halk sag hem der Halk Sağlığı Hemşireliği Dergisi 2667-8047 Halk Sağlığı Hemşireliği Derneği 10.54061/jphn.1846757 Environmental Health Public Health Nursing Çevre Sağlığı Halk Sağlığı Hemşireliği Halk Sağlığı Hemşireliği Perspektifinden Çevresel Davranışlar ve Sağlık Üzerindeki Etkileri: Klasik Derleme The Effects of Environmental Behaviors on Health from a Public Health Nursing Perspective: A Narrative Review https://orcid.org/0009-0002-9960-1270 Akbaş Hatice MARMARA ÜNİVERSİTESİ https://orcid.org/0000-0001-7752-605X Erol Saime MARMARA ÜNİVERSİTESİ 04 27 2026 8 1 57 65 12 22 2025 01 17 2026 Copyright © 2019, Halk Sağlığı Hemşireliği Dergisi 2019 Halk Sağlığı Hemşireliği Dergisi

Bu klasik derleme, çevreye yönelik bireysel ve toplumsal davranışların halk sağlığı üzerindeki etkilerini halk sağlığı hemşireliği perspektifinden kapsamlı biçimde değerlendirmeyi amaçlamaktadır. Derleme kapsamında çevre dostu ve çevreyi kirleten davranış türleri, bu davranışların sosyodemografik ve çevresel belirleyicileri ile solunum, kardiyovasküler, nörolojik-psikolojik, bulaşıcı ve onkolojik hastalıklar üzerindeki etkilerine ilişkin ulusal ve uluslararası literatür incelenmiştir. Bu doğrultuda, 2015–2025 yılları arasında Türkçe ve İngilizce dillerinde yayımlanmış çalışmalar PubMed, Scopus, Web of Science ve Google Scholar veri tabanlarında sistematik olmayan bir tarama ile değerlendirilmiştir.Literatür bulguları, çevre dostu davranışların hava kirliliğine maruziyeti azaltarak solunum ve kardiyovasküler hastalık riskini düşürdüğünü; yeşil alanlara erişim ve doğa temelli aktivitelerin psikolojik iyi oluşu ve ruh sağlığını desteklediğini ortaya koymaktadır. Buna karşılık, çevreyi kirleten davranışların hava kirliliği, iklim değişikliği ve çevresel bozulma yoluyla kronik hastalıklar, bulaşıcı hastalıklar ve kanser yükü ile anlamlı biçimde ilişkili olduğu bildirilmektedir. Çevresel davranışların eğitim düzeyi, gelir, yaş, cinsiyet, aile yapısı ve doğayla etkileşim gibi çok sayıda bireysel ve yapısal belirleyiciyle ilişkili olduğu; bu davranışların yalnızca bireysel tercihlerle açıklanamayacağı vurgulanmaktadır.Halk sağlığı hemşireleri, birincil koruma, çevresel risklerin değerlendirilmesi, sağlık eğitimi, davranış değişikliği danışmanlığı ve savunuculuk rolleri aracılığıyla çevre–sağlık etkileşiminin yönetiminde stratejik bir konuma sahiptir. Türkiye’de çevresel davranışlar ile sağlık çıktıları arasındaki ilişkiyi doğrudan ele alan çalışmaların sınırlı olduğu dikkate alındığında, halk sağlığı hemşireliğinin bu alandaki rolünün güçlendirilmesi, çevre sağlığı temelli eğitim ve müdahale programlarının yaygınlaştırılması ve sağlık sonuçlarıyla ilişkilendirilen araştırmaların artırılması önerilmektedir.

This narrative review aims to comprehensively evaluate the effects of individual and collective environmental behaviors on public health from a public health nursing perspective. The review examines environmentally friendly and environmentally harmful behavior types, their sociodemographic and environmental determinants, and their associations with respiratory, cardiovascular, neurological–psychological, infectious, and oncological health outcomes through an analysis of national and international literature. In this context, studies published in Turkish and English between 2015 and 2025 were evaluated through a non-systematic literature search conducted in PubMed, Scopus, Web of Science, and Google Scholar databases. The findings indicate that pro-environmental behaviors reduce exposure to air pollution and are associated with lower risks of respiratory and cardiovascular diseases, while access to green spaces and nature-based activities support psychological well-being and mental health. Conversely, environmentally harmful behaviors are reported to be significantly associated with increased burdens of chronic diseases, infectious diseases, and cancer through pathways such as air pollution, climate change, and environmental degradation. Environmental behaviors are influenced by multiple individual and structural determinants, including education level, income, age, gender, family structure, and interaction with nature, highlighting that these behaviors cannot be explained solely by individual choice. Public health nurses occupy a strategic position in managing the environment–health nexus through their roles in primary prevention, environmental risk assessment, health education, behavior change counseling, and advocacy. Given the limited number of studies in Türkiye that directly examine the relationship between environmental behaviors and health outcomes, strengthening the role of public health nursing in this field, expanding environment-focused education and intervention programs, and increasing research linking environmental behaviors to health outcomes are strongly recommended.

 çevresel davranış iklim değişikliği halk sağlığı çevresel sürdürülebilirlik halk sağlığı hemşireliği environmental behavior climate change public health environmental sustainability public health nursing Alyami, M. M., Balharith, F. H., Ravi, S. K., & Reddy, R. S. (2025). Urban air pollution and chronic respiratory diseases in adults: Insights from a cross-sectional study. Frontiers in Public Health, 13, 1-11. https://doi.org/10.3389/fpubh.2025.1507882 Anderson, D. J., & Krettenauer, T. (2021). Connectedness to nature and pro-environmental behaviour from early adolescence to adulthood: A comparison of urban and rural Canada. Sustainability, 13(7), 1-17. https://doi.org/10.3390/su13073655 Argacha, J. F., Bourdrel, T., & Van De Borne, P. (2018). Ecology of the cardiovascular system: A focus on air-related environmental factors. Trends in Cardiovascular Medicine, 28(2), 112–126. https://doi.org/10.1016/j.tcm.2017.07.013 Berman-Rosa, M., Logan, J., Ghazawi, F. M., Le, M., Conte, S., Netchiporouk, E., Mukovozov, I. M., Cyr, J., Mourad, A., Miller, W. H., & others. (2022). Analysis of geographic and environmental factors and their association with cutaneous melanoma incidence in Canada. Dermatology, 238(6), 1006–1017. https://doi.org/10.1159/000524949 Bouman, T., Steg, L., & Perlaviciute, G. (2021). From values to climate action. Current Opinion in Psychology, 42, 102–107. https://doi.org/10.1016/j.copsyc.2021.04.010 Cavalier, H., Trasande, L., & Porta, M. (2023). Exposures to pesticides and risk of cancer: Evaluation of recent epidemiological evidence in humans and paths forward. International Journal of Cancer, 152(5), 879–912. https://doi.org/10.1002/ijc.34300 Charlson, F., Ali, S., Benmarhnia, T., Pearl, M., Massazza, A., Augustinavicius, J., & Scott, J. G. (2021). Climate change and mental health: A scoping review. International Journal of Environmental Research and Public Health, 18(9), 1-23. https://doi.org/10.3390/ijerph18094486 Costa, M. J. S., Azeiteiro, U., Ryan, R., Ferrito, C., & Melo, P. (2025). Nursing interventions to reduce health risks from climate change impact in urban areas: A scoping review. International Journal of Environmental Research and Public Health, 22(8), 1-33. https://doi.org/10.3390/ijerph22081177 Culqui Lévano, D. R., Díaz, J., Blanco, A., Lopez, J. A., Navas, M. A., Sánchez-Martínez, G., Luna, M. Y., Hervella, B., Belda, F., & Linares, C. (2022). Mortality due to COVID-19 in Spain and its association with environmental factors and determinants of health. Environmental Sciences Europe, 34, 1-12. https://doi.org/10.1186/s12302-022-00617-z Dadvand, P., Nieuwenhuijsen, M. J., Esnaola, M., Forns, J., Basagaña, X., Alvarez-Pedrerol, M., Rivas, I., López-Vicente, M., De Castro Pascual, M., Su, J., Jerrett, M., Querol, X., & Sunyer, J. (2015). Green spaces and cognitive development in primary schoolchildren. Proceedings of the National Academy of Sciences (PNAS), 112(26), 7937–7942. https://doi.org/10.1073/pnas.1503402112 de Bont, J., Jaganathan, S., Dahlquist, M., Persson, Å., Stafoggia, M., & Ljungman, P. (2022). Ambient air pollution and cardiovascular diseases: An umbrella review of systematic reviews and meta-analyses. Journal of Internal Medicine, 291(6), 779–800. https://doi.org/10.1111/joim.13467 Dereli, F. (2024). Hemşirelik öğrencilerinin çevresel risk algıları ile çevresel tutumları arasındaki ilişkinin incelenmesi. Hemşirelikte Eğitim ve Araştırma Dergisi, 21(2), 85–92. https://doi.org/10.61399/ikcusbfd.1461407 Ergin, R. G., & Dal, N. E. (2023). Davranışsal çevre bilincinin sürdürülebilir tüketim davranışına etkisi hakkında bir araştırma. Bilge Uluslararası Sosyal Araştırmalar Dergisi, 7(1), 28–53. https://doi.org/10.47257/busad.1306912 Glanz, K., Rimer, B. K., & Viswanath, K. (2015). Health behavior: Theory, research, and practice (5. baskı). Jossey-Bass. Gómez Gómez, R. E., Kim, J., Hong, K., Jang, J. Y., Kisiju, T., Kim, S., & Chun, B. C. (2022). Association between climate factors and dengue fever in Asuncion, Paraguay: A generalized additive model. International Journal of Environmental Research and Public Health, 19(19), 1-10. https://doi.org/10.3390/ijerph191912192 Gömülütaş, M., & Gençay, S. (2024). Doğa kulüplerine üye rekreasyonel doğa yürüyüşçülerinin çevresel davranışlarının incelenmesi. International Journal of Social and Humanities Sciences Research, 11(104), 493–502. https://doi.org/10.5281/zenodo.10737548 Gürgen Şimşek, H., & Altuğ Özsoy, S. (2024). Evaluation of the effectiveness of hospital recycling program for improving nurses' recycling behaviours. Journal of Basic and Clinical Health Sciences, 8, 308–318. https://doi.org/10.30621/jbachs.1257886 Hatono, Y., Suzuki, H., & Shimazu, T. (2025). Developing a scale to measure public health nurses’ advocacy practices in group and community settings in Japan. Public Health Nursing, 42(1), 161–168. https://doi.org/10.1111/phn.13478 Jones-Garcia, E., Bakalis, S., & Flintham, M. (2022). Consumer behaviour and food waste: Understanding and mitigating waste with a technology probe. Foods, 11(14), 1-31. https://doi.org/10.3390/foods11142048 Kadelbach, P., Weinmayr, G., Chen, J., Jaensch, A., Rodopoulou, S., Strak, M., de Hoogh, K., Andersen, Z. J., Bellander, T., Brandt, J., Cesaroni, G., Fecht, D., Forastiere, F., Gulliver, J., Hertel, O., Hoffmann, B., Hvidtfeldt, U. A., Katsouyanni, K., Ketzel, M., … Nagel, G. (2024). Long-term exposure to air pollution and chronic kidney disease-associated mortality: Results from the pooled cohort of the European multicentre ELAPSE study. Environmental Research, 252(Part 3), 1-9. https://doi.org/10.1016/j.envres.2024.118942 Kestepe, M. S., & Karatekin, K. (2024). Öğretmen adaylarının ekolojik kimlikleri ile sorumlu çevresel davranışları arasındaki ilişkinin incelenmesi. Diyalektolog – Uluslararası Sosyal Bilimler Dergisi, (34), 1–13. https://doi.org/10.29228/diyalektolog.74147 Kurth, A. E. (2017). Planetary health and the role of nursing: A call to action. Journal of Nursing Scholarship, 49(6), 598–605. https://doi.org/10.1111/jnu.12343 Linder, N., Giusti, M., Samuelsson, K., & Barthel, S. (2022). Pro-environmental habits: An underexplored research agenda in sustainability science. Ambio, 51(3), 546-556. https://doi.org/10.1007/s13280-021-01619-6 Lucas, R., Norval, M., Neale, R. E., Young, A. R., de Gruijl, F. R., Takizawa, Y., & van der Leun, J. C. (2015). The consequences for human health of stratospheric ozone depletion in association with other environmental factors. Photochemical & Photobiological Sciences, 14(1), 53–87. https://doi.org/10.1039/c4pp90033b Megha. (2024). Determinants of green consumption: A systematic literature review using the TCCM approach. Frontiers in Sustainability, 5, Article 1-26. https://doi.org/10.3389/frsus.2024.1428764 McKeon, T. P., Vachani, A., Penning, T. M., & Hwang, W. T. (2022). Air pollution and lung cancer survival in Pennsylvania. Lung Cancer, 170, 65–73. https://doi.org/10.1016/j.lungcan.2022.06.004 Meo, S. A., Abukhalaf, A. A., Alessa, O. M., Alarifi, A. S., Sami, W., & Klonoff, D. C. (2021). Effect of environmental pollutants PM2.5, CO, NO2, and O3 on the incidence and mortality of SARS-CoV-2 infection in five regions of the USA. International Journal of Environmental Research and Public Health, 18(15), 1-12. https://doi.org/10.3390/ijerph18157810 Mora, C., McKenzie, T., Gaw, I. M., Dean, J. M., von Hammerstein, H., Knudson, T. A., Setter, R. O., Smith, C. Z., Webster, K. M., Patz, J. A., & others. (2022). Over half of known human pathogenic diseases can be aggravated by climate change. Nature Climate Change, 12(9), 869–875. https://doi.org/10.1038/s41558-022-01426-1 Najafi, E., Khanjani, N., Ghotbi, M. R., & Nejad, M. E. M. (2019). The association of gastrointestinal cancers (esophagus, stomach, and colon) with solar ultraviolet radiation in Iran—An ecological study. Environmental Monitoring and Assessment, 191, 1-12. https://doi.org/10.1007/s10661-019-7263-0 Nickel, S., & von dem Knesebeck, O. (2020). Effectiveness of community-based health promotion interventions in urban areas: A systematic review. Journal of Community Health, 45(2), 419–434. https://doi.org/10.1007/s10900-019-00733-7 Orellano, P., Kasdagli, M. I., Pérez Velasco, R., & Samoli, E. (2024). Long-term exposure to particulate matter and mortality: An update of the WHO global air quality guidelines systematic review and meta-analysis. International Journal of Public Health, 69, 1-14. https://doi.org/10.3389/ijph.2024.1607683 Otto, S., & Pensini, P. (2017). Nature-based environmental education of children: Environmental knowledge and connectedness to nature, together, are related to ecological behaviour. Global Environmental Change, 47, 88–94. https://doi.org/10.1016/j.gloenvcha.2017.09.009 Özdemir, Z., & Özeltürkay, Y. E. (2019). Tüketicilerin çevre konusundaki bilinçlerinin eko–etiketli gıdalar için daha fazla ödeme isteklilikleri üzerindeki etkisi: Adana ili örneklemi. Çukurova Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 23(1), 77–100. https://izlik.org/JA77ZF92HX Park, H., Kang, C., & Kim, H. (2024). Association between air pollution (PM10, PM2.5), greenness and depression in older adults: A longitudinal study in South Korea. Epidemiology and Psychiatric Sciences, 33, 1-10. https://doi.org/10.1017/S2045796024000684 Peters, R. L., Mavoa, S., & Koplin, J. J. (2022). An overview of environmental risk factors for food allergy. International Journal of Environmental Research and Public Health, 19(2), 1-12. https://doi.org/10.3390/ijerph19020722 Piao, X., & Managi, S. (2024). Determinants of pro-environmental behaviour: Effects of socioeconomic, subjective, and psychological well-being factors from 37 countries. Humanities and Social Sciences Communications, 11, 1-17. https://doi.org/10.1057/s41599-024-03790-z Purushothaman, V. L., Cuomo, R. E., Garland, C. F., & Mackey, T. K. (2021). Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer? BMC Public Health, 21, 1-19. https://doi.org/10.1186/s12889-021-11089-w Romanello, M., Walawender, M., Hsu, S.-C., Moskeland, A., Palmeiro-Silva, Y., Scamman, D., … & Watts, N. (2025). The 2025 report of the Lancet Countdown on health and climate change: Climate change action offers a lifeline. The Lancet, 406(10521), 2804–2857. https://doi.org/10.1016/S0140-6736(25)01919-1 Saraç, H., & Özarslan, M. (2018). Üstün zekâlı ve yetenekli öğrencilerin çevresel tutum düzeyleri ile bilişüstü yetilerinin bazı değişkenler açısından incelenmesi. Journal of Computer and Education Research, 6(11), 65–87. https://doi.org/10.18009/jcer.364377 Sawyer, L., Kemp, S., James, P., & Harper, M. (2021). Assessment of a nurse-led energy behavior change intervention in an NHS community hospital ward. Energies, 14(20), 1-17. https://doi.org/10.3390/en14206523 Semenderoğlu, A., & Arslan, K. (2022). Coğrafya öğretmen adaylarının çevresel davranışlarının belirlenmesi: Buca Eğitim Fakültesi örneği. International Journal of Geography and Geography Education, (46), 1-19. https://doi.org/10.32003/igge.1071222 Sharma, A., Verma, H. K., Joshi, S., Panwar, M. S., & Mandal, C. C. (2015). A link between cold environment and cancer. Tumor Biology, 36(8), 5953–5964. https://doi.org/10.1007/s13277-015-3270-0 Shen, J., Wong, C. U. I., Zhang, H., Li, F., & Chen, J. (2025). The intrinsic experience of tourism autobiographical memory on environmentally responsible behavior: A self-expansion perspective. Behavioral Sciences, 15(1), 1-20. https://doi.org/10.3390/bs15010002 So, R., Andersen, Z. J., Chen, J., Stafoggia, M., de Hoogh, K., Katsouyanni, K., Vienneau, D., Rodopoulou, S., Samoli, E., Lim, Y.-H., Hoffmann, B., Weinmayr, G., Sørensen, M., & Loft, S. (2022). Long-term exposure to air pollution and mortality in a Danish nationwide administrative cohort study: Beyond mortality from cardiopulmonary disease and lung cancer. Environment International, 164, 1-13. https://doi.org/10.1016/j.envint.2022.107241 Sundas, A., Contreras, I., Mujahid, O., Beneyto, A., & Vehi, J. (2024). The effects of environmental factors on general human health: A scoping review. Healthcare, 12(21), 1-38. https://doi.org/10.3390/healthcare12212123 Syed, S., Acquaye, A., Khalfan, M. M., Obuobisa-Darko, T., & Yamoah, F. A. (2024). Decoding sustainable consumption behavior: A systematic review of theories and models and provision of a guidance framework. Resources, Conservation & Recycling Advances, 20, 1-26. https://doi.org/10.1016/j.rcradv.2024.200232 Tian, H., & Liu, X. (2022). Pro-environmental behavior research: Theoretical progress and future directions. International Journal of Environmental Research and Public Health, 19(11), 1-16. https://doi.org/10.3390/ijerph19116721 Topçu Yenerçağ, F. N., & Sünter, A. T. (2022). Effects of air pollution on mortality and morbidity in Samsun province of Turkey. Middle Black Sea Journal of Health Science, 8(4), 624–638. https://doi.org/10.19127/mbsjohs.1158787 Twohig-Bennett, C., & Jones, A. (2018). The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes. Environmental Research, 166, 628–637. https://doi.org/10.1016/j.envres.2018.06.030 World Health Organization. (2013). Outdoor air pollution a leading environmental cause of cancer deaths (IARC Scientific Publication No. 161). World Health Organization. (2016). Estimating environmental health impacts. https://www.who.int/activities/environmental-health-impacts World Health Organization. (2023, October 12). Climate change and health. https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health Xia, X., Ren, P., Wang, X., Liu, D., Chen, X., Dan, L., He, B., He, H., Ju, W., Liang, M., Lu, X., Peng, J., Qin, Z., Xia, J., Zheng, B., Wei, J., Yue, X., Yu, G., Piao, S., & Yuan, W. (2024). The carbon budget of China: 1980–2021. Science Bulletin, 69(1), 114–124. https://doi.org/10.1016/j.scib.2023.11.016 Yıldırım, M. S., Elkoca, A., Gökçay, G., Yılmaz, D. A., & Yıldız, M. (2025). The relationship between environmental literacy, ecological footprint awareness, and environmental behavior in adults. BMC Public Health, 25, 1-9. https://doi.org/10.1186/s12889-025-21340-3 Zoran, M. A., Savastru, R. S., Savastru, D. M., & Tautan, M. N. (2020). Assessing the relationship between surface levels of PM2.5 and PM10 particulate matter impact on COVID-19 in Milan, Italy. Science of The Total Environment, 738, 1-12. https://doi.org/10.1016/j.scitotenv.2020.139825