Global climate change is a health concern, and one which should be incorporated into practice by those working to advance health care reforms towards a healthier population (Sayre et al., 2010, Richardson et al., 2014). Nurses and healthcare providers therefore have a particular interest in preventing the problems while mitigating the potential outcomes, including the challenge of healthcare during catastrophe and increased urgent situations due to air pollution and heat triggering problems in existing conditions. The purpose of this paper is to review the implications of global climate change and health in the field of nursing and the provision of healthcare as well as direct actions that nurses can take in order to support healthy outcomes through prevention.
Health concerns related to global climate change
There are several health concerns related to global climate change. Climate change modelling has shown that we should expect the increase in greenhouse gases to lead to extreme weather which can be the cause of increased temperature, a rise in sea levels, and drought and these can be the cause of health issues as they trigger or exacerbate existing conditions and catastrophic events may lead to urgent health situations (Sayre et al., 2010). This is a critical issue for public health objectives, and preparations must be in place.

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The most efficient health promotion and protection strategy would be the prevention of such impacts by reducing carbon emissions and harmful waste in the environment. Clearly, nurses have the capacity to use their knowledge and expertise to take action towards a healthy community but also a healthier world by strongly supporting an end to the American practice of oil and gas dependence for energy giving the alternate options that are available. A community level nursing program which can have an impact is social marketing of the importance of environmental health. This might include several main messages including the impacts of toxins in the environment, the impacts of climate change, and the strategies which households can use to reduce their emissions and protect their own health.

U.S. comparison
Every country takes a unique approach to climate change, and this provides comparison and potential insights with regard to implementation strategies in the United States. Some developed countries, such as France, have implemented systems that ensure that their energy comes from sources other than oil and gas. Other countries, such as Kiribati, have real concerns with regard to the potential damage caused to their population due to events predicted at the cause of climate change.

In France there appears to be more general concerns with ensuring environmental health, and this is reflected in the choices that this nation has made with regard to the production of energy as well as how households manage their consumption of energy and waste. France continues to have concerns about a more temperate climate as heat waves cause problems for persons with respiratory disease and make existing conditions for many people worse, leading to a greater number of emergency room visits (Sayre et al., 2010).

Kiribati is a low lying island nation in the Pacific Ocean near the equatorial region that has considerable concerns as the rising sea levels and extreme weather would leave the country vulnerable to flooding and catastrophe (McIvor et al., 2015). The impacts on health and providing health care would be drastic, as the flooding can lead to conditions which are unhealthy and spread water borne contagions, in addition to the problems it would pose for the economy and maintaining everyday lifestyles (McIvor et al., 2015). For example, flooding is associated not only with water borne illnesses such as cholera and dysentery; it is also a stressor that can exacerbate cardiac conditions and mental illness (Tapsell et al., 2002). The impacts of flooding can cause damage to psychological and other aspects of health long after the physical flooding has subsided, and this poses further problems for preventative healthcare and a proactive nursing approach (Ohl & Tapsell, 2000).

The US, unlike France, is dependent on petroleum for energy. In fact, the Kyoto Protocol was rejected by the American government as it would have a great impact on economic objectives, which are known to have a carbon emissions increase for each dollar of growth. The United States has sufficient land mass to avoid the concerns of Kiribati, however it has been a more of a contributor to climate change that the less developed nation. This is despite not bearing the burden of the results of these emissions. For comparison, population of the United States has a carbon emissions output of 17.56 metric tons per person (World Bank, 2016). This is far greater than the 5.2 metric tons per capita used in France, or the 0.64 metric tons of carbon emissions per capita produced by the population of Kiribati (World Bank, 2016).

Global climate change is a concern for public health, and this makes it a concern for nurses and the provision of healthcare in general. Nurses can seek the best possible outcomes for patients and communities by looking at local and broader level initiatives, from supporting national emissions reductions to community level initiatives to raise awareness of waste management. Attention to all opportunities to meet the challenge posed by climate change requires both educating patients and their families regarding actions they can take to reduce harm to the environment as well as preparing for the health problems which accompany higher temperatures and extreme weather events.

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