Advancing health equity: Organizational characteristics emphasized by health department nurse lead executives

Abstract

Objective: To compare nurse and non-nurse lead executives' relationship with organizational characteristics supporting performance and health equity in local health departments (LHD).

Public Health Nurses’ Proficiencies and Training Needs in an Emergency Response: A Cross-Sectional Observational Study

“…[9][10][11] Recent research provides evidence indicating that nurses represent a critical part of the public health workforce needed to advance health equity and engage in these populationlevel efforts due to their skills in areas such as crosssector collaboration, partnership building, working with diverse populations, and systems thinking, even as they have been the staff in most significant decline. [12][13][14][15] The retention and utilization of nurses in LHDs further vary by geography and type of health department and could negatively affect health equity in a community where these nurses do not exist or are in short supply. 16 The substitution of nursing positions and recruitment/retention issues for PHNs are, therefore, a growing concern.…”

“…In the United States, the conceptualizations of our public health system activities and focus have evolved in the past 15 years with the development of Public Health 3.0, the Foundational Public Health Services, and updated Essential Public Health Services—all of them centering on population-level efforts, rather than direct clinical services, to address the underlying causes of health inequities 9-11. Recent research provides evidence indicating that nurses represent a critical part of the public health workforce needed to advance health equity and engage in these population-level efforts due to their skills in areas such as cross-sector collaboration, partnership building, working with diverse populations, and systems thinking, even as they have been the staff in most significant decline 12-15. The retention and utilization of nurses in LHDs further vary by geography and type of health department and could negatively affect health equity in a community where these nurses do not exist or are in short supply 16.…”

“…While few LHDs in the United States, if any, were prepared for this pandemic, health departments with more nurses may have had greater “surge capacity” in being able to respond more quickly and effectively during the pandemic,23 perhaps given PHNs’ understanding of both clinical approaches to disease response and prevention, as well as health equity and collaboration. Research focused on nurse directors of LHDs provides some insight—these studies found that the presence of a nurse-trained health department director was associated with reduced Black-White mortality disparities in the community; in addition, nurse-trained health directors were more likely to emphasize policy activities focused on the social determinants of health and credited their nursing education and experience with their ability to be inclusive in their leadership, to use systems thinking in their work, and to build and maintain strong community partnerships 12,13,24. However, additional research is needed which explores whether such qualities or competencies are evident among the staff working in such nurse-led LHDs and among the PHN staff themselves.…”