The environment and health interface in nursing training: an integrative literature review

Abstract

Environmental health has gained prominence in recent decades due to the impacts of ecosystem degradation, climate change, and socio-environmental transformations that directly affect human health. In this context, the training of healthcare professionals, especially nurses, must incorporate competencies to understand and intervene in the environmental determinants of the health-disease process. Brazil, a country marked simultaneously by high biodiversity and accelerated urbanization and industrialization processes, faces unique challenges, such as epidemics of vector-borne diseases, chemical contamination, and inequalities in access to sanitation. The COVID-19 pandemic has reinforced the interdependence between human, animal, and environmental health, highlighting the need for interdisciplinary approaches in healthcare training. This integrative study analyzed the inclusion of environmental health in nursing curricula, aiming to outline a national overview and identify future prospects. The review followed five methodological stages and included the analysis of six Brazilian scientific articles that met the selection criteria. The results highlight weaknesses and fragmentation in the approach to the topic, which is treated in a specific, superficial, or overly disciplinary manner, lacking the necessary cross-disciplinary approach to promote a systemic view of health, the environment, and the territory. Despite some innovative initiatives, such as specific courses and extramural practical experiences, these remain isolated and poorly institutionalized. The conclusion is that there is a significant gap in nursing training regarding environmental health, and that integrative pedagogical strategies, active methodologies, and the strengthening of teacher training are urgently needed to consolidate environmental health as a structuring axis in the educational process.