CHAPTER 2: COMMUNITY HEALTH

NURSING: ESSENTIALS OF
PRACTICE
INTRODUCTION

Lillian Wald: mother of public health nursing

o Coined the term public health nurse
o Established nursing schools
o Advocated for better housing
o Worked to change child labor laws
o Taught preventive practices
o Advocated occupation health nursing
o Improved education of public health nurses
1940s: discovery of antibiotics and vaccines
o Improvements in environmental sanitation decline in morbidity and
mortality due to communicable diseases
1960s: prevention of chronic diseases and risk factors such as cigarette
smoking and dietary fat
o Screening, case finding, home visiting to clients, and health education
related to disease prevention
Public health adds 25 years to life expectancy
o Ten Great Public Health Achievements in the 20th Century
1. Immunizations
2. Improvement in motor vehicle safety
3. Workplace safety
4. Control of infectious diseases
5. Decline in deaths from heart disease and stroke
6. Safer and healthier foods
7. Healthier mothers and babies
8. Family planning
9. Fluoridation of drinking water
10.Tobacco as a health hazard
1990s: emphasis on clinical care and high tech medicine; high cost of care
become a major concern
2000s: emphasis on health promotion and disease prevention

10 ESSENTIAL PUBLIC HEALTH SERVICES

Provide a fundamental framework by describing the public health activities

that should be undertaken in all communities
1. Monitor health status and identify problems
2. Diagnose and investigate health problems and hazards
3. Inform, educate, and empower people about health issues

4. Mobilize community partnerships to identify and solve health problems

5. Develop policies and plans that support individual and community health
efforts
6. Enforce laws and regulations that protect health and ensure safety
7. Link people to needed personal health services
8. Ensure competent public health and personal health care workforce
9. Evaluate effectiveness, accessibility, and quality of health services
10.Research new insights and innovative solutions to health problems

COMMUNITY HEALTH NURSING PRACTICE

Quad Council: includes the ANA, Council of Community, Primary, and LongTerm Care; American Public Health Association Public Health Nursing
Section; Association of Community Health Nurse Educators; Association of
State and Territorial Directors of Nursing
Public health nursing: practice of promoting and protecting the health of
populations using knowledge from nursing, social, and public health services
Factors Shaping 21st Century Health
1. Health care reform
2. Demographics
3. Globalization
4. Poverty and growing disparities
5. Violence, injury, and social disintegration
HEALTH CARE

The critical need for health care reform stemmed from 5 factors:
1. High rate of uninsured Americans under age 65
Approximately 50 million
2. Unsustainable health care spending that represented almost 18% of
our gross domestic product
3. Lack of emphasis on preventions
7 of 10 deaths in the US are related to preventable diseases
75% of health care dollars are spent on treating preventable
diseases
4. Poor health outcomes
High spending in medical care but 24th in countries in terms
of life expectancy
5. Health disparities
High death rates of African America women in heart disease,
breast, and lung cancers