“Is that really nursing?” “Not my area of science!” “I don’t know enough about it.” The responses I receive when asking about the planetary health crisis and cancer nursing science are telling. The magnitude of this health crisis is incalculable, spanning the lives of every person on the planet. But the reasons offered when dismissing the notion of including the planetary crisis in our science don’t hold up. This is our crisis, affecting our climate, the air, and biodiversity on which all life relies. The threats it poses demand a nursing response. So why are we backing away?

As nurses, we hold that our understanding of human health always exists in the context of the environment. Every human being shares this planet as our collective environment. As cancer nurses, we know that cancer is a set of epigenetic diseases and thus always tied to environment. We also know that some environments are healing, and others are harmful. Environment and health are integral to our science. The planetary health crisis must become so. The strength of our science promises distinctive ways we can contribute to understanding, responding to, and mitigating this crisis.

Our science is complex and highly developed. Our education, training, and projects combine in tightly woven programs of research. Consideration of the triple planetary crisis was not on most of our scientific agendas. I confess to being one of those researchers for whom planetary health was a personal interest, not a scientific direction. My identity as a gero-oncology nurse researcher and clinician is long and deeply held. Then I, as the editor of a gerontological nursing journal, was asked to publish an editorial on planetary health in 2021. That request crystallized my sense that, as a scientist, I had to do more to help combat the planetary health crisis. I set out to educate myself by reading key science and connecting with expert colleagues. In a few months, I went from educated layperson to knowledgeable scholar who regularly collaborates with others doing environmental science.

The planetary crisis is truly terrifying. But educating myself, reconsidering my science, and making connections with colleagues around the world help sustain me. Those actions temper my fears, allowing for cautious optimism as I join with others. I liken my own growth here to that I saw during the COVID pandemic. With that clear threat to human health—no matter how scared I felt—I took heart watching nurses around the world swerve to confront it. We rapidly altered our clinical care, education for our students and our colleagues, and science. If we did it with COVID, why not with the planetary health crisis?

The planetary health crisis is far more threatening and graver than COVID. Pause for a moment and take that in. The planetary crisis is so much worse than any other threat to health. It will continue to be so unless we act now. This crisis is tied to all aspects of health and well-being. It intersects with all 17 sustainable development goals (https://sdgs.un.org/goals), worsens all social determinants of health, is generated by commercial determinants of health, and then generates deleterious environmental determinants of health. The planetary health crisis disproportionately affects marginalized people everywhere and those in low- and middle-income countries. Thus, we, whose science aims for health equity and justice, are by default addressing the planetary health crisis. For example, I now acknowledge that the planetary crisis is ageist, preventing healthy aging if it persists unchecked. Doing my gero-oncology science well means aligning it with planetary health science.

As I write, I realize that I am risking generating more fear than action. Information such as that conveyed by the most recent report from the Stockholm Resilience Center1 graphically displays the dire situation in which we find ourselves. Knowing that 6 of the 9 domains of planetary health are now breached for the first time in world history, isn’t it time for us to do what we did during COVID? Together, we achieved truly incredible transformation throughout nursing globally for the people and communities in our care. We overcame our terror then to act with strength. We can do the same in this crisis, knowing that everyone on the planet will benefit as we succeed. Please turn to my Insights essay in this issue for suggestions about how we can each alter our own programs of research starting today.

Sarah H. Kagan, PhD, RN
School of Nursing and Abramson Cancer Center at Pennsylvania Hospital, Penn Medicine,
University of Pennsylvania, Philadelphia