Public Health Nurses' Contributions to Planetary Health Practice in Public Health Departments: A Qualitative Study

Public health nurses (PHNs) may be well positioned to address planetary health challenges through their clinical, population health, and community-based roles, yet their contributions to planetary health practice remain understudied. This qualitative study used reflexive thematic analysis to examine PHNs' roles, contributions, and capacities related to planetary health practice in public health departments. Semi-structured interviews were conducted from October 2024 to February 2025 with 30 participants, including 13 PHNs, 11 public health leaders, and 6 community-based organization representatives across 10 U.S. states. Participants described a spectrum of PHN engagement in planetary health work, ranging from active practice to unrealized capacity. Four interrelated themes described mutually reinforcing dimensions of PHN practice relevant to planetary health: ethical and justice-oriented responsibility, trust-based relational care, bridging clinical and population health, and translating environmental data into action and advocacy. Across participant groups, PHNs were described as trusted community partners able to integrate clinical insight with systems-level public health action. These capacities were enacted to varying degrees across public health department contexts. Leadership support, workforce development, and organizational alignment may strengthen integration of these capacities into routine public health nursing practice.