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Environmental and health education for schoolchildren: other directions for nursing


Crystiane Ribas Batista RibeiroI; Vera Maria SaboiaII; Donizete Vago DaherIII; Fabiana Ferreira KoopmansIV

I Nurse. Master. PhD student, Fluminense Federal University. Niterói, Rio de Janeiro, Brazil. E-mail:
II Nurse. PhD. Full Professor, Fluminense Federal University. Niterói, Rio de Janeiro, Brazil. E-mail:
III Nurse. PhD. Full Professor, Fluminense Federal University. Niterói, Rio de Janeiro, Brazil. E-mail:
IV Nurse. Master. PhD student. Fluminense Federal University. Niterói, Rio de Janeiro, Brazil. E-mail:





Objective: to summarize the scientific production on environmental education for schoolchildren establishing an interface with human health. Method: this integrative literature review was conducted in 2016 in the LILACS, SciELO, MEDLINE, BDENF and PubMed databases. Results: review of 11 articles published between 2012 and 2016 revealed environmental education linked to the possibility of transformation and behavioral change, and highlighting the social/civic perspective. Schoolchildren were also found to have systematic knowledge about the environment as to preservation, but unassociated with health. In addition, the schoolchildren were unconcerned to relate health issues to the context in which they occur. Conclusion: in view of nurses' responsibility as health educators planet-wide, there is a clear need for socio-environmental projects that interrelate humankind, environment and health in such a manner that the knowledge construction is collaborative, and involves school, family and local community.

Keywords: Environmental education; elementary school; health; nursing.




Environmental education encompasses the processes by which the individual and the community construct social values, knowledge, attitudes and skills to preserve the environment, a good of common use of the population, essential to a healthy quality of life and sustainability¹.

The environmental issue has motivated the society to seek solutions to make the human/environment relationship to take place in a sustainable and critical way in favor of humanity. The insertion of environmental education in school programs can be a strategy for the transformation towards a critical conscience based no longer on the valorization of man to the detriment of the environment, but rather in the establishment of a continuous link between both, seeing children as potential agents of change.

Nurses, as health educators, should not lose sight of their co-responsibility in the various health themes. To do this, they need to understand that for men to be considered healthy, they need to be inserted in a healthy environment.

This fact was corroborated in the final report of the 8th National Health Conference, which systematized a model to reform health, conceived as a result of food, housing, education, income, land tenure, labor, transportation, employment, leisure, freedom, access to health services and environment2.

In order to achieve human health, it is understood that all determinants need to be in a satisfactory condition, including the environmental aspects, understanding the environment beyond the exclusionary concept that refers to something that only circumvents the central-man, but it is not found within human life.

All persons should reflect on environmental health, because this does not express an isolated problem; it actually needs interdisciplinary and creative actions. It is thus imperative to address issues involving environmental health in the school setting in view of the challenges posed by this theme, such as the recognition of the consequences of ecological imbalance in human life3.

From this context, the problem of this research was configured in the way environmental education has been worked on among schoolchildren, considering the importance of this discussion in the health area ​​ and in the performance of nurses in schools.

Thus, the objective of the study was to synthesize the scientific production about environmental education with schoolchildren, establishing an interface with human health.



This is an integrative review of literature that included the following databases: PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (MEDLINE), Nursing Database (NURDB), from July to September 2016, with articles published in the last 5 years, 2012-2016.

Integrative review is a research method generally carried out in six stages that allows the search, critical evaluation and synthesis of the available evidence on a given investigated subject, being its final product the current state of the knowledge on the researched subject4. The broad sample along with the multiplicity of proposals generates a consistent and comprehensible picture of complex concepts, theories or health problems that are relevant to nursing5.

For the construction of the first stage of this integrative review, the topic was identified and the guiding question was established, namely: What knowledge has been produced about environmental education with schoolchildren and an interface with human health?

In the second stage, the following descriptors were used to carry out the search in the databases: environmental education and primary education defined according to Health Sciences Descriptors (DeCS) and the Boolean operator and was used to associate them. The inclusion criteria were also established at this stage: adherence to the proposed objective and theme; articles published in Portuguese, English and Spanish; original articles available in full length that portrayed the theme environmental education with Primary School students; and articles published and indexed in the selected databases over the last five years, 2012-2016. The exclusion criteria were: articles repeated in the databases; theses; articles that did not address the theme; articles that were not published in full length.

The third stage consisted of selecting articles, to which a data collection tool was used to organize and synthesize key information, according to the authors' name, reference number at the end of the text, year of publication, methodological approach, and type and objective of the study. After that, the articles were categorized.

In the fourth stage, the studies included in the integrative review6-16 were analyzed in detail, aiming to validate the review.

In the fifth and sixth stage, the results were interpreted based on the discussion of notes made by the various authors, and then the synthetized knowledge about environmental education with schoolchildren in interface with human health was highlighted.

The analysis of data gave rise to two thematic categories: environmental education and its processes; and health in the man/environment relationship.



In 11 texts examined6-16, the distribution of articles evidenced the publication of two to five publications per year, except in 2016, when no scientific production was identified in the selected databases, according to Figure 1.

FIGURE 1: Distribution of the studies examined according to authors, reference number /year of publication/methodological approach /type of study/objectives of the research.

No prevalence of publications on the subject in any journal was observed. However, journals with educational scope are the ones that most publish articles on the subject. The year with greatest more publications was 2013, totaling five publications per year as shown in Figure 1. The predominant methodological approach was qualitative, of the reflective type. Regarding authorship, there was no participation of nurses. As for the databases, three articles were found in LILACS6,15,16 and eight articles in SciELO7,8,9,10,11,12,13,14.

All articles associated environmental education with the possibility of social transformation and change of attitudes. In relation to the contents, the following issues were highlighted: training, context and the social/civic perspective of environmental education7,9,11, collective construction of environmental education, associating scientific knowledge with popular knowledge12,13,16, ecological actions8,14, the use of instruments that promote critical environmental awareness such as information and communication technologies (ICTs) and sports10,15 and association between environmental and human health6.

1st Category: Environmental education and its processes

In this category the contemporary concept of Environmental Education (EE) was analyzed, transcending the green and preservationist paradigm prevalent so far, emphasizing a socially transformative EE.

In Brazil, in the 1980s, environmental education gained significant public dimensions despite the fact that the environmental debate began in the country by international pressures but under the aegis of the military regime in the 1970s. Rising up discussions on the environment was the same as thinking of natural heritage, a technical subject aimed at solving the environmental problems identified and in something that prevented the development of the country17. There was no educational concern beyond ecological and reductionist preservation issues.

The contemporary concept of EE has gained another outlook with discussions on the theme with the impacts of economic development on the environment, and it has therefore become a permanent learning process that seeks to increase the information and public knowledge about environmental problems, promoting critical sense and capacity to intervene civically11.

In the case of environmental liability, some authors highlighted issues associated with economic development with the consequent creation of the expression "Education for Sustainable Development" (ESD) by UNESCO, directing the key theme of EE toward the relationship between society and environment in an attempt to promote behavioral changes11 through communication and education strategies that help to understand the areas of life affected by its inactivity in before environmental issues7.

These strategies aim to play a relevant role in the social field of training for citizenship, which necessarily encompasses mobilization towards sustainable development.

The National Environmental Education Policy (NEEP) determines that EE is a task of the Ministry of the Environment - Department of Environmental Education - in its non-formal organization, and of the Ministry of Education - General Coordination of Environmental Education - in the formal scope. Both collaborate for the planning and realization of EE in Brazil, in the NEEP Management Group9.

In the formal context, however, EE is supposed to be between the educational process for the maintenance of capital and the struggle for an education aimed at social transformation18.

Within the critical area of ​​EE, one of the challenges was to seek theoretical-methodological approaches that guarantee the development of attributes of this subject in the school context as a interdisciplinary, critical and problematizing perspective; the contextualization; the transversality; participatory educational processes; the consideration of the articulation between local and global dimensions; the production and dissemination of didactic-pedagogical materials; the continuous and permanent nature of EE and its critical evaluation19.

However, although regulated since 2002, the insertion of EE in schools (formal scope) has taken place but as a difficult process.

As some studies point out, there is a need for an education that covers science, technology, society and the environment (STSE), reaches undergraduate and graduate courses and updating and improvement courses for teachers so that they be able to integrate environmental awareness into the traditional teaching found in basic schools aiming at a sustainable society10.

It is therefore fundamental to search educational alternatives that can somehow solve the problem of the distancing between students and environmental issues.

In an action-research carried out with schoolchildren in Venezuela, the use of ICTs was highlighted as an innovative strategy in the attempt to solve problems related to environmental degradation10

The development of EE since childhood motivates young people to have greater understanding and sensitivity about the environment and responsibility towards others. Thus, the participation of schoolchildren in all stages of a technological environmental project, focused on research, analysis and reflection situations and composed of key moments of formation of groups for the socialization of the findings, provides a critical reflection on socio-environmental issues.

In the view of Freire, action is only human when, rather than pure doing, it is what to do, being non-dichotomized from reflection20, making dialogue very important in the educational process of EE. The language of thought is translated by the word in its constituent dimensions: action and reflection. The possibility of pronouncing the world in the dialectic action-reflection, mediated by language and thought, is part of the process of constitution of the subject21.

There is also theatrical presentation14 and the continuous practice of sports, which are considered strategies to arise environmental awareness, which would be the starting point for a transformative praxis through active participation in improving the environment, sustainability and citizenship15.

It is possible to perceive the appreciation of bodily practice in nature as the understanding of one's own body and as a path towards a more respectful man/nature relationship. In this sense, the strategy of the theatric play becomes fundamental in the process of environmental awareness.

In a diagnosis carried out in Portugal to learn the types of EE projects carried out in the country, it was identified that most projects do not last more than three years due to the lack of mobilization of civil society and the school community itself, mainly due to the difficulty in involving teachers in the projects11.

In Brazil, according to the proposed discussion, despite increasing the awareness of some segments of society towards environmental issues in the last decades, the majority of the population never participated in any social organization oriented to the promotion of quality of life. Citizens are immersed in a fragmented, individualistic society that is not willing to wait for medium and long-term results22.

In several scenarios, there is stagnation in the face of the current crisis that points to a disenchantment of the world, loss of human freedom and a threat of reification of life, far from the cultivation of social, vitalist, participatory and group values ​​that make the lives of the subjects sustainable, as well as education23.

The facts point to the environmental theme as a revision of the model of life, habits, relationships/contacts, fundamentally passing through the mode of consumption, deleterious or ecological, a new human consciousness and action, a new attitude towards life, immersed in an evolutionary process, which becomes an act of communion with the whole and of collective love toward the neighbor with each expression of being, not as the human being were outside the universe in the process of ascension, but within, as a part and a component of it24.

In the same diagnosis, the predominance of the ecological aspect to the detriment of the civic aspect, an essential chapter of the objectives of the decade of the United Nations of education for sustainable development, is highlighted11.

One of the analyzed studies highlights the internal communication processes in educational institutions as being fragile and implying low levels of appropriation of school environmental projects7. The lack of dissemination of results, which denunciate the achievements of such projects, end up weakening the multiplicity and the incentive to formulate projects and their potentialities in solving real problems7,11.

2nd Category: Health in the man/environment relationship, an interdisciplinary construction

This category discusses the importance of the man/environment/health relationship in school education and the integration of the various disciplines in favor of this formative, social and human construction.

In the twentieth century, one of the ways of driving the field of health closer to the environmental approach was related to the conception of quality of life and health promotion, challenging objectivist, mechanistic, quantitative and disease-focused assumptions that predominate in their theorizations and practices25.

In the man/environment relationship, it is fundamental that health be one of the nuclear issues when thinking about EE. However, some authors emphasize that the value of the natural environment for human health and well-being becomes clear only when earthly systems are degraded. For example, the ability of mangroves, coral reefs, and other types of wetlands to provide wave attenuation and reduce tsunami damage was only highlighted when a Tsunami occurred in the Indian Ocean in 200426,27.

A study carried out with schoolchildren in Cuiabá (MT) found that these children had systematized knowledge about the environment regarding its preservation, but without association with health6. Another study found that EE was not linked to crucial issues such as health, making it difficult to carry out a network action11.

It is a fact that the multiplication of environmental problems has imposed on the various subjects themes for which they were not prepared, and whose confrontation demands a reformulation of teaching and research parameters through an integrated and interdisciplinary conception28.

It has been identified that health issues inherent to the context in which schoolchildren are inserted are little discussed with them; the real world seems to be far from EE. Thus, education for sustainable development must take into account regional realities and respect the cultural diversity of the population12.

A survey of schoolchildren from Honduras regarding the control of the vector of dengue showed that education directed at schoolchildren also generates benefits for their relatives because children share the knowledge with their families16. This, in turn, leads to a readjustment of behavior and long-term results in the community.

Socio-environmental education must be humanist, training new generations of critical thinkers and managers, new generations of people who will put up a fight in favor of human dignity, protection of nature and the possibility of conceiving a development that does not imply the destruction of fauna and flora, neither expropriate territories and or create social crises (crisis of values, ethics, of social institutions, of the sense of being in the world)13.

Thus, the different health professions need to foster discussions both in the training process and in the professional practice so that the relation health and environment become a guiding axis in training29, favoring the effectiveness of policies directed towards the environment30.

The training process must be taken into consideration because it constitutes the basis for raising awareness among future professionals, an opportunity in which essential values ​​are worked out in order to commit to the sustainability of the planet25.

The problems that affect humanity and the environment end up dissociated in the different school contexts due to the way in which they are approached, as a result of super specialization and difficulty to establish interdisciplinary explanatory models, and the construction of a postmodern science that does not seek to be capable of being appropriated by society through the empowerment of the subjects, production of knowledge in a collaborative way31.

Incoherent behaviors of schoolchildren happen due to actions unrelated to theoretical knowledge and may also be tied to the lack of promotion of interdisciplinarity in the school context8. Thus, EE should be basically an interdisciplinary content, which should evolve towards the transdisciplinarity of all sets of knowledge, making possible a learning process that enables citizens to live with sustainability13.



This study made it possible to learn relevant aspects of recent research on the promotion of environmental education with schoolchildren and how human health is inserted in this theme.

Among the articles analyzed, it was noticed that there are no publications made by nurses. This endorses the scientific relevance of this study, since the thematic axis environment and health should guide the process of health education of nurses committed to planetary health.

In all the articles analyzed, the authors pointed to reflective and critical EE as a way of reorienting behaviors, enabling a mobilization for sustainable development and for social transformation. The strategic proposals aimed at achieving a school education aimed at citizenship were the use of ICTs, theatrical presentation and practice of environmental friendly sports.

As for the challenges of EE projects at national and international level, the lack of mobilization of civil society and of the school community itself stood out, mainly due to the difficulty in involving teachers, the predominance of the ecological aspect to the detriment of the civic aspect, weak internal communication processes in educational institutions that result in low levels of appropriation of school environmental projects and of their potential to solve real problems.

In relation to EE with schoolchildren and the interface with health, we identified in the studies examined that the students have systematized knowledge about the environment regarding its preservation, however without association with health. EE is not linked to crucial subjects such as health, making it difficult the network action. Furthermore, there is no concern to relate health issues inherent to the context in which students are inserted.

The importance of interdisciplinarity in the school space and the construction of knowledge in a collaborative way, extended to the family and local community were highlighted.

Despite the distancing of EE from the real proposal in school contexts, it is assumed that the existing knowledge can leverage and direct new research and projects on the subject, fostering the reflection and criticism of other scholars in the subject, permeating the man/environment/health relationship.



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