Health Sciences (Sustainability)

Anaker and Elf (2014) undertook a concept analysis of sustainability in nursing. They argue that the “term is not clearly defined and is poorly researched in nursing.” (p382). This does not only apply in nursing, it has diverse and contested meanings in many disciplines (Williams and Millington 2004, Thompson 2011). The quest to tie down the concept is probably futile, as Anaker and Elf themselves suggest that

“a concept analysis is never a finished product” (p388).

Nonetheless, they provide a definition which is a helpful contribution to the discussion, while their model and contrary case illustrate for clinical nurses the value of trying to understand sustainability in practice. Throughout the paper they provide attributes and definitions from various sources and refer at times to sociocultural factors and political commitment. The defining attributes were ecology, environment, the future, globalism, holism and maintenance. However, while getting tantalisingly close to discussing the political economy underpinning such issues as climate change, ocean acidification and soil erosion and the social (WHO 2008) political (Ottersen et al) and environmental (Barton and Grant 2006) determinants of health rooted in the emerging concept of ecological public health (Lang and Rayner 2012) analysis misses something important, the link between Late (or Finance) capitalism, climate change and sustainability.

May 2015

'Climate change (is) the public health challenge of the 21st century and will come to dwarf all others.' (Griffiths 2007).


Of the many global challenges to health, climate change and unsustainable lifestyles are arguably the most important factors in determining the future health of populations. If this is the case, and if nurses are to play a part in health promotion, education for health must include education for sustainability. It may be argued that there needs to be a paradigm shift within nursing from individualistic, narrowly defined vocational and biomedical models towards a more radical ecocentric paradigm. Supporting this is the fact that sustainability and health care is now a policy objective of the UK government (DH 2008c). This chapter will not outline the links between global warming and health in great detail, but rather will address some of the challenges and how Nursing Education is currently responding.

We will begin the discussion by:

1) Briefly outlining what we may mean by ‘sustainability’.
2) Briefly noting the impacts on health by the changing climate.
3) This will be followed by an overview of the current response by nursing and other organisations to the challenges. This will be done by within the context of accessing developments for nursing as a profession and its education base.
4) The Public Health ‘forum’, which is shared with medicine, appears to be the lens through which nursing can see the ideas and apply them in a more obvious manner than if viewed from the context of, say critical care. Therefore developments in this field will be highlighted.
5) The curriculum is the foundation upon which nurse education rests and ideas for curriculum development will be offered for critical debate and issue raising.
6) Finally, we will be asking the question: ‘what needs to be done?’

We argue there is a ‘sustainability-climate change-health’ triad (Goodman and Richardson 2010) which makes it an imperative that we examine notions of sustainability and climate change in the curriculum. This paper will begin by briefly outlining the need for addressing sustainability (and climate change) in the BSc nursing curriculum by reference to global issues. This will be followed by a discussion on the implications for education, focusing on the ‘what is education for’ question. An answer is to base education on some key principles such as that of Education for Sustainability (EfS) which focuses on transformative rather than transmissive education, then we will be considering Selby’s (2007) ‘10 propositions’ followed by a Nurse Education for Sustainable Wellbeing framework. To further assist thinking there will be a list of recommendations for consideration by curriculum planners.

As the name indicates, this book is a justification for further economic growth and progress. It is based on the idea that humanity is apart from nature (human exceptualism) and is capable of enormous technical, cultural and progressive ingenuity. Humanity should strive to achieve more in terms of economic development so that everyone should have access to a Ferrari (if they want it). It is a counter to what he terms ‘growth scepticism’, i.e. the ‘tendency to undermine economic progress by indirect means’ (p3). What follows is a critique of the arguments around economic growth v limits put forward in part two of the book. It will argue that Ben-Ami’s faith in human progress is based on inductive reasoning, ignores a key statistical problem, and is over confident that limits (on energy supply for example) can be overcome. His faith in growth is thus based on wishful thinking and a confidence in the statistical analysis of a few commentators (notably Bjorn Lomborg).