apply them to practice, participate in debate and contribute to policy-making that aims to reduce the burden of global changes. The extent to which the profession is prepared to diversify in response to these challenges is discussed. Copyright 2002 Harcourt Publishers Ltd.