Nursing supply for 21st century public health practice
Kristine M. Gebbie, DrPH, RN Columbia University AcademyHealth Annual Research Meeting June 3, 2007
Questions I have
How many nurses do we need in public health practice? What do they need to know?
AcademyHealth June 3, 2007
The counting challenge
Enumeration 2000
NACCHO 2005 report
49,232 nurses in federal, state, local ph Count done by job title 38,000 Average, 6 per county; Range, 2 to 69 259,011 in community/public health 47,885 in state and local public health Excludes occupational health and regulatory
HRSA 2004 RN survey
AcademyHealth June 3, 2007
Who is a public health professional?
A public health professional is a person educated in public health or a related discipline who is employed to improve health through a population focus.
IOM. Who will keep the public healthy?
AcademyHealth June 3, 2007
What does that mean?
Public health works best when multiple disciplines are represented at the table Position descriptions that foster this are difficult to maintain People with clinical skills are often more expensive, and thus employed for limited roles
AcademyHealth June 3, 2007
What do they need to know?
Varying levels of
Biostatistics Epidemiology Environmental Health Policy and Management Social/behavioral science
In addition to or filtered through nursing competency
AcademyHealth June 3, 2007
Plus 8 more areas:
Informatics Communication Global health Ethics Genomics Cultural Competency Policy and law Community-based participatory research (CBPR)
AcademyHealth June 3, 2007
In order to balance and respond to
Emerging and re-emerging infections Chronic diseases Behavioral risk factors Community empowerment and development Healthy development across the whole life span
AcademyHealth June 3, 2007
And do this while competing
With personal care nursing that is easier to explain and may pay better With generic public health jobs without acknowledging the nursing component
AcademyHealth June 3, 2007
Bottom line
We need to know what we have
Training Job titles Role and function
And how well they do So we can plan better to keep nursing within this dynamic field
AcademyHealth June 3, 2007
Thank you!
kmg24@columbia.edu
AcademyHealth June 3, 2007