MOVING TO A POPULATION-BASED PERSPECTIVE

At present, when the nursing profession addresses environmental health at all, it is generally in the context of the individual patient or the patient's family. However, as in the case of health issues related to environmental justice, an equally important dimension of environmental health is the community context. Populations of entire neighborhoods and regions can be affected by industrial pollution, waste disposal facilities, contaminated streams and soil, toxic incinerator emissions, and other potential environmental threats to health.

The effects of environmental hazards on the health of the community often generate public controversy, and concerned citizens organize their communities to protect their health, legal, and financial interests. One of the most familiar examples occurred at Love Canal, New York, in the 1960s when citizens learned that their residential neighborhood was contaminated with potentially dangerous industrial waste. They organized under the leadership of Lois Gibbs, a resident of the community with no special training in environmental issues, and sought professional help from local and state health department officials and scientific experts. Their concern eventually grew into a major social movement involving litigation, social protest, and government intervention. Because of the national media attention that the movement received, Love Canal became an important symbol for the national environmental movement. Ms. Gibbs' organization developed its own scientific expertise through self-training with expert assistance. The organization subsequently developed into a national resource center (see Appendix D), offering technical assistance to communities facing environmental health threats. Other more recent examples of community-based environmental health activism abound (Ashford, 1994; Needleman and Landrigan, 1994). Some of these efforts occur on an entirely local level. Others (for example, dioxin in the soil at Times Beach, Missouri, and contaminated drinking water at Woburn, Massachusetts) have been covered intensively by the national press and television networks and have become the focus of major health research efforts.

In such situations, residents of the community tend to seek help from local health professionals, including nurses. Residents will especially turn to nurses working in public health, community health, and occupational health, but nurses outside these specializations may also be drawn into the issue simply because they reside in the area and are trusted by the community. Whether or not they are prepared for the role, nurses in all fields of practice may find themselves interacting with worried residents of the community. They may be asked to assess, advise, and counsel pregnant women who are concerned about the possibility of birth defects,



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