Chapter 27: Environmental & Ecological Determinants of Health

Environmental & Ecological Determinants of Health introduces the concept of the Anthropocene, an era marked by human activities that significantly threaten these foundational resources through global changes such as climate change, pollution, and the depletion of natural assets. Central to this discussion is the reality of environmental health inequities, which arise when certain populations face disproportionate exposure to toxins or lack access to resources based on their geographic, geopolitical, or social locations. The text highlights that vulnerability is often determined by developmental stages, specifically noting that children and older adults possess limited physiological defenses against environmental stressors. To address these challenges, the chapter advocates for the integration of Traditional Ecological Knowledge and Wisdom (TEKW) from Indigenous perspectives, utilizing the holistic "Two-Eyed Seeing" framework to bridge the gap between Western science and ancestral understandings of the land. Theoretical approaches such as planetary health and intersectional ecological-feminist perspectives are presented to expose and dismantle the power structures that facilitate environmental exploitation and social oppression. For community health nurses, practice involves engaging in five distinct levels of prevention: primordial efforts to influence environmental policy; primary prevention through education on healthy living spaces; secondary screening for environmental risks; tertiary management of existing conditions; and quaternary prevention to minimize over-medicalization and its chemical impact on ecosystems. The narrative also emphasizes "co-benefits," where interventions like urban greening or sustainable transport improve both ecological integrity and human well-being. Finally, it explores salutogenesis, focusing on the health-enhancing properties of nature and the therapeutic potential of human-animal connections to foster a more just and sustainable future.