An ecofeminist conceptual framework to explore gendered environmental health inequities in urban settings and to inform healthy public policy

Abstract

This theoretical exploration is an attempt to conceptualize the link between gender and urban environmental health. The proposed ecofeminist framework enables an understanding of the link between the urban physical and social environments and health inequities mediated by gender and socioeconomic status. This framework is proposed as a theoretical magnifying glass to reveal the underlying logic that connects environmental exploitation on the one hand, and gendered health inequities on the other. Ecofeminism has the potential to reveal an inherent, normative conceptual analysis and argumentative justification of western society that permits the oppression of women and the exploitation of the environment. This insight will contribute to a better understanding of the mechanisms underlying gendered environmental health inequities and inform healthy public policy that is supportive of urban environmental health, particularly for low-income mothers.

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© 2008 The author. Journal compilation © 2008 Blackwell Publishing Ltd
Nursing Inquiry 2008; 15(2): 135–147
Feature
Blackwell Publishing Ltd An ecofeminist conceptual framework
to explore gendered environmental
health inequities in urban settings and
to inform healthy public policy
Andrea Chircop
Dalhousie University, Halifax, Nova Scotia, Canada
Accepted for publication 18 December 2007.
CHIRCOP A. Nursing Inquiry 2008; 15: 135–147
An ecofeminist conceptual framework to explore gendered environmental health inequities in urban settings and to inform
healthy public policy
This theoretical exploration is an attempt to conceptualize the link between gender and urban environmental health. The
proposed ecofeminist framework enables an understanding of the link between the urban physical and social environments
and health inequities mediated by gender and socioeconomic status. This framework is proposed as a theoretical magnifying
glass to reveal the underlying logic that connects environmental exploitation on the one hand, and gendered health inequities
on the other. Ecofeminism has the potential to reveal an inherent, normative conceptual analysis and argumentative justification
of western society that permits the oppression of women and the exploitation of the environment. This insight will contribute
to a better understanding of the mechanisms underlying gendered environmental health inequities and inform healthy public
policy that is supportive of urban environmental health, particularly for low-income mothers.
Key words: ecofeminist theory, environmental health, gender, health inequities, urban health.
Renewed public and political interests in the environment
and its effects on human health create an opportune time
for nurses to once again provide leadership in the area of
environmental health. The mechanisms underlying environ-
mental health inequities are undeniably complex and warrant
innovative conceptualizations to guide research and policy.
This theoretical exploration is an attempt to conceptualize
the link between the environment and health inequities in
a way in which gender, class and the social as well as physical
environments are interconnected to mediate health, or health
inequities. An ecofeminist framework is proposed as a
theoretical magnifying glass to reveal the underlying con-
nections between the physical and social environments as
they relate to gender and health. A brief overview of environ-
mental health inequities in urban settings as they relate to
gender and class, or socioeconomic status, will provide the
context for the discussion. Main concepts of the proposed
ecofeminist framework are outlined and discussed as they
mediate health or health inequities. This insight will con-
tribute to a better understanding of the mechanisms under-
lying gendered environmental health inequities that is
necessary to inform healthy public policy to support urban
environmental health for low-income mothers.
The categories of gender and women are complex and
continuously debated for their usefulness in health research
practice and policy. The following discussion is not meant to
reflect an essentialist position, rather it is emphasized that
there are shared historical, social and political connections
of women as a social group in Western societies. According
to Morrow, Hankivsky and Varcoe (2007), health inequities
for women persist, ‘particularly for women disadvantaged by
multiple forms of oppression’ (p. 3).
Correspondence: Andrea Chircop, School of Nursing, Dalhousie University,
5869 University Avenue, Halifax, Nova Scotia, Canada B3H 3J5
E-mail: andrea.chircop@dal.ca

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136 © 2008 The author. Journal compilation © 2008 Blackwell Publishing Ltd
URBAN ENVIRONMENTS AND
HEALTH INEQUITIES
Today, 80% of North Americans live in urban areas (Canadian
Institute of Health Information (CIHI) 2006; Hancock 2002).
According to Hancock, this makes the urban environment the
‘natural’ environment for the majority of North American
populations. Hancock views urban settlements as human
ecosystems, but cautions that it is important to recognize
that human ecosystems are situated within larger natural
ecosystems, and that human health ultimately depends on
ecosystem health. According to the World Health Organiza-
tion, the environment is ‘one of the most critical contributors’
to the global disease burden (WHO 2005). A viable society
requires a healthy physical environment to support human
health and to sustain its socially created, cultural, economic
and political environments. Therefore, physical and social
environments cannot be dealt with in isolation but have to
be considered as one entity. Urban living necessarily exposes
populations to both the physical and social environments at
the same time, creating complex interactions and pathways
for health. Since people inhabit different physical, social
and historical spaces, the effects, however, on their health
are different.
Evidence suggests that collectively, people in some urban
neighbourhoods are healthier than others. The distribution
of health, for example in Canada, can be visualized on a map
as one of geographical inequality between and within urban
areas (CIHI 2006). Generally, self-reported obesity tends
to be lower in, or near, downtown neighbourhoods, and
in higher income neighbourhoods. Neighbourhoods with
higher rates of postsecondary education, are more likely
to rate their health as very good or excellent, and residents
from these neighbourhoods were more likely to be physically
active and to smoke less (CIHI 2006). This evidence supports
earlier evidence that income and education contribute to
better health (Raphael 2004). However, the CIHI (2006)
research did not employ a gender or time analysis, and
the report clearly states that the mechanism linking
socioeconomic characteristics of neighbourhoods with its
residents is unclear.
After closer examination, this unequal distribution of
health in Canada is related to a combination of factors in the
physical as well as the social environments (Ellen and Turner
1997; CIHI 2006). Studies show that particular geographical
areas or neighbourhoods can expose residents to environ-
mental pollution, hazardous substances and fewer civic
benefits (NIEHS 2004). Examples in the physical environment
include poor urban planning and inadequate housing that
can lead to a variety of health concerns including depression,
aggressive behavior, asthma, obesity, heart disease and stressors
on the immune system (Srinivasan, Fallon and Dearry 2003;
Welch and Kneipp 2005). Housing disrepair, which is dis-
proportionately higher in poor neighbourhoods, can lead to
exposure to lead, pests and air pollution as well as an increase
in injuries. Lack of affordable public transport, sidewalks,
bike lanes, playgrounds and parks can lead to an increased
sedentary lifestyle. Studies have shown an association between
deteriorated physical environments and higher crime rates,
making communities less safe, which can lead to an increase
in social isolation and a sense of disconnect in communities
(Srinivasan, Fallon and Dearry 2003; Welch and Kneipp 2005).
Urban neighbourhoods of low-cost or public housing are
associated with negative health outcomes including higher
rates of asthma, allergies, greater exposure to toxic materials
such as lead and pesticides, increased stress, fear of personal
safety, unintentional injuries, feelings of anger, hopelessness
and frustration, and feelings of shame, lack of control and
stigmatization (Wasylishyn and Johnson 1998; Butterfield
2002; Bent 2003; Kaplan and Kaplan 2003; Gee and Payne-
Sturges 2004; Howell, Harris and Popkin 2005; Welch and
Kneipp 2005; CIHI 2006). The urban environment and its
resources for low-income families have implications for health
and social interactions (Shostak 2000). According to Ellen
and Turner (1997), the neighbourhood environment may
affect people with less socioeconomic resources more than
affluent residents, who can afford to obtain services and gain
access to facilities outside their residential neighbourhood.
In particular, single female-headed households may be more
vulnerable to the neighbourhood environment because of
a lack of resources and a greater dependency on neighbour-
hood services and institutions. Neighbourhood effects need
to be differentiated and explored to identify mechanisms
that link environmental conditions with health. According
to Kemp (2001, 9) ‘it is not appropriate to assume that some
experiences are common to all’; on the contrary, the environ-
ment is experienced differently along axes including
identity, class, race and gender. A review of the literature
indicates that poverty is the leading determinant of health
inequity in Canada. Poverty can be a pathway to environmental
health inequities. The majority of people living in poverty
are women, particularly single mothers and their children.
Gender is a strong mediator in addition to many other deter-
minants of health (Colman 2003; CIHR Institute of Gender
and Health 2004; Spitzer 2005). The negative health outcomes
due to the combination of gender and class for low-income
women are compounded, which becomes a triple jeopardy,
when ethnicity/race is added (Raphael 2004). There is growing
evidence that environmental burdens are disproportionately
carried by women and children, low-income communities,

Ecofeminism
© 2008 The author. Journal compilation © 2008 Blackwell Publishing Ltd 137
indigenous people and neighbourhoods of racial and ethnic
minorities in North America (Bullard 1993; DiChiro 1997;
Gay 1999; Colman 2003; Northridge et al. 2003; Evans
and Marcynyszyn 2004; NIEHS 2004). For example, more
chemical plants with higher risk for accidents, and more
landfills containing hazardous waste, tend to be located
in predominantly African-American and Native American
communities (Elliot et al. 2004; Jackson 2005). The importance
of ethnicity/race in the debate about environmental health
and justice cannot be underestimated and warrants its own
in-depth analysis, which cannot be pursued within the scope
of this discussion.
Negative effects of poverty are compounded by sub-
standard housing (Welch and Kneipp 2005). Since the
majority of Canadians living in poverty are women, more
women tend to be affected by substandard housing arrange-
ments (Colman 2003; Khosla 2006).
The rise in the use of food banks has been associated
with the continuous housing crisis impacting on available
monetary resources for the working and non-working poor
(Bryant 2004). For example, McIntyre, Officer and Robinson
(2003) studied the experience of low-income mothers, and
found that mothers compromise their own food intake to
feed their children. Since more women than men assume
childcare responsibilities, more mothers than fathers jeopardize
their own health to respond to their children’s needs.
Urban infrastructure, for example public transportation,
is often disadvantageous for low-income women (Khosla
2005). Women’s daily activities, particularly mothers with
small children, often require access to transportation schedules
and transit routes which in many cities are designed around
the needs of full-time, down-town, 9 am–5 pm, Monday–Friday,
office employees. School and daycare services for children
often require parents to organize transportation to multiple
locations, and at times outside of 9 am–5 pm.
In summary, women’s health inequities are related to
low-income, poverty and environmental conditions includ-
ing residential exposures in low-income neighbourhoods
and substandard housing (Wasylishyn and Johnson 1998;
Welch and Kneipp 2005). Because of women’s responsibilities
in society, and in particular low-income mothers, they are in
‘positions of unique exposure as well as unique conscious-
ness’ (Clay 2003, A34). Ample evidence indicates that social
determinants of health, including income, housing and
social policy have a far stronger influence on health than
individual lifestyle choices, and are rooted in factors beyond
the control of most individuals (Hayward and Colman 2003;
Raphael 2004). Trends in an increased burden of chronic
diseases are reflected in geographical distributions of
economic and social disparities and a rural–urban divide.
Statistical analysis of urban areas also points to an intra-
urban divide between high-income and low-income urban
neighbourhoods (Community Counts 2006; CIHI 2006).
Effective policy planning to alleviate health inequities
requires a better understanding of these complex relation-
ships (Hayward and Colman 2003). Policies may not
have been designed to disadvantage certain populations;
however, the effect of some policies may create unintended
health inequities. There is an increasing awareness among
some policy-makers of the impact of health promotion
programmes and policies on social and economic inclusion.
To ‘put the population back into population health’ neces-
sitates strategies that include lay knowledge, as well as empirical
evidence, and the importance of integrating upstream policies
with community participation (Hayward and Colman 2003).
The following ecofeminist framework embraces individual
voices from the grassroots that will inform necessary policy
changes (Warren 1996, 1997, 2000; Lock and Kaufert 1998;
Reutter, Neufeld & Harrison 2000; Butterfield 2002; Bent
2003; Brown 2003). It responds to the Ottawa Charter’s (WHO
1986) principles of primary healthcare call, for individuals
to gain control over their lives, and for healthy public policy.
ECOFEMINISM
Framework
This proposed ecofeminist framework consists of a core
which constitutes the overlap between low-income mothers’
systematic oppression, urban neighbourhood (physical
and social environments), and mothers’ local knowledge.
This overlap warrants ecofeminist analysis (Warren 1997).
The analysis simultaneously informs and is informed by
important connections between women as a group in society
and the physical environment. These connections are
conceptual, socioeconomic, epistemological, empirical,
ethical and historical. An ecofeminist analysis is diagnostic
and future oriented and informs healthy public policy to
address gendered environmental health inequities (Fig. 1).
According to ecofeminism, there are important connec-
tions between the domination of women, as a social group,
and the domination of nature within patriarchal societies.
In order to overcome domination, one of its forms cannot be
addressed without simultaneously addressing others (Warren
1996, 1997, 2000). Ecofeminism is an action-oriented
philosophy, a theory in progress as well as a practice (Lahar
1996). Its goals are to deconstruct oppressive and exploita-
tive social practices, and to re-construct more viable social
and political communities (Lahar 1996). The liberation
of nature requires the liberation of women, and vice versa

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138 © 2008 The author. Journal compilation © 2008 Blackwell Publishing Ltd
(Gardner 2006). Human societies have the capacity to change
exploitative and oppressive practices.
Ecofeminists understand the relationship between human
and non-human nature as one of respect, based not only on
reason, but also on emotional values of love, friendship
and care (Plumwood 1996). The relationship is one of inter-
relatedness and interconnectedness, with an appreciation
for difference and distinctness (Plumwood 1996; Warren
1996; Glazebrook 2004). If both health and environmental
inequities based on gender, race/ethnicity and class are
a result of oppression, then, according to ecofeminism, these
inequities need to be addressed simultaneously.
One simply cannot make ecologically perfect decisions or
lead an ecologically perfect lifestyle within current institu-
tional structures characterized by unequal distributions of
wealth, consumption of energy, and gendered divisions of
labour. When institutional structures themselves are unjust,
it is often difficult to make truly just decisions within them
(Warren 2000, 45).
Ecofeminism in this sense is not about judging
individuals’ decision-making as being good or bad; rather,
it is concerned about institutional structures of power
and privilege and how they impact on people’s everyday
decisions and lives (Warren 2000). Ecofeminist theory then
connects the physical environment, oppressive social struc-
tures and women’s concrete, everyday experiences.
According to ecofeminist philosopher Warren (2000),
ecofeminism draws from feminism, ecology and environ-
mentalism, and from philosophy. From feminism, it draws
a sex/gender analysis. It draws insights from ecology and
environmentalism into the human–nature interaction, and
from philosophy, it draws a conceptual analysis and argumen-
tative justification. What makes ecofeminism feminist is that
its starting point is women’s experiences, and its analysis
starts with gender. What makes ecofeminism an environmental
ethic lies in its acknowledgement that non-human nature
warrants human moral consideration. The conceptual
analysis that makes ecofeminism a philosophy holds that
all forms of unjustified domination in the west are based on
the same western, patriarchal logic of domination. Accord-
ing to Warren (1996), this logic holds that the female is
associated with nature, whereas the male is associated
with culture. Nature is regarded as the opposite of culture
(including reason).
Origins
Ecofeminist philosophy recognizes the connection between
the environment and women as one of shared oppression.
In 1974, French feminist Françoise d’Eaubonne (as cited
in Glazebrook 2002, 12) coined the term ‘ecofeminism’ by
establishing a connection between overpopulation through
the exploitation of women’s reproductive capacity, and
resource scarcity through the destruction and exploitation
of natural resources for material production. This dual
exploitation is threatening human survival. Ecofeminism,
as a philosophical and political movement, aims to reveal
oppressive ideologies, practices and structures within
patriarchal social systems that support these interconnected
Figure 1 Ecofeminist framework

Ecofeminism
© 2008 The author. Journal compilation © 2008 Blackwell Publishing Ltd 139
exploitations, and seeks their elimination; as such, it is
diagnostic and future oriented (Glazebrook 2002).
Contemporary ecofeminists have expanded the notion
of oppression beyond early feminist analyses of gender to be
more inclusive. According to Warren (1997), ecofeminism is
concerned with the connection between women, people
of colour, children, the poor and nature. Thus, issues of
oppression within patriarchal social structures and societies
cannot be dealt with in isolation, but must be addressed
simultaneously. The oppression of women, children, the poor
and ethnic/racial minorities within patriarchy is interrelated
by a common logic of domination.
CONNECTIONS BETWEEN WOMEN AND
THE ENVIRONMENT
Conceptual connections: Warren’s
logic of domination
The logic of domination is the central feature of an oppres-
sive conceptual framework, and some of the most important
connections between women and nature are conceptual
(Warren 1996). Warren illustrates the nature of conceptual
frameworks, which are socially constructed sets of basic
values and beliefs that influence how we see ourselves and
the world around us. Conceptual frameworks are influenced
by many factors including age, race, gender, nationality and
religion. According to Warren, conceptual frameworks are
oppressive if they explain, justify and maintain relationships
of domination and subordination. For example, a patriarchal
framework explains, justifies and maintains the subordina-
tion of women by men. Patriarchy is defined as a system of
male domination (Gardner 2006), recognizing that individual
women can enact patriarchal values, and that individual men
can suffer under patriarchal domination; for example, if
there is an ethnic/race, and/or class difference between the
oppressor and the oppressed. Patriarchal domination is a
system of male power to maintain their privilege and control
over natural, economic and social resources in society. For
Warren (2000), patriarchy is an unhealthy social system:
The claim that patriarchy is a social system locates patriarchy
within historical, socioeconomic, cultural and political
contexts thoroughly structured by such factors as gender,
race/ethnicity, class, age, ability, religion, national and
geographic location. The claim that patriarchy is an unhealthy
social system describes and evaluates patriarchy as a system
of up–down relationships of domination and subordination
in which downs, and, in many respects, ups, have difficulty
getting their basic needs met. The downs in an unhealthy
patriarchal system include women, other human others
(sic), and non-human animals and nature (p. 206).
The faulty belief system underlying patriarchal domination
is evident in oppressive conceptual frameworks. According
to Warren (1996), the most significant features of oppressive
frameworks are: (i) value dualism which uses a disjunctive
pair to establish exclusiveness and opposition rather than com-
plementarities and inclusiveness, for example, when histori-
cally ‘mind’, ‘reason’ and ‘male’ are portrayed as opposites
of ‘body’, ‘emotion’ and ‘female’; (ii) value-hierarchical
thinking which places a higher value on what is ‘up’ as
opposed to ‘down’; and (iii) justification of the domination
of the group subordinated in value-hierarchical thinking.
That is, a logic of domination is established when the
structure of an argument leads to justification of subordina-
tion (Warren 1996, 20). The most significant feature of an
oppressive framework is the logic of domination because
an ethical premise is needed to establish the argument to
sanction a ‘legitimate’ subordination. What is problematic
then is not value-hierarchical thinking in itself, but the way
and to what end an oppressive conceptual framework is
constructed and used to justify subordination. This is
established by a combination of the logic of domination with
value-hierarchical thinking and value dualism as illustrated
in Warren’s following example:
Humans do, and plants and rocks do not, have the capacity
to consciously and radically change the community in
which they live.
Whatever has the capacity to consciously and radically
change the community in which it lives is morally superior
to whatever lacks this capacity.
Thus, humans are morally superior to plants and rocks.
For any X and Y, if X is morally superior to Y, then X is
morally justified in subordinating Y.
Thus, humans are morally justified in subordinating plants
and rocks (Warren 1996, 22).
This argument, which uses the assumption of moral
superiority and the assumption that superiority justifies
domination, is expanded in western patriarchal societies
to justify the dual oppression of women and nature:
Women are identified with nature and the realm of the
physical; men are identified with the ‘human’ and the
realm of the mental.
Whatever is identified with nature and the realm of the
physical is inferior to (‘below’) whatever is identified with
the ‘human’ and the realm of the mental: or conversely,
the latter is superior to (‘above’) the former.
Thus, women are inferior to (‘below’) men; or, conversely,
men are superior to (‘above’) women.
For any X and Y, if X is superior to Y, the X is justified in
subordinating Y.
Thus, men are justified in subordinating women (Warren
1996; 22).

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The notion that women are identified with nature, and
that whatever is identified with nature is inferior to the
‘man’ has historically been asserted in dominant western
philosophical and intellectual tradition (Ortner 1986;
Merchant 1993; Warren 1996; Twine 2001). As Warren
(1996) explains, these assertions are then regarded as
matters of historical fact, and accepted as the truth. This
truth is perpetuated by ideologies that are kept alive by
metaphors that describe women as chickens, cows, hare-brains
and snakes, while nature (or whoever is considered weak) is
described as barren, and needing to be penetrated (Merchant
1993; Warren 1997). The female is naturalized, and nature
is feminized.
This is supported by Twine (2001), who states that
historically in the west, women are categorized as closer to
nature and more embodied than men. He argues that
certain bodies are socially constructed as ‘marked bodies’
to confer a lesser status upon a person and to establish
otherness. He explains the hierarchical up–down logic
underlying the animalization of people as vertical
matching of western dualisms. Building on Descartes’
contribution to western dualism, in particular his under-
standing of animals as mere bodies, Twine argues that
associating certain bodies with animals constitutes a process
of agency stripping.
For ecofeminist sociologist Ariel Salleh (2003), the
industrial division of labor lead to fragmentation of know-
ledge. Tacit, lay knowledge was marginalized, which
alienated people from their own organic nature, resulting
in environmental abuse. According to Salleh, current social
movements, to overcome the global ecological crisis, seek
strategies across the human-nature divide ‘with little help
from sociological theory’ (p. 61). She argues that ‘the nexus
where reproductive labour and its knowledges mediate
humanity and nature is the most promising vantage point
for an ecologically literate sociology’ (p. 74). Sociology’s
historic separation of human and nature, which can be found
in the split between productive and reproductive labour,
reflects a masculine social construction of gender identity,
and consequently its conceptualization of human and
nature as dichotomous. Through this analysis, ecofeminism
becomes sociology of knowledge (Salleh 2003). It does so
by critiquing gender-biased construction of the sociological
concepts used to explain how society works. The relevance
of ecofeminism as sociology of knowledge is that the starting
point for inquiry is women’s experiences of their urban
environments, and a critical analysis and sensitivity towards
gender-biased conceptualizations that underlie hegemonic
discourses concerning women living in poverty and low-
income urban neighbourhoods.
This, however, is a different approach from ecofeminist
philosophy’s patriarchal logic of domination put forward by
Warren (1996, 1997, 2000). Using Warren’s logic of domina-
tion would facilitate an understanding that the economy
of patriarchal society does not value women’s reproductive
capacity equally to the material production of goods and
services that, in contrast to childbearing and childrearing,
are accounted for in national gross domestic productivity.
At the same time, dimensions of the environment, that
cannot easily be converted into monetary value, are also
not valued and accounted for equally (Colman 2005). The
link between Salleh, Warren and Twine is that the valuing, or
rather devaluing, is at the ideological level. This hegemonic
ideology offers a seemingly rational explanation of the
superiority of men over nature and women, to justify ongoing
oppression and exploitation.
The power of ecofeminism can be seen in its analysis of
oppressive conceptual frameworks as they relate to the treat-
ment of women and nature, and the acknowledgement of
meaningful difference that does not sanction domination.
As such, ecofeminism is relevant beyond a nature–gender
connection to include race, class, sexual identity, religion and
many more factors. Within the context of Canadian public
policy, this analysis contributes to a better understanding of
the social and political determinants of health by explicating
neo-liberal agendas of policy-making that have weakened
the Canadian welfare state and at the same time promoted
the notion of individual responsibility for health and welfare
(Raphael 2004).
Socioeconomic connections
The connection among women, people of colour, children,
the poor and nature, lies at the intersection of common
experience of oppressive socioeconomic structures within
patriarchal societies. The majority of the poor are women
and children. Women of colour tend to be worse off in
terms of, for example, income, education, health and living
standards (Colman 2003). Economic inequity based on
evidence of income, employment and unpaid domestic
work is the broadest underlying factor in gendered health
disparities (Spitzer 2005). It leads to compromised access for
women to education, housing, health-care, childcare and
nutrition.
The socioeconomic connection between women and
nature is evident in the exploitation of women’s labour
and reproduction, and the exploitation and destruction of
natural resources. Although Warren (2000) illustrates the
socioeconomic connection based mainly on examples of
mal-development policies in countries such as India, the

Ecofeminism
© 2008 The author. Journal compilation © 2008 Blackwell Publishing Ltd 141
socioeconomic connection is also relevant to Canada.
Environmental destruction and resource depletion directly
affect women’s lives in the form of exposure to hazardous
toxic materials at work or at home, and living conditions in
dilapidated, unsafe neighbourhoods with negative health
impacts, based on the available empirical data (Srinivasan,
Fallon and Dearry 2003; Raphael 2004; Health disparities
Task Group 2005; Spitzer 2005; Welch and Kneipp 2005).
Healthy environments are required for all. What makes
women as a social group more vulnerable is their systemic
exclusion from political and economic institutions of power
and privilege (Warren 2000).
Systemic practices that allow for unequal pay for the
same work based on gender need to be eliminated through
relevant public policy changes. In addition, other systemic
practices and policies that discriminate against women
due to their biological role of childbearing and childrearing
in terms of loss of pensionable years of employment, lack
of affordable and accessible childcare, and many other
barriers, need to be rectified. The significance in the con-
nection between women and socioeconomic status is the
acknowledgement that there is something fundamentally
wrong in a society where the majority of the poor are women
and children. This systemic perspective and analysis does
not blame the victim, but points to the structural short-
comings of a system that allows this situation not only to
develop, but exacerbates it.
At the same time as women are exploited socioeconomi-
cally, society sanctions environmental destruction and resource
depletion for socioeconomic gains. This is evident by past
and present industrial practices including the mining industry,
oil and gas industry, large-scale agribusiness, the lumber
industry, fishery and many more. What these industries have
in common is their exploitation of non-renewable resources
for economic gain; at the same time these industries’ by-
products pollute the environment at no cost to the industry
rather, communities suffer the consequences of pollution
and/or resource depletion (Suzuki 2003).
Damaging the physical environment to the point that it
negatively affects human and non-human lives is particularly
relevant to women, because of their biological and social roles
in society. Environmental exposure to pollutants, for example,
has negative health consequences to mothers and their
children. Toxic chemicals have been found in follicular fluid,
breast milk and women’s breast tissue (Chance and Harmsen
1998; Schreiber 2001). Ironically, Inuit women who have
least benefited from modern industrial growth in the
North American Great Lakes region are paying the highest
price in terms of the highest amount of persistent organic
pollutants, originating from the Great Lakes area, found
in their breast milk (Arctic Monitoring and Assessment
Program 2000).
The connection between women’s social roles and
low-income urban environments is established through
socioeconomic inequities based on gender, race and class,
and economic and political neglect of urban infrastructure,
particularly those of low-income neighbourhoods (Bullard
2005). Socioeconomic necessity forces some women to live
in environments that are less conducive to health. Women
earn less than men for equal work, and more women
than men live in poverty (Colman 2003), more single-parent
households are female headed, and more of these house-
holds, out of economic necessity, are located in low-income
neighbourhoods (Community Counts 2006). The infrastruc-
ture of these neighbourhoods has been neglected in the
form of missing sidewalks, unsafe playgrounds, insufficient
public transport (Khosla 2005), and the lack of accessible
parks and health-enhancing green spaces (Maller et al. 2005).
Thus, women, as a group, are significantly more affected by
the connection between poverty and the environment
(Khosla 2005; Welch and Kneipp 2005). Neoliberal govern-
ments save money by keeping welfare payments to single
mothers and their children to a minimum, and by keeping
investments in urban infrastructures to a minimum
(Shapcott 2004; Ross 2006). The connection between
low-income women and low-income urban neighbourhoods
lies in their shared history of oppression, on the basis of
poverty.
The socioeconomic connection between low-income
women and their urban environment can be understood
as a pathway, whereby economic disadvantage dictates the
location of affordable housing. Low-income families may
be more affected by low-income neighbourhoods because of
the lack of accessible supports and services in their neighbour-
hood, and the lack of financial resources to obtain needed
support and services outside their own neighbourhood.
Women are more likely to be poor, the poor are more
likely to live in unhealthy environments, and our economic
system is based on environmental degradation, which most
seriously harms women, thus women and the environment
are linked through economic logic. According to ecofemi-
nism then, both issues of oppression need to be addressed
simultaneously, that is women’s poverty and unhealthy
urban environments.
Epistemological connections
According to Warren (1997, 2000), a distinct ecofeminist
analysis arises where three spheres overlap: (i) feminism,
(ii) science/technology/development, and (iii) native/

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indigenous/local knowledge. Warren (2000) refers to
Haraway’s (1988) notion of knowledge as ‘situated’ in
explaining how ecofeminism challenges western notions of
knowledge. Ecofeminism examines the context within which
ethical and epistemological claims are made (Warren 2000).
Lived experience provides knowledge derived through being
part of, and participating and living within a community or
social context and environment. For example, knowledge of
indigenous people about their natural surroundings and
ecosystem is experiential knowledge. Ecofeminist epistemology
claims that the object of knowledge is an actor and co-creator
of knowledge along with the agent. We come to know about
the environment by experiencing and forming a relation-
ship with the natural environment, not just by observing it.
We come to know the environment through our bodies, by
experiencing it as members of the ecosystem, not merely
through intellectual reflection. The knower is then not an
objective, detached observer, independent of the context,
and neither a purely rational knower (Warren 2000). Con-
trary to the dichotomous conception of the human person
as a separate entity from the environment, according to
ecofeminist theory, humans are part of and experience the
surrounding environment with the whole body, mind and
spirit. Thus, by being part of nature, humans come to know
nature through lived experience over a particular spatio–
temporal moment. According to Besthorn and McMillen
(2002), ecofeminist philosophy provides a new ontology of
person and nature and their inter-relationship. This ontology
provides an opportunity for a fundamental change in
the way the relationship between human and non-human
nature is understood. Nursing as an art and a science is
given an opportunity to develop a new understanding of its
metaparadigm of person, environment, health and nursing,
leading to a better understanding of environmental health
inequities. This new conceptualization can provide the basis
for changing current, oppressive social, political, economic
and environmental conditions to alleviate health inequities.
Cuomo (1996) questioned our limited ability to ‘know
nature’ and noted that arrogance may ‘prevent us from
regarding our ability to be acquainted with nature and care
for nature equal to our limited ability to know and care about
each other’ (pp. 154, 155). The prevailing dualistic thinking
in western society that splits male–female, human–nature,
black–white and so forth perpetuates and reinforces categories
and conceptualizations of exclusion and otherness, and
prevents a conceptualizing that allows for fluidity, degrees,
shades and less concrete categories that could be more
inclusive, yet respectful and inviting of differences. Dualistic
thinking then excuses us from an imagination of wholeness
(not sameness!) with the environment. Conversely, if we
imagine ourselves as part of the environment, theoretically
we should not treat anyone or the environment in a way that
is unhealthy, or oppressive and exploitative, because it would
eventually lead to self-destruction.
An imagination of wholeness with the environment
would allow us to advocate on behalf of the environment or
nature. This imagination would provide me, as a researcher,
as well as participants, with a voice for nature. According
to ecofeminism, non-human nature is an active agent, actor
and co-creator, and we can gain access to this knowledge
(even if ever so limited) through the notion of embodiment,
as being one with nature, and acting as conduit to know
nature.
According to Twine (2001), all our understanding of
nature is cultural, since it has accumulated within a cultural
and political context. The concepts of body and nature have
been socially constructed with opposing meanings attached.
For Twine, ‘embodiment’ is the way out of this dualistic
conceptualization and ‘ecofeminism can make all aware
of their closeness to nature and embodiment’ (p. 35), by
reflexively granting some agency to bodies and nature.
For example, ecofeminist epistemology recognizes
low-income mothers as subjective knowers of their urban
environment or ecosystem. We can gain knowledge about
the low-income urban environment through low-income
mothers’ experiences. According to ecofeminist theory, the
data obtained from low-income mothers will be analysed
by explicating oppressive conceptual frameworks, which
will then provide evidence for policy change that can turn
oppressive urban neighbourhoods into more viable com-
munities, where women, other human others and non-human
nature are not oppressed.
A broader definition of environmental health allows
for the inclusion of urban neighbourhoods. Ecofeminist
epistemology informs this research to explicate what is
implicit in the overlap between (i) feminism, (ii) science/
technology/development, and (iii) local knowledge.
For example, the focus of inquiry is on the relationships
between (i) the systematic oppression of mothers living in
poverty, (ii) the urban environment including its institutions,
and (iii) mothers’ knowledge from their lived experiences
of these relations.
Empirical connections
Empirical connections are those that link data concerning
environmental degradation to the experiences of women,
children, people of colour, and the poor (Warren 2000).
For example, evidence exists that hazardous waste sites
are predominantly, if not exclusively located in or near

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© 2008 The author. Journal compilation © 2008 Blackwell Publishing Ltd 143
neighbourhoods of colour (Bullard 1993; Elliot, Wang
Lowe and Kleindorfer 2004; Jackson 2005). A wide range
of health consequences results from poor urban planning
and inadequate housing. Pesticides and other toxic chemicals
have a significant effect on women’s reproductive systems
and children’s development. Individual compounds,
such as hormone-disrupting chemicals and organic solvents,
have been associated with miscarriages and cancer
(Health Canada 1997; McMartin and Koren 1999; DES
Action Canada 2000; Saillenfait and Robert 2000; Kleiner
2004).
Estimates of the World Health Organization (WHO)
state that almost one-third of the global disease burden can
be attributed to environmental factors, many of which are
anthropogenic, that is, man-made. ‘Over 40% of this burden
falls on children under 5 years of age’ (WHO 2002). It has
been recognized that a growing number of chronic diseases
can be attributed to environmental exposure, and children,
due to their developmental vulnerability, are at increased
risk (Landrigan 2001; Powell and Stewart 2001; WHO 2002).
Children are not little adults: they have disproportionately
greater exposure to environmental toxins, their metabolic
pathways are immature, and ‘windows of vulnerability’
during phases of development increase the risk of permanent
disruption of developmental processes by environmental
agents (Landrigan 2001). In the Maritimes, children in chronic
poverty show 30% higher rates of asthma than the Canadian
average (Lethbridge and Phipps 2005). Children’s health
has a greater impact on women than men, as women are
largely responsible for home health-care.
Empirical connections therefore are important to reveal
existing evidence about environmental effects on the health
of populations, particularly the most vulnerable, as well
as evidence of inadequate urban environmental planning.
Empirical connections also identify gaps in the scientific
literature that need to be addressed by further research.
Ethical connections
Warren (2000) offers an ecofeminist ethic that is a ‘care-
sensitive’ ethic. For Warren, any ethics needs to be care
sensitive, that is, ethical decision-making requires emotional
intelligence in addition to rational intelligence, and the
underlying ability to care about oneself and others. Building
on Goleman’s (1995) work, Warren states that care is a moral
emotion, and the ability to have empathy is one of the
characteristics of emotional intelligence. Warren distinguishes
between an ethics of justice and an ethics of care, although
neither is sufficient to capture a ‘care-sensitive’ ethics that
incorporates both emotional and rational intelligence,
neither one to the exclusion of the other. Key features of this
care-sensitive ethics include an understanding of ethical
theory as theory in process, the condition that ecofeminist
ethics must be antisexist, antiracist, anticlassist, antinaturist
and opposed to all ‘isms’ that advance a logic of domination.
An ecofeminist ethics is moreover contextualist in that ethical
discourse and practice emerge differently from voices in
varying historical, social and cultural circumstances.
Narrative voice therefore is at the heart of moral thinking.
‘For ecofeminist ethicists, how a moral agent is in relation-
ship to another
—
and not simply the nature of the agent
or “other”, or the rights, duties and rules that apply to the
agent or “other”
—
is of central significance’ (Warren 2000,
99). An ecofeminist ethics is thus inclusive of difference and
diversity of perspectives: ‘It emerges from the voices of those
who experience disproportionately the harmful destruction
of non-human nature’ (Warren 2000, 99). This inclusiveness
extends to non-human nature and rejects the notion that
humans are totally separate from nature; rather humans are
members of the ecological community. The notion of inclu-
siveness is significant for researchers because it ensures that
voices from the margins are given legitimacy, and at the
same time minimizes reductionist bias. Samples must there-
fore be representative of women, but represent diversity, not
stereotype, and they must contain contributions from feminist
researchers and scientists. Ecofeminist ethics rejects objectivity
in the sense of a bias towards exclusion, in favour of a ‘better’
bias that is more inclusive of diversity and context. Ecofeminist,
care-sensitive ethics provides researchers with specific guidelines
for the design of research about the relationship between
human health and the environment. It does so by taking
empirical data seriously, and by a method that includes diver-
sity of narrative voice as well as objective scientific methods.
For example, policy makers should use evidence for
ethical decision-making concerning healthy public policy
that is informed by marginalized voices of low-income
mothers. For example, Canada’s first health goal (which was
developed under the leadership of the federal Minister of
Public Health) addressing basic needs such as the social and
physical environment is well intended and commendable,
but requires the support of research evidence that is con-
textualized and directly relevant to low-income mothers, living
in low-income neighbourhoods, if it is to reverse health
inequities. Gender-based analysis of public policy appears to
have slowed down over the past few years and ‘the persistence
of health disparities among diverse populations of women
and men suggests a postponement of the vision of a just
society with health for all’ (Spitzer 2005, S90).
Research based on such an ecofeminist ethics can
provide policy-makers with evidence that will enable them to

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empathize with vulnerable populations, and design programmes
and policies that are based on caring as part of rational
intelligence. To address health inequities of socially excluded
and vulnerable populations adequately, a care-sensitive
public policy is required.
Historical connections
According to Warren (2000), ecofeminists disagree about
the beginning of patriarchy, and with it the domination
of women and nature, as much as they disagree about the
bases for the alleged historical–causal connection between
women and nature. Some accounts, based on archaeological
findings, locate the connection as far back as the invasion of
Indo-European societies by nomads from Eurasia, while
other writers start much later with classic Greek philosophy
of Athens, and the rationalist tradition (Plumwood 1996).
Rationalism elevates humans over non-humans on the
grounds of the ‘superior’ human ability to use reason. The
logic underlying the human/nature dualism also underlies
gender dualism, that is, masculine
—
rational; feminine
—
emotional, bodily and natural; hence, ‘humanity is defined
oppositionally to both nature and the feminine’ (Plumwood
1996, 163). Merchant (1993) starts her discussion about the
historical connection between women and nature with the
scientific revolution during the sixteenth century. Her ana-
lysis illustrates how the rise of modern science contributes to
the legitimization of the destruction and exploitation of
nature and natural resources, while at the same time power-
ful metaphors link women with nature, thus sanctioning the
oppression of women within western patriarchal societies.
According to Merchant, ‘new interpretations of the past pro-
vide perspectives on the present and hence the power to
change it’ (p. 269).
An understanding that nothing and nobody starts with a
sum zero, and that everyone’s circumstances are rooted in
past events, makes it unethical to ignore history. Since much
depends on who is telling that history, however, it is essential
to recognize that there is not only one history but many
diverse histories and her-stories that need to be told with sen-
sitivity to a plurality of perspectives of gender, class, race/
ethnicity, religion and other standpoints. Systemic injustices
and oppression that have existed for generations can easily
be regarded as ‘naturally given’ and therefore interpreted as
inevitable. Only a critical, historic analysis will reveal the
social construction of systemic injustices and lay the ground-
work for restructuring viable communities. The historical
perspective will be provided by inviting research participants
to share stories of their past as they relate to living in an
urban environment.
SUMMARY
The design of an ecofeminist theory, that can be applied to
lived experiences in such a way that it is meaningful to the
subjects of that experience, requires a theory that places the
research participants and their experiences at the centre.
The centre or core element in this ecofeminist epistemology
represents the overlap between (i) low-income mothers’
systematic oppression, (ii) their urban neighbourhood,
and (iii) their local knowledge. In order to understand and
to generate solutions to gender and environmental issues
from an ecofeminist philosophical perspective, one needs to
aim for the overlap of the three spheres.
Ecofeminism acknowledges that there is no one
‘woman’s voice’, no women simpliciter, but rather that every
woman has her own distinct background and experience.
As such, ecofeminism is a ‘solidarity movement’ of shared
social and political experiences (Warren 1996). Only by
listening to marginalized voices ‘can one begin to see alterna-
tive ways of viewing an environmental problem’ (Warren
2000, 33). ‘Objectivity’ is balanced with strong narrative
voices from the grassroots. Mothers are regarded as agents
of knowledge, but also as experts of their own unique lived
experience (actors) within their social and biophysical
context. Mothers have embodied knowledge about their
urban environment through everyday interactions in their
relationship with the environment. Mothers are active
players within their urban social, cultural, economic and
political context. A researcher is entering in to a relationship
with low-income mothers and will take part in the co-creation
of knowledge about urban environmental health.
In this framework, ecofeminist analysis informs, and
simultaneously is informed by: (i) empirical data that link
environmental degradation to the experience of women,
children, the poor and people of colour; (ii) socioeconomic
connections revealing shared experiences of oppressive
socioeconomic structures within patriarchal societies; (iii) a
historical perspective that is empowering and enlightening
through critical interpretations of social programmes
and welfare policies; (iv) an epistemology that recognizes
humans as being one with nature; (v) a care-sensitive
ethics to guide policy design with emotional and rational
intelligence, and (vi) ecofeminist analysis of oppressive
conceptual frameworks.
CONCLUSION
This design of this ecofeminist framework for analysis of
low-income mothers’ urban environmental health addresses
the dimensions of gender, particularly women’s perspectives,

Ecofeminism
© 2008 The author. Journal compilation © 2008 Blackwell Publishing Ltd 145
the environment, conceptual frameworks, socioeconomic,
epistemological, empirical, ethical and historical connections
as they affect women and nature in conjunction. This
framework supports and guides research, in its diagnostic
attempts to reveal oppressive social structures, and institu-
tional relations of low-income, urban environments, as they
are experienced by low-income mothers. The framework is
future oriented towards influencing healthy public policy,
seeking to change the status quo, particularly by focusing on
those determinants of health that are beyond the control of
individuals. According to Kleffel (1991), ecofeminism offers
a conceptual foundation and new consciousness to nursing’s
environmental domain. Ecofeminism can support advocacy
for public policies that are more responsive to the link
between women’s health and urban environments. At the
theoretical level, the conceptual analysis and argumentative
justification of the women–nature connection by the patri-
archal logic of domination is ecofeminism’s fundamental
insight underlying all forms of oppression. This insight will
contribute to a better understanding of the mechanisms
underlying gendered environmental health inequities and
inform healthy public policy.
ACKNOWLEDGEMENTS
I would like to thank Barbara Downe-Wamboldt, Angela
Gillis, Patrick Glazebrook and Brenda Beagan for their
support and insightful critique of my research. This work
has been supported by the Killam Trust.
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