Historical Influences on Community and Public Health Nursing

Florence Nightingale

Founder of modern nursing

Improved sanitation and patient outcomes

Lillian Wald

Founder of public health nursing

Historical Influences – 1900s

Nurses saved numerous lives during flu epidemic (1918)

Increased funding for nursing education Specialty nursing areas emerged

National Institute of Nursing Research established (1986)

Sanitation

1800s – lack of housing, clean water, and waste removal

Dr. John Snow

Investigated cholera outbreak

Traced it back to a specific water pump

Development of epidemiology

Vaccines

• Save millions of lives

• 1700s – smallpox killed about 30% of infected

• School vaccine mandates

- Regulations determined by state

• Dr. Edward Jenner

• Noticed milkmaids with cowpox were immune to smallpox

• Developed smallpox vaccine from this information

World Health Organization (WHO)

• Established 1948

• 194 member states and 8,000 health experts

• Expanded the definition of health to include overall well-being

• Goals

-Address global emergencies

-Improve health care inequities

-Promote health worldwide

UNICEF

• United Nations Children’s Fund

• Similar to WHO but focuses on children

• Works in over 190 countries

• Goals: Protect children’s rights, Provide emergency relief, clean water, sanitation, etc.

CDC

• Centers for Disease Control and Prevention

• Protects health of the public

• Goals: Secure global health, Eliminate disease, End epidemics

Centers for Medicare and Medicaid Services (CMS)

Medicare:

Federally managed

65 years and older

Under 65 years with disability

Medicaid:

State managed

Low-income individuals

Occupational Safety and Health Administration OSHA

Addresses workplace injury and death

Maintains safe workplace

• Personal protective equipment (PPE)

• Contaminants

• Unfair labor practices

Technology

• Public health informatics (PHI) integration • Telemedicine

Aging

• More chronic illness

• Increased health care spending

• Shortage of providers

• Quality of life ethical issues

Workforce shortage

• Baby Boomer retirements

• Increased need for population health nurses

Medicalization

• Increased use of pharmaceuticals

• Takes focus away from preventative lifestyle changes

Focus on populations

• Health care should address social determinants of health

Climate change

• Poses major health risks

• Nurses can advocate for climate-friendly health policies

Food insecurity

• Increased with pandemic lockdowns and shortages

• SNAP and WIC programs

Human trafficking

• 40 million people trafficked worldwide

• Under-reported

Racism

• Violence results from systemic racism

• Results in health disparities

Violence

• Domestic violence

• Gun violence

Global pandemics

• Likely to cause increase in poverty and poor health outcomes