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  1. Valentine-Maher, Sarah K. MSN, RN, FNP
  2. Butterfield, Patricia G. PhD, RN, FAAN
  3. Laustsen, Gary PhD, RN, FNP, FAANP, FAAN


Human health is substantially impacted by the state of the environment, and environmental degradation has a disproportionate impact on persons with less immediate access to financial and social power. This article calls for upstream nursing action to address the natural environment in order to turn about health injustices and improve health for all. Such action would move nursing towards a greater actualization of the nursing environmental domain. The health impacts of climate change, air and water quality, and toxic chemical exposure are substantiated and specific policy leadership recommendations are proposed. Recommended actions include work to build environmental health literacy and empowerment, advocacy for regulatory protection and enforcement, and environmental engagement within health care systems.