Reflections on Environmental Health And Justice in the wake of the Centenary Year of the Public Health Nursing Section

American Public Health Association Conference, November 12-15, 2023

by Robin Evans-Agnew, RN, PhD

Prologue: “Love, if understood as action, calls forth response and Responsibilities”1

I came to this meeting as a Public Health Section Member,

as an immigrant from Wales,

coming into the story of my Responsibilities

as a cis-gendered man nurse, school nurse,

            exploring environmental justice with other

            immigrants and children, and

nurses from around the world

Investigation2: “Our collective networks are ecological”3

We stayed until the end of the conference

To hear Dr. Vera speak

Of lessons for nurses who choose

The path to Planetary Health

Of Tsm’syen & Yaqui First Nations,

Her words wove a millennia

of nursing knowledge into the now

“Our collective networks are ecological,” she said.

I, white settler, writing this down

am moved to think of all of my relations:

            Welsh hillside, bog, and beach

            Down the lane

            My fathers crinkled hands

            Holding the orchid still,

  so that I might see

Negotiation: “We cannot solve the problems of climate change

with the same systems that created them”3

Lavinia Dock and Isabel Hampton Robb plotting

out Materia Medica4 for nurses should have listened to Dr Vera.

What I learned at Hopkins

Was not Dock’s political ardor,

                                                but separation/disconnection.

The environment, was outside

Not inside, not permitted to be


But if I had really listened to Dock,

            and followed her back to Henry Street

            and if I had

embraced the radical imagination of Emma Goldman5

I would have realized, that we

                                                are still not free

to be nurses for the Planet

In Welsh there are two words for landscape

Tirlun to look at

Tirwedd to be within

            My mother and father as botanists & ecologists,

                        Spoke to me about this:

                        “Plants are strange and wondrous beings”6

Action: “Violence in Mother Earth is violence on women”2

And now I am wading through the violence

of extraction in docklands of my home town

Tacoma, Land of the Puyallup Tribe of Indians

            Our nights are lit by burning flares

            Our days endure the clamor of import/export

            Our histories replete with stories

of detention, conviction, eviction, extraction7

I remembered Dr. Vera’s elegant defense of Mother Earth anew

– violence on Her is violence on women

And I grieve my failure to protect a woodland

in the heart of this chaos

And I struggle to justify this as the point of

nursing action

Climate justice, as we envision,

And endorse, as Public Health Nurses8

lifts up the justice issues of our time

These are multispecies justice issues:

            The social, racial, and economic violences

                        that bring despair, ecocide, genocide,

                        a warming earth, overburdened with aerosols,

                        rapidly acidifying oceans lapping land

                        irrevocably changed by erosion and erasure

That can only be addressed

Through solidarity with those under threat

Recovery: “Climate justice principle 36: Grow environmental consciousness

through transformative experiences in

embodied land-based, art-based,

storytelling, drumming, and dancing”9

Last night in despair

At the failures of my making,

At the conflicts and the silencing of voice;

I joined a vigil for hunger strikers

Outside the for-profit detention center,

            that houses climate migrants,

            encamped upon the clams and mud

            of the Tacoma tideflats

            on Stolen land

And the moment my feet touched the ground

Standing in a circle on this frontline with friends

Stamping out a drum beat through the soil

So that those caged and hungry inside might hear –

            singing “Chinga la Migra!

I knew I was home again.

I found recovery through regeneration,

            The tirwedd of song and dances of resistance stamped into the soil

– just enough recovery, – just enough love as action

            to resume the long struggle

towards a revolutionary future for nursing,

            for the fierce urgency of climate justice.

…and don’t stop me from singing and drumming

            Because if I cannot sing and drum,

                        then I too cannot be part of this revolution.

Epilogue: 100 years of Investigation, Negotiation, Action, and Recovery

“Climate Justice Principle 15. Advance environmental health, Planetary Health, and human rights

in nursing, public health, and healthcare education systems”9

Our Planet cannot heal without peace

Our allies stood up for human rights at the meeting in Atlanta

Passing in the waning hours of the third day

            A call for ceasefire in Gaza

Whittled down to one, poetic sentence.10

One of our members who witnessed the turmoil

recounted the ordeals of its crafting:

            grief, gratitude, pain, unity

It is to me a bleak but insistent call for peace,

            within a burning war machine11

Dr. Vera said, “Our collective networks are ecological”

            and I guess I see how

the unity of our collective networks under threat,

is a step towards engagement

with these ecologies of power.

The inspiration for this poem arises out of the great public health nurses I know: Stephen Padgett, Kia Skrine Jeffers, Jessica LeClair, Alex Dudek, Rose Atkinson, De-Ann Sheppard, Janeile Luebke, Katie Huffling, Lisa Campbell, Cara Cook, Doriam Camacho Rodriguez, Mary Joy Garcia Da, Beth Schenk, Jennifer Fricas, Denise Drevdahl, Ruth McDermott-Levy, Jenn Morin, Rita Munley-Gallagher, Sheila Stone, Julie Postma, Doris Boutain, Lori Edwards, Gina Alexander & June Strickland.


1Sheppard, D-A. M. (2020) p.55. Getting to the Heart of Cultural Safety in Unama’ki: Considering kesultulinej (Love). Witness: The Canadian Journal of Critical Nursing Discourse, 2(1) 51-65.

2The four strategies of organizing: investigation, negotiation, action, and recovery; as described in several talks given by Reverend Lawson, who organized non-violent actions with Martin Luther King: Lawson, J. M. (2022). Revolutionary Nonviolence: Organizing for Freedom (1st ed.). University of California Press.

3Vera, M. (2023). Planetary health for public health professionals: an Indigenous perspective. APHA Climate Change and Health Equity Lecture, PHN Section. Wednesday November 13. See also Redvers, N., Celidwen, Y., Schultz, C., Horn, O., Githaiga, C., Vera, M., Perdrisat, M., Mad Plume, L., Kobei, D., Kain, M. C., Poelina, A., Rojas, J. N., & Blondin, B. (2022). The determinants of planetary health: An indigenous consensus perspective. The Lancet Planetary Health, 6(2), e156–e163. 00354-5

4One of the first nursing texts was written by Dock and Robb at Johns Hopkins. Garofalo, M. E., & Fee, E. (2015). Lavinia Dock (1858-1956): picketing, parading, and protesting. American journal of public health, 105(2), 276–277.

5Connolly C. A. (2010). “I am a trained nurse”: the nursing identity of anarchist and radical Emma Goldman. Nursing history review, 18, 84–99.

6Wilson, J. B., Agnew, A. D. Q., & Roxburgh, S. H. (2019). The nature of plant communities. Cambridge University Press.

7Evans-Agnew, R. A. (2023). Climate justice is environmental justice: Public health nursing photovoice research for multispecies justice in the Port of Tacoma. Oral presentation, PHN Section. APHA Annual meeting November 12, 2023

8In 2021 the PHN Section participated with APHN in an international nursing effort led by ANHE to determine a Global Nurse Agenda for Climate Justice and present it at the global conference on climate change COP 26 in Glasgow, November 2021. The original Agenda can be found on the ANHE website:
See also PHN Scope and Standards #17, & LeClair, J., Evans‐Agnew, R., & Cook, C. (2022). Defining climate justice in nursing for public and planetary health. American Journal of Public Health, 112(S3), S256–S258. 306867

9Evans-Agnew, R., LeClair, J., & Sheppard, D.-A. (2023). Just-relations and responsibility for planetary health: The global nurse agenda for climate justice. Nursing Inquiry, e12563–e12563.

10APHA policy statement on ceasefire for Israel and Gaza conflict November 12, 2023. “In light of the continuing escalating of civilian casualties in Gaza and Israel and the collapse of the healthcare infrastructure in Gaza, APHA calls upon President Biden and Congress to urgently demand an immediate ceasefire and to call for de-escalation of the current conflict by securing the immediate release of the hostages and those detained; the restoration of water, fuel, electricity and other basic services; and the passage of adequate humanitarian aid to the Gaza Strip.”

11Lin, H.C., Buxton, N., Akkerman, M., Burton, D., de Vries, W. (October 2023), Climate crossfire: how NATO’s 2% military spending targets contribute to climate breakdown, Transnational Institute

Robin Evans-Agnew RN, PhD, is an associate professor in the University of Washington School of Nursing and Healthcare Leadership where he teaches public health nursing, leadership and followership, and environmental justice. Robin is a member of the PHN Section of the American Public Health Association.

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