Alliance of Nurses for Healthy Environments

Mental Health Awareness Month frequently focuses on therapy and diagnosis, but in the Rio Grande Valley, mental health is inseparable from environmental realities. In Hidalgo, Starr, Willacy, and Cameron counties, conditions like extreme heat, air pollution, flooding risk, food insecurity, and limited behavioral health access converge to shape mental health.

These are not abstract public health concerns; they are daily realities that shape anxiety, depression, and recovery across communities. When families worry about whether their homes are safe, their air is clean, and their next meal is secure, mental health cannot be separated from environmental and social conditions.

Mental Health Awareness Month should expand our knowledge of mental health. It is not simply an individual concern; it is essentially shaped by local environmental and organizational factors that produce sustained psychological strain in the Rio Grande Valley.

Across the region, environmental insecurity goes beyond hurricanes, flooding, and extreme heat. Environmental insecurity goes beyond hurricanes, flooding, and extreme heat. It includes poor air quality, unstable housing, food insecurity, and limited behavioral health services. In South Texas, these stressors combine. They lead to chronic stress, fatigue, and psychological distress, often neglected by traditional mental health frameworks. State of the Air report identified the Brownsville–Harlingen–Raymondville area as one of the most polluted regions in the United States for year-round particle pollution, ranking 16th nationally (American Lung Association, 2025). These patterns reflect sustained exposure to fine particulate matter (PM2.5) across parts of the Rio Grande Valley, including surrounding border communities.

PM2.5 exposure is especially concerning because these microscopic particles can penetrate deep into the lungs and enter the bloodstream. Long-term exposure is linked to heart and lung disease and systemic inflammation. This increases the risk of anxiety and depression.

For communities facing economic and social stress, pollution adds a further layer to the mental health burden. Households are forced to make tradeoffs between nutrition, housing, utilities, and healthcare; the resulting stress contributes to anxiety, depression, and a persistent sense of instability. For children and families, food insecurity is not only a physical health issue, but also a chronic psychological stressor that affects development, emotional management, and long-term psychological well-being.

For residents in Starr and Willacy counties, where poverty rates remain among the highest in Texas, think Starr and Willacy counties, poverty rates are among the highest in Texas. These problems worsen with limited healthcare and behavioral health services. Ecoanxiety here are real. It reflects distress and uncertainty caused by extreme heat, flooding, and poor air quality. Physiological burden of chronic stress. Elevated allostatic load has been strongly associated with anxiety, depression, and other stress-related conditions (McEwen & Akil, 2020). For many individuals in the Rio Grande Valley, stress is not episodic, it is continuous, formed by environmental and structural conditions that are difficult to avoid.

As we observe Mental Health Awareness Month, it is critical to broaden the conversation. To properly address mental health in the Rio Grande Valley, we must acknowledge the environmental systems that shape it and promote policies that support air quality, climate resilience, food security, and environmental justice as vital factors of mental health. Dealing with these environmental and community factors is essential to reducing the mental health burden in South Texas.

About the Author:

References:

American Lung Association. (2025). State of the air 2025. https://www.lung.org/research/sota

McEwen, B. S., & Akil, H. (2020). Revisiting the stress concept: Implications for affective disorders. Journal of Neuroscience, 40(1), 12–21.

U.S. Environmental Protection Agency. (2024). Health and environmental effects of particulate matter (PM2.5). https://www.epa.gov/pm-pollution

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We need clean, renewable energy to protect our health and to drive down energy costs. As organizations representing public and environmental health as well as frontline healthcare professionals, including the American Lung Association, Alliance of Nurses for Healthy Environments, Concerned Health Professionals of New York, and Physicians for Social Responsibility, we urge Governor Hochul and the New York State Legislature to ensure that renewable energy investments remain a central priority in this year’s state budget negotiations.

At a moment defined by rising energy costs, worsening air quality, and increasing climate-driven health risks, failing to fully fund wind, solar, and geothermal energy would be a profound mistake; one that New Yorkers cannot afford. Our organizations see firsthand how pollution and climate instability harm our communities. Fossil fuel combustion remains a leading contributor to increasing asthma attacks, worsening COPD exacerbations, cardiovascular disease, and premature death across New York State. Rising temperatures and poor air quality have led to more emergency room visits and hospitalizations. These burdens fall disproportionately on low-income communities, communities of color, children, and older adults, populations who already face systemic health inequities.

The fossil fuel-based energy system has created both a climate crisis and a public health crisis that demands courageous and equitable policy action now. Renewable energy is a public health intervention that can help improve patient outcomes. Expanding wind, solar, and geothermal infrastructure will reduce harmful air pollutants, decrease hospitalizations, and improve quality of life for millions of New Yorkers. At the same time, renewable energy is one of the most effective ways to bring down long-term energy costs for everyday residents. Unlike fossil fuels, which are subject to volatile global markets and geopolitical disruptions, renewable sources like wind and solar provide stable, predictable pricing once infrastructure is in place. Investing in these technologies now will shield New Yorkers from future price spikes while reducing reliance on imported fuels.

For example, geothermal systems offer households consistent, efficient heating and cooling, cutting utility bills significantly over time. Leaving these investments out of the state budget would mean locking families into higher, less predictable energy costs for years to come. Renewable energy development drives economic growth and job creation across the state. From offshore wind projects along our coasts, to solar installations in rural and urban communities alike, these investments support thousands of good-paying jobs while strengthening local economies. They also reduce strain on our healthcare system by preventing illness before it begins, an often overlooked but critical form of cost savings.

New York has already positioned itself as a national leader in climate action through the Climate Leadership and Community Protection Act (CLCPA). But leadership requires follow-through. If renewable energy funding is weakened or omitted from the state budget, it will not only delay progress toward our climate goals, it will also jeopardize the health and financial stability of New Yorkers. Governor Hochul and state legislators face a clear choice. Invest in a cleaner, healthier, and more affordable energy future, or allow short-term budget decisions to undermine long-term wellbeing.

The evidence is overwhelming. Renewable energy saves lives, reduces healthcare costs, and puts money back into the pockets of working families. For the sake of public health, economic stability, and environmental justice, New York must not leave renewable energy behind.

Authors:

Max Micallef, NYS Advocacy Manager – Clean Air Initiatives, American Lung Association
Bryanna U. Patterson, MS, FNP, RN-BC, Fellow, Alliance of Nurses for Healthy Environments
Carmi Orenstein, MPH, Program Director, Concerned Health Professionals of NY
Zach Williams, MPH, Associate Director, Environment & Health, Physicians for Social Responsibility

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One nurse’s experience running for township trustee reveals how local governance shapes water, land, and community health.

Ann M. Stalter, PhD, RN, M. Ed. | Professor | Wright State University |College of Health, Education, and Human Services | School of Nursing, Kinesiology, and Health Sciences

Key Takeaways to Consider

• Local government decisions shape health. Land use, infrastructure, and environmental stewardship affect air quality, water systems, food security, and climate resilience.
• Governance is a nursing practice setting. Nurses can bring population health expertise to planning boards, township meetings, and elected leadership roles.
• Planetary health leadership starts locally. When nurses participate in governance, prevention and environmental protection become part of community decision-making.

One evening not long ago, I stood outside a local polling place explaining something unusual to voters.

“You have to write my name in.”

I was running as a write-in candidate for Township Trustee, something this nurse never imagined doing. But as I explored planetary determinants of health, I realized: 

Decisions shaping community health are often made by local governments, not in hospitals.

Long before someone develops asthma, cardiovascular disease, or heat-related illness, local governments have already shaped the environment where they live. Decisions about land use, water systems, infrastructure, and development influence air quality, food systems, transportation patterns, and climate resilience. Yet nurses aren’t present to influence decisions. Running for office became an extension of health promotion. 

You might ask, “What does the township government have to do with health?”

Township governments make decisions about land use, agriculture, infrastructure, stormwater, and public resources. Each affects air, water, food systems, biodiversity, and climate resilience– planetary determinants of health.

When farms are replaced with sprawl, communities experience cascading impact—more traffic emissions, flood risk, and reduced food production. Participating in these decisions is prevention and health promotion.  

In my township, development pressure is increasing rapidly. Residents voiced their concerns– a farmer worried about losing land, and a mother about speeding traffic. Yet these concerns were not systematically translated into policy. Planning discussions included consultants, government staff, but lacked meaningful  community engagement. As a nurse, I recognized a familiar pattern: 

Policy decisions were being made without a comprehensive community assessment.

Listening to communities, identifying shared values, and translating evidence into action are core nursing skills and essential to governance.

Land as a Public Health Issue

Nurses understand that health is shaped long before clinical care is needed. Land use decisions determine access to nutritious food, safe activity, toxins exposure, and climate resilience. Local officials make these upstream decisions daily. Nurses bring a prevention lens that guides equitable, sustainable, and healthy outcomes.

My Story: Nursing Praxis in Action

Running as a write-in candidate required persistence and listening. At the same time, nursing students conducted a community assessment to inform land-use planning. Students completed surveys, observations, and interviews. Their role was assessment, not advocacy.

Two concerns surfaced repeatedly: Groundwater and Traffic Safety. Residents worried about wells running dry and aquifer contamination. In rural areas, aquifers take decades to recover. Residents also described fatal crashes involving teenage drivers on roads lacking safety improvements. 

Students also identified priorities such as agricultural preservation, responsible growth, and environmental sustainability. Their findings demonstrated how local governance can serve as a real-world setting for nursing practice.

Why Should Nurses Participate in Local Governance?

Nurses bring a perspective often missing in decision-making. Our training emphasizes prevention, population health, environmental exposure, and equity across generations. Participating in governance allows nurses to move beyond advisory roles and directly influence community health outcomes.

Protecting farmland, planning sustainable development, and investing in resilient infrastructure are forms of public health prevention. These choices help preserve food systems, reduce exposure, protect biodiversity, and strengthen climate resilience. 

Nurses can advance planetary health at the local level.

You don’t have to run for office to begin engaging in governance. Nurses can start by:

1. Attending local government meetings,
2. Serving on planning commissions or advisory boards,
3. Bringing public health evidence into policy discussions,
4. Supporting community health assessments, and/or
5. Considering appointed or elected leadership roles.

Local governments need leaders who understand how environmental decisions affect population health.

Author Reflection

Running for township trustee reshaped my view of nursing. It made clear that health is shaped by land, water, and local decisions. Listening to residents revealed governance and care intertwine, showing politics is an extension of nursing practice. Township planning reflects prevention, ethics, and community voice. If planetary health begins locally, nurses belong in spaces where those decisions are made.

This blog reflects my professional experience and perspectives; I used an AI tool for drafting support and to assist with word count reduction, organization, clarity, and grammar.

Bio 

Nurse leader and advocate for planetary health, this author is a full professor at Wright State University School of Nursing and Co-Chair of the Association of Community Health Nursing Educators (ACHNE) Research Committee. Her work integrates population health, environmental stewardship, and community engagement, emphasizing the role of local governance in shaping health outcomes and advancing sustainable, community-centered nursing practice. Contact: drannmariestalter@gmail.com or ann.stalter@wright.edu

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