Teaching Nurses for Climate Justice: Why Planetary Health Education Needs Decolonial Awakening

Article information

Cleofas, J. V. (2025). Igniting climate justice consciousness and decolonial awakening through nursing education. Teaching and Learning in Nursing. https://doi.org/10.1016/j.teln.2025.01.017 

What this paper is about

Climate change is not only an environmental issue. It is also a health issue, a justice issue, and a nursing education issue.

This discussion paper asks: How can nursing education prepare students to respond to climate change in ways that are not only scientifically competent, but also socially just and decolonial?

The paper begins from the idea of the Anthropocene, a term used to describe the current period in which human activity has deeply changed the Earth’s climate, ecosystems, and living conditions. In this context, nurses are increasingly called to become planetary health stewards: health professionals who understand the connections among human health, ecological systems, sustainability, and social justice. 

But the paper argues that many planetary health and climate justice discussions in nursing are still dominated by Global North perspectives. This can limit their usefulness for countries and communities in the Global South, where climate impacts are often more severe, but where local knowledge and lived experience are less represented in global nursing literature. 

Why climate justice needs a decolonial lens

The article defines climate justice as an ethical framework concerned with the fair distribution of climate harms, responsibilities, and responses. Climate change does not affect everyone equally. Poor communities, Indigenous peoples, racialized groups, coastal communities, women, children, older people, and Global South populations often face heavier climate-related health burdens despite contributing less to the causes of climate change. 

The paper argues that these inequalities cannot be understood without looking at coloniality. Coloniality refers to the continuing systems of power that remain after formal colonial rule has ended. These systems still shape economies, knowledge, authority, culture, identity, and global health relationships.

For a country like the Philippines—identified in the paper as the highest-ranking country in the 2024 World Risk Index—climate injustice is not abstract. The author grounds the paper in experiences from community health nursing work with fisherfolk communities affected by heat waves, storms, displacement, and livelihood loss. 

The key framework: Colonial Matrix of Power

The paper uses the Colonial Matrix of Power, or CMP, to explain how coloniality works. The CMP has four domains:

1. Control of economy
2. Control of knowledge
3. Control of authority
4. Control of subjectivity

These domains help show why climate injustice is not only about emissions or disasters. It is also about whose resources are extracted, whose knowledge is treated as legitimate, whose institutions make decisions, and whose values shape what counts as progress.

The article’s Table 1 on page 3 summarizes how these four CMP domains intersect with climate injustice and planetary health education. For example, the control of economy appears when resources from the Global South are extracted to support industries and technologies elsewhere, increasing environmental vulnerability. The control of knowledge appears when Western and Global North scientific frameworks dominate climate research while Indigenous and local knowledges remain marginalized. 

Coloniality in planetary health education

The paper does not reject planetary health education. Instead, it asks nursing educators to strengthen it by making it more critical and decolonial.

For example, planetary health education may teach students about climate science, sustainability, and healthcare’s carbon footprint. These are important. But if the curriculum mainly uses Global North frameworks, English-language materials, technology-focused solutions, and individual behavior change, it may miss deeper questions:

Who caused the climate crisis?
Who benefits from extractive economies?
Whose knowledge is ignored?
Who controls global climate and health decisions?
Which communities are asked to “adapt” without being given power or resources? 

The paper argues that nursing education must move beyond individual-level solutions such as reducing personal carbon footprints. It must also teach students to analyze structural injustice, colonial histories, health inequities, and community-based ways of responding to climate change.

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The CJCDA framework

The paper’s main contribution is the Climate Justice Consciousness and Decolonial Awakening framework, or CJCDA. 

The framework combines two sets of ideas:

First, it uses the four CMP domains: economy, knowledge, authority, and subjectivity.

Second, it uses three domains of planetary health and sustainable healthcare nursing education:

1. The science of planetary health and climate change
2. Mitigation of healthcare’s environmental impacts
3. Adaptation to the health impacts of climate change

The article’s Table 2 on page 4 turns this framework into a practical teaching guide. It gives examples of educational strategies at the intersection of each CMP domain and each planetary health education domain. 

Domain 1: Teaching the science of planetary health and climate change

The first domain focuses on helping nursing students understand climate science and planetary health. But the CJCDA framework says this should not be taught as neutral science alone. Students should also examine how colonial histories shaped global health disparities and climate vulnerabilities. 

For example, students can study how extractive industries, such as mining, increase disaster risk in climate-vulnerable countries. They can critique scientific literature for epistemic bias. They can learn from Indigenous and community health practitioners about ecological knowledge and sustainable health practices.

In plain language: students should learn climate science, but they should also learn whose science is centered and whose knowledge is missing.

Domain 2: Reducing healthcare’s environmental harm

Healthcare systems contribute to environmental damage through waste, energy use, supply chains, single-use materials, and carbon emissions. The paper argues that nurses should be prepared to reduce these harms.

But again, the CJCDA framework asks educators to go deeper. Students should not only learn “green practices.” They should ask whether sustainability solutions are equitable, affordable, locally appropriate, and culturally grounded. 

For example, students can conduct sustainability audits in clinical settings, analyze healthcare supply chains, design low-cost interventions for resource-limited settings, and examine Indigenous waste management practices. They can also reflect on their roles as consumers and providers within resource-intensive healthcare systems.

The point is not only to make healthcare greener. The point is to make sustainable healthcare just.

Domain 3: Adapting healthcare to climate change impacts

Climate change already affects health through heat illness, food insecurity, disasters, vector-borne diseases, respiratory problems, mental health distress, displacement, and disrupted health services. Nurses must be prepared to respond.

The CJCDA framework encourages students to co-create adaptation plans with communities, especially marginalized groups. This means listening to local voices, using local knowledge, and designing health responses that fit real community conditions. 

Students can participate in simulated disaster responses, critique global adaptation frameworks, use patient-centered storytelling, and role-play advocacy for fair distribution of healthcare resources during climate crises.

The aim is to prepare nurses who can adapt to climate change while resisting colonial habits of imposing one-size-fits-all solutions.

Why the framework matters

The CJCDA framework argues that climate justice consciousness and decolonial awakening belong together. A nurse who understands climate justice must also understand coloniality. A nurse who thinks decolonially must also care about climate justice. 

This matters because climate education can become too technical if it only teaches carbon emissions, disaster preparedness, or environmental sustainability. It can also become too individualistic if it focuses only on personal responsibility. The CJCDA framework pushes nursing education toward a more structural and transformative approach.

It asks nursing students to become not only competent climate-health professionals, but also critical advocates who can recognize injustice, value marginalized knowledge, and work with communities toward sustainable health futures.

Challenges and limits

The paper is careful to note that implementing this framework will not be easy. Nursing schools may face limited faculty expertise in decolonial pedagogy, resistance to discussing colonial histories, lack of resources, and the continued dominance of Eurocentric curricula. 

The paper also includes an important caveat: its use of coloniality may not fully capture all colonial experiences, especially settler colonialism and the experiences of First Nations peoples in Global North contexts. The framework is therefore a starting point, not a final answer. It needs further development, implementation, and empirical testing. 

Bottom line

This paper argues that nursing education in the Anthropocene must do more than add climate change content to the curriculum. It must help students understand the unequal histories, power relations, and knowledge systems that shape climate vulnerability and health injustice. 

The CJCDA framework offers nursing educators a way to design learning activities that connect planetary health science, sustainable healthcare, climate adaptation, coloniality, and justice. Its core message is clear: future nurses must be trained not only to care for people in a warming world, but to challenge the unjust systems that make some people more vulnerable to that warming.

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Policy/practice recommendations

1. Integrate climate justice into nursing curricula
   Climate change should not be taught only as environmental science. It should be connected to health inequities, colonial histories, poverty, gender, race, geography, and global power relations.
2. Use the CJCDA framework to redesign learning activities
   Educators can map lessons across the four CMP domains and the three planetary health education domains to create more critical and justice-oriented teaching strategies.
3. Center Global South and Indigenous knowledge
   Nursing programs should include Indigenous ecological knowledge, local health practices, community experience, and Global South scholarship in planetary health education.
4. Train faculty in decolonial and planetary health pedagogy
   Faculty development is necessary because many educators may not have formal training in climate justice, planetary health, or decolonial theory.
5. Teach sustainability as a structural issue
   Students should learn how healthcare’s environmental footprint is shaped by procurement, supply chains, industry, waste systems, and global inequalities—not only individual behavior.
6. Use community-based learning
   Climate-health education should involve communities affected by heat, storms, flooding, food insecurity, displacement, and environmental degradation.
7. Develop locally relevant teaching materials
   Nursing schools in climate-vulnerable countries should not rely only on imported frameworks. They should co-create teaching resources that reflect local hazards, cultures, languages, and health systems.
8. Empirically test the framework
   Future studies can implement CJCDA-informed teaching modules and evaluate their effects on students’ climate justice consciousness, decolonial awareness, advocacy skills, and community engagement.

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Glossary of key terms

• Anthropocene — A term used to describe the period in which human activity has deeply affected Earth’s climate, ecosystems, and planetary systems.
• Planetary health — A field that studies the connections between human health, ecological systems, environmental sustainability, and social justice.
• Climate justice — An ethical approach that asks how climate harms, responsibilities, and solutions are distributed, especially among vulnerable and marginalized groups.
• Decoloniality — A critical approach that challenges the continuing power of colonial histories in knowledge, institutions, identities, economies, and social relations.
• Coloniality — The persistence of colonial forms of power after formal colonial rule has ended.
• Colonial Matrix of Power / CMP — A framework describing coloniality through four domains: control of economy, knowledge, authority, and subjectivity.
• Control of economy — The way colonial and global systems organize extraction, labor, markets, resources, and wealth in unequal ways.
• Control of knowledge — The privileging of Western and Global North knowledge systems while marginalizing Indigenous, local, and Global South knowledges.
• Control of authority — The concentration of decision-making power in dominant institutions, states, professions, or global bodies.
• Control of subjectivity — The shaping of people’s identities, desires, values, and ways of seeing the world through colonial and modern norms.
• Climate injustice — Unequal exposure to climate harms and unequal access to resources, voice, protection, and recovery.
• Global South — Countries and communities historically shaped by colonialism, unequal development, and marginalization in global systems.
• Global North — Wealthier and more powerful countries and institutions that often dominate global knowledge, policy, finance, and decision-making.
• Epistemic bias — Bias in what kinds of knowledge are treated as valid, scientific, important, or worth teaching.
• Indigenous ecological knowledge — Knowledge held by Indigenous communities about land, ecosystems, sustainability, health, and survival developed through long relationships with place.
• Sustainable healthcare — Healthcare that protects human health while reducing environmental harm and resource waste.
• Healthcare carbon footprint — The greenhouse gas emissions produced by healthcare systems, including energy use, transport, supply chains, equipment, and waste.
• Green innovation — Technologies or practices promoted as environmentally friendly; the paper encourages assessing whether such innovations are also equitable and locally appropriate.
• Climate adaptation — Adjustments in health systems, communities, and practices to respond to actual or expected climate impacts.
• Climate mitigation — Actions that reduce greenhouse gas emissions or environmental harm.
• CJCDA framework — The Climate Justice Consciousness and Decolonial Awakening framework proposed in this paper to guide nursing education strategies.
• Climate justice consciousness — Awareness of the unequal causes and effects of climate change, and commitment to equitable climate-health action.
• Decolonial awakening — Heightened sensitivity to and resistance against injustices rooted in coloniality.
• Planetary health steward — A nurse or health professional prepared to protect human health by caring for ecological systems, communities, and future generations.