The Local to Global Ripple Effects of Planetary Health
By Rebecca Jamieson
Although it’s in Los Angeles County, the high desert town where Ashley Smith, MSN, RN, PHN, grew up, felt a world away from the big city. “I grew up on a ranch with five acres and a lot of animals,” she says. “Growing up in a small town, you’re used to everyone jumping in and helping. Our door was open to anyone and everyone.”
Acton, CA, where Smith grew up, was predominantly white. But, as families were pushed out of L.A. by rising costs and gentrification, the area became more diverse, and not everyone in the community was as welcoming as Smith’s family.
Those early experiences forged Smith’s commitment to social justice. In high school, she joined Leo Club International, the Lions Club International youth organization, which connected her with international communities and honed her leadership skills and ability to speak out about inequity. “Because of my upbringing, I’ve always had this call to help. I have a deep empathy for people,” she says.
Those early experiences forged Smith’s commitment to social justice. In high school, she joined Leo Club International, the Lions Club International youth organization, which connected her with international communities and honed her leadership skills and ability to speak out about inequity. “Because of my upbringing, I’ve always had this call to help. I have a deep empathy for people,” she says.
That concern for others sparked her interest in nursing. Initially, Smith wanted to become a cardiothoracic intensive care unit nurse; a medical mission to Panama sent her in a different direction. “It changed my world because I saw communities coming together — public health nurses helping their community by trekking through the jungle, bringing vaccines out, addressing inequities and social determinants of health,” she remembers. “That, to me, was real nursing.”
Despite how impactful traveling was, Smith decided to return home. “I left my hometown thinking I’m never coming back because that’s what we always do in our early twenties. But I couldn’t imagine serving any other community.”
After completing her bachelor of science in nursing and a master’s degree in school nursing, Smith decided to pursue a doctorate. She was drawn to Madison because her father grew up there, and the University of Wisconsin–Madison is her family’s legacy school. When she saw that UW–Madison had started an online doctor of nursing practice (DNP) program in population health, she knew the time was right. “It was like all the stars aligned,” Smith says.
The resources available at a state university also appealed to her. “I wanted to make sure that I was going to become a leader and a change agent,” she says. “I knew UW–Madison would definitely help me get there, and that’s why I chose it. I’m so thankful I did because it’s been an amazing experience.”
A supportive phone call with Dr. Katie Gillespie, who would be Smith’s advisor, sealed the deal. “With all the advice she gave me before I’d even applied to the program, I knew I was going to be set up for success.”
The online format of the program hasn’t been a challenge. “I very much feel a part of the culture of UW even though I’m an online student,” she says. The small cohort size also helps her feel connected. “We’re constantly talking to each other. And I’m just a phone call or an email away from any advisor. The relationships that I’ve established with faculty, advisors, and support staff through this journey have opened up so many doors of opportunity.”
Smith is already putting her DNP education to use. She recently started a nonprofit called Village in Action, which focuses on families involved in the justice system and helps them connect to resources. Her goal is to break the cycle of incarceration. “We want to show kiddos who are headed down the wrong path how a life with better connections, maybe going to college or trade school, can get them back on track to a better life.”
Smith is also passionate about planetary health — a solutions-oriented, transdisciplinary field and social movement focused on analyzing and addressing how human disruptions to Earth’s natural systems impact human health and all life on Earth. She’s putting her passion to work as an intern with the Alliance of Nurses for Healthy Environments (ANHE), a global nursing organization focused on the intersection of health and the environment. She’s currently supporting a federal-level working group that provides recommendations and feedback to the Occupational Safety and Health Administration (OSHA) regarding heat-related illness in workers. “It’s so inspiring to work with brilliant people who are thinking outside the box and looking at difficult situations with the perspective of positivity,” she says.
As if her plate isn’t full enough, Smith is also the North American regional nursing lead for the Planetary Health Report Card — a student-led, metric-based tool for evaluating and improving planetary health content in health professional schools. School of Nursing faculty Dr. Jessica LeClair recommended Smith for the position.
In January, Smith gave a presentation about the collaborative approach to the Planetary Health Report Card for ANHE’s Nurses Climate Challenge. She shared the student-led evaluation of how planetary health is integrated into nursing and medical education at UW–Madison. Using the Planetary Health Report Card, students identified key gaps in visibility, leadership, and curricular integration, then offered concrete recommendations to help institutionalize planetary health as a core part of clinical education.
Most nursing students aren’t exposed to planetary health classes. Smith is eager to change that, and she helped Dr. Jessica Coburn create a population health class with planetary health content for undergraduate nursing students at UW–Madison. Smith’s DNP project focuses on how undergraduate nursing students understand the intersection of social determinants of health and health outcomes. She wants to understand if new graduates will be able to apply this to nursing practice when these concepts are integrated throughout nursing curricula.
Smith sees a natural relationship between these two areas. “We can be so hyper-focused on what’s going on with us and our community that we forget we are intertwined with everyone else,” she says. “What we do in Madison affects what is happening in Wisconsin, and that can affect the United States and the entire globe. It’s showing students that there’s a much bigger picture we have to look at.”
When she reflects on the most rewarding part of the DNP program, her connections with faculty stand out. “The program is designed to bring students together in a collaborative way with faculty, and I felt very welcomed into the circle,” Smith says. “Faculty have been the key to my success. They’ve challenged me to think outside the box. I don’t think I would get that at any other university.”
Smith has also found a close-knit community with other students who make biannual trips to Madison together. “Even though we are separated because we’re in the online program, we can come to campus and feel we’ve never left,” she says. “I can’t say enough good things about the program, to be honest.”
For those considering a DNP, Smith says, “If you want to go to a program where you can take your degree and actually do something with it, this is definitely the program for it.” Although it’s hard work, it’s worth it. “The program is designed to make us leaders,” she says. “There’s no doubt in my mind that I’ll be able to take the skills I’ve learned and easily implement them into my practice once I graduate. I feel like I’m prepared for success.”