Climate change is one of the greatest threats to human health and a key factor in achieving the UN Sustainable Development Goals (SDGs) by 2030. These global goals aim to promote "peace and prosperity for people and the planet." The SDGs emphasize the interconnectedness of health, economic, social, and environmental challenges.
Addressing the effects of climate change is a person-centered priority in which nurses play a vital role. This includes preventing further climate change effects, mitigating existing impacts, and adapting healthcare practices to align with environmental realities.
The science is clear: Human behavior is affecting the climate, and this impact poses a major risk to human life (as we have seen very recently in the unfortunate events of the Californian wildfires). Across the world, extreme weather events—including fires, floods, rising sea levels, droughts, and heatwaves—are exacerbating health inequalities, increasing illness, and heightening the risk of communicable diseases.
In England, the Chief Medical Officer’s 2022 Report highlighted the severe health threats posed by air pollution, which contributes to approximately 38,000 deaths annually. Climate change disproportionately affects the most vulnerable populations. A tragic example is Ella Adoo-Kissi-Debrah, the first person in the world to have air pollution officially listed as a cause of death. Her mother, Rosamund, shared:
“My daughter Ella was a playful, happy child growing up in South East London. Healthy at birth, with a lust for life, she didn’t develop asthma until just before her 7th birthday. A few weeks after her 9th birthday, she suffered a fatal asthma attack. Ella is the first person in the world to have air pollution listed as a cause of death on her death certificate.”
Furthermore, climate change threatens global populations across all age groups. In 2019, UNICEF warned, “Every child born today will be affected by climate change.” Water contamination, changes in vector-borne diseases, excessive heat, food shortages, and population displacement have a huge effect on vulnerable populations, including infants, children, and pregnant women.
For these reasons, I believe the climate crisis is a critical patient safety issue. The foundational principle of patient safety is “first, do no harm.” The World Health Organization (WHO) defines patient safety as the absence of preventable harm to patients and prevention of unnecessary harm by healthcare professionals. I would argue that climate change presents an equivalent risk of harm, comparable to failures in healthcare. Addressing climate change with the same urgency as patient safety is essential to preventing catastrophic health outcomes. Both issues exacerbate health inequalities, and research links socio-economic disadvantage to higher rates of morbidity and mortality. Sustainability and health equity must become core principles of patient safety.
In my experience, high-quality care is generally lower carbon care. Engaging nurses in clinical conversations about their practice, alongside multidisciplinary teams, fosters awareness of the healthcare sector's carbon footprint. Understanding the total greenhouse gas emissions from healthcare products, services, and pathways is crucial for sustainable care. Patient safety methodologies such as root cause analysis, process mapping, and dynamic system analysis help drive improvement in these areas. This is especially important given that healthcare systems globally are the fifth-largest carbon emitters and serve as first responders to climate-related health crises.
As nurses, I believe we have a moral, ethical, and professional imperative to act and protect the health of populations. As the world’s largest professional group, we are uniquely positioned to take practical steps to reduce our carbon footprint wherever we can. We have a vital role in delivering SDG 3 (Good Health and Well-being) to SDG 13 (Climate Action) and beyond. Addressing climate change is fundamental to our existence, not just for today’s generation but for future generations.
I took action by attending the 2024 United Nations Climate Change Conference, also referred to as the Conference of the Parties (COP) in Baku, Azerbaijan. I was invited as a representative of Sigma in my UN liaison role by the Alliance of Nurses for Healthy Environments. COP29 was the annual global meeting where country representatives negotiate and address climate change issues, including mitigation, adaptation, and financing.
Attending COP for the first time was an overwhelming yet invaluable experience. With over 65,000 delegates, including politicians, civil servants, industry leaders, NGOs, and activists, the scale was immense. My schedule was packed from early morning to late in the evening. I spent much of my time in the health pavilion, where different countries were represented. I took part in a panel at the UK pavilion discussing how to amplify clinicians' voices in climate change mitigation. I also attended sessions from Spain, Brazil, and Canada on lessons learned from extreme heat and flooding events. This year’s COP emphasized finance, and I sat in on negotiation meetings to understand the diverse geopolitical and financial contexts at play.
On the health front, it was encouraging to hear discussions on the WHO’s recently published report, "Taking Action for Climate Change and Health." This report underscores why health should be the primary argument for climate action, focusing on people, places, and the planet. Alongside colleagues from the Alliance of Nurses for Healthy Environments (ANHE), we used our platform to educate delegates on the critical role of nurses in climate advocacy, education, and equitable healthcare delivery.
A key takeaway for me was the urgent need to place health at the forefront of this agenda. Nursing requires stronger representation and a more coordinated voice in influencing climate policies. Despite nurses delivering the majority of healthcare worldwide, I noticed only a handful of nursing professionals at COP. Repeatedly, I heard about the challenge of translating national climate plans into local action—a gap that nurses, as the most trusted profession, are well-positioned to address.
The critical question now is: How can we better support nurses in advocating for climate action and amplifying their voices at
COP30 in Brazil in November 2025? In my final year as a Sigma UN liaison, I will continue championing the SDGs and advocating for health as a central pillar of climate action. I am collaborating with ANHE and the Society of Nurse Scientists Innovators Entrepreneurs (SONSIEL) on events leading up to COP30, building on our collective experience. Stay tuned for more updates as we work toward this goal!
Charlotte McArdle, BScN, MSc, RGN, is a registered nurse and former Deputy Chief Nursing Officer for Patient Safety and Improvement for National Health Service (NHS) England. In addition to being a Sigma UN Liaison, she is also a member of Sigma’s Phi Mu Chapter.