title: Upstream reflections on environmental health: an abbreviated history and framework for action.
abstract: Upstream thinking considers the social, economic, and environmental origins of health problems that manifest at the population level. The upstream thinking perspective is applied to an examination of environmentally associated health problems and the opportunities that citizens have (or do not have) to access information and resources to make health-promoting choices in response to environmental health risks. A proposed framework for nurses to reduce environmental health risks includes distributive and strategic actions. Distributive actions include tracking, embedding, and translating; strategic actions include discovering through etiologic research, discovering through community-based research, advocating, and reframing. Together these actions can help formalize nursing's role in responding to citizens' concerns about environmental health problems.
authors.affiliation: Montana State University Bozeman, Montana, USA.
authors.forename: Patricia G
authors.initials: PG
authors.lastname: Butterfield
mesh_terms: D001294:Attitude to Health; D003625:Data Collection; D003627:Data Interpretation, Statistical; D004781:Environmental Exposure / Q000009:adverse effects / Q000517:prevention & control; D004782:Environmental Health / Q000706:statistics & numerical data / Q000639:trends; D004812:Epidemiologic Methods; D006291:Health Policy; D006801:Humans; D008119:Lobbying; D016294:Models, Nursing; D009017:Morbidity; D024802:Nurse's Role; D015399:Nursing Research / Q000379:methods; D009742:Nursing Theory; D010344:Patient Advocacy; D010687:Philosophy, Nursing; D011050:Policy Making; D015980:Public Health Practice; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology