Public health nursing

Public health nursing is a specialized subfield of nursing focused on helping to address a variety of critical public health issues. Unlike private practice nurses, who work one-on-one to help both direct and sustain a patient’s response to illness in a hospital or with home care, public health nurses recognize that some health issues affect the whole community and that only by coordinating the efforts of a number of public agencies can a community improve its health profile. The goal of a public health nurse is to improve the quality of life in a community or, in the case of larger communities, in a specific neighborhood or matrix of neighborhoods.

Public health nurses most often have completed some form of higher education program in nursing, to which can be added a special curriculum program specifically in issues related to public health. Most frequently, public health nurses work for local health departments. However, they also work in any network that involves a wide range of residents within a community, such as corporate offices, correctional facilities, youth and senior services centers, and schools or universities. In each case, the public health nurse addresses the particular, pressing health concerns of a wide and often disparate community. Thus, in addition to nursing expertise and a strong medical background, public health nurses must have leadership, communication, and community-building skills; that is, they must be able to work efficiently and effectively with people with varying backgrounds and varying levels of interest and motivate them to address, collectively, health problems that face that same community.

Background

The term "public health nursing" was coined by Lillian Wald in 1893. That year, Wald, who is generally considered the founder of the field, established what would become the Visiting Nurse Service of New York, which provided not only home nursing care but also health education to immigrants of New York’s Lower East Side who were experiencing poverty. The organization, which eventually opened branches in other New York neighborhoods, also worked with the local government to establish programs that would improve the overall health of the community, such as free school lunches.

While, in the twenty-first century, the home care aspect of public health nursing has become less prominent, health education and liaising with local governments have remained important parts of the public health nurse’s role. The focus on assisting vulnerable communities that may be underserved with regard to health care due to factors such as race or socioeconomic status has also remained. The particular responsibilities of public health nurses vary community to community; the needs of a neighborhood of a large industrial city, for instance, are not the same as the needs of a rural town. Generally, however, public health nurses address six primary areas of community health: immunization campaigns (most often through public schools) against preventable diseases; standard safety issues, most often involving home or office environments; the maintenance of sexual health and the prevention of sexually transmitted diseases; education and public awareness campaigns of ongoing health and safety issues (such as smoking, drunk driving, firearms education, care and abuse of older individuals, and teenage obesity); preparation for potential weather or environmental catastrophes that might face the area, including charting evacuation routes, operating relief stations, and developing communications systems for use during the emergency; and specific and community-wide efforts at disaster relief.

Public health nurses stress connectivity—the way that individuals and their health and choices can affect their community’s overall well-being, and vice versa. Decisions individuals make about attending to their health inevitably have an effect on their family, friends, and neighbors. Public health nurses think in terms of systems. Their clinical knowledge, their familiarity with the most up-to-date information and research in their field, and their own hands-on experience as a nurse help; however, in directing efforts to address community health, public health nurses develop strategies for working with other public representatives. By coordinating the efforts of a wide variety of public groups, such as advocacy groups, think tanks, academic or research teams, public government committees, businesses with a vested interested in the community, political parties, churches and religious organizations, and social clubs and public philanthropic organizations, public health nurses work on a larger scale to improve the community’s health.

Public Health Nursing Today

Since the first decade of the twenty-first century, public health nursing has had an increased focus on providing access to quality health care for the widest percentage of the population within their community. Health care access inevitably involves socioeconomic factors; specifically, the risk factors for insufficient insurance include race, income, and levels of education. Many public health nurses argue that lack of insurance is often a critical determinant in families simply ignoring pressing health issues that, in turn, can affect the wider community. If public health considers a community to consist of interrelated and interdependent elements, then encouraging early treatment of illnesses and, more important, providing long-term preventive care is vital to the community’s health. In this way, public health nurses have continued working to protect the health of their communities, though this has become increasingly difficult in the face of several countries' shortages of nurses, both overall and in this particular field.

Bibliography

The Definition and Practice of Public Health Nursing. American Public Health Association, 2013.

Cox, Karen. "Nurses and the Social Determinants of Health." Public Health Nursing, vol. 33, no. 1, 2011, pp. 1–2.

"A Healthful Form of Work: The History of Public Health Nursing." Royal College of Nursing, www.rcn.org.uk/library/Exhibitions-and-Events/Exhibitions/Public-Health. Accessed 20 Nov. 2024.

Kulbok, Pamela A., et al. "Evolving Public Health Nursing Roles: Focus on Community Participatory Health Promotion and Prevention." OnLine Journal of Issues in Nursing, vol. 17, no. 2, 2012.

Nigenda, Gustavo, et al. "Recent Developments in Public Health Nursing in the Americas." International Journal of Environmental Research and Public Health, vol. 7, no. 3, 2010, pp. 792–50.

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Stanhope, Marcia, and Jeanette Lancaster. Public Health Nursing: Population-Centered Health Care in the Community. 11th ed., Elsevier, 2025.

Swider, S. M., et al. "Evidence of Public Health Nursing Effectiveness: A Realist Review." Public Health Nursing, vol. 34, no. 4, 2017, pp. 324–44.