Health care practitioners who work in public health are interested in the health and well-being of large groups of people, which could be at local, regional, state or even tribal levels. CDC Foundation describes public health as “the science of protecting and improving the health of people and their communities.” In fact, the Centers for Disease Control and Prevention is one of the United States’ largest public health employers, with more than 14,000 employees in 170 occupations in all 50 states and more than 50 countries around the world.
The difference between private and public health care practitioners is that private health care professionals focus on individuals, while public health care professionals focus on communities or groups of people.
Public health professionals are concerned about global health issues such as infectious diseases, epidemics, trends in diseases and social issues like technology addiction and substance abuse.
What is Public Health Nursing (PHN)?
A public health nurse collaborates with other health care providers, as well as community agencies and leaders, to promote the health of populations. As authors of the article “Public Health and Nursing: A Natural Partnership” describe, the public health nurse establishes ranges of services for things like well-baby care, health education, screening and immunization clinics, disaster management and emergency preparedness.
The American Public Health Association describes public health nursing as a specialty practice within nursing and public health. A key word that you’ll often see within public health nursing is “prevention” because public health nurses and public health organizations are primarily focused on identifying health trends in communities and administering education and resources to prevent illnesses and diseases.
The difference between public health nursing and other types of nursing is that while other types of nurses diagnose and treat individuals, the public health nurse sees the individual as part of a whole community. In a traditional medical setting, a patient presents with symptoms, and nurses collaborate with their health care teams to diagnose and prescribe treatment. That nurse may be part of administering treatment and educating the individual patient on aftercare.
Public health nurses, on the other hand, are collecting information from other nurses and health care providers to identify trends in medical illnesses. They’re assessing communities and situations to create strategies to educate populations and administer care to entire communities.
How to Become a Public Health Nurse
Step 1: Become a registered nurse (RN) by holding a certificate of completion from a nurse training program, an associate degree or a Bachelor of Science degree in Nursing and pursuing state licensure. You may also work as a public health nurse at the nurse practitioner level, which requires more advanced education and training.
Step 2: Take and pass the NCLEX-RN exam and become licensed by the state in which you live and practice medicine.
Step 3: Complete additional coursework to become a certified public health nurse.
Step 4: To become an advanced public health nurse (APHN-BC) you must complete a Master of Science degree, which can sometimes be an RN to MSN program, with a specialization in public health.
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1 U.S. News & World Report, 2022 Best Nursing Schools: Master’s. Ranked in 2021.
Areas of Study for Public Health Nurses
These are areas of study that fall within the reach of public health, as defined by Association of Schools and Programs of Public Health (ASPPH):
- Behavioral and social science
- Biostatistics and informatics
- Community health
- Environmental health
- Global health
- Health policy and management
- Health promotion and communication
- Maternal and child health
- Minority health and health disparities
What Do Public Health Nurses Do?
Public health professionals’ duties tend to fall into these four broad categories:
- Educate communities
- Administer services
- Develop policies
- Conduct research
They work for nonprofits, for-profits, health care companies and governments and governmental agencies.
Public health nurses need special skills, in addition to nurse training. They must be able to evaluate public and community health needs, plan a strategy for addressing those needs and implement the plans.
Public Health Nurses Core Competencies
According to the 2018 Quad Council Coalition Competency Review Task Force report “Community/Public Health Nursing Competencies,” there are three tiers of competencies for public health nurses:
- Tier 1 Core Competencies: working directly with at-risk populations; carrying out health promotion programs at all levels of prevention; engaging in basic data collection and analysis, field work, program planning, outreach activities, programmatic support, and other organizational tasks.
- Tier 2 Core Competencies: taking responsibility for clinical services, home visiting, community-based and population-focused programs. Responsibilities may include implementing and overseeing personal, clinical, family-focused and population-based health services; developing programs and budgets; establishing and managing community relations; establishing timelines and work plans; presenting recommendations on policy issues.
- Tier 3 Core Competencies: apply to public health nurses at executive or senior management and leadership levels in public health or community organizations. Responsibilities may include setting the vision and strategy for an organization (e.g., public health department, public health nursing division, nonprofit community organization).
Where Do Public Health Nurses Work?
Public health employers (and examples) include:
- Nongovernmental organizations: Catholic Relief Services, Public Health Institute, ICF International and PATH
- Consulting firms: Thomson Reuters, Booz Allen Hamilton and BioStat Solutions Inc.
- Research organizations: American Institute for Research, RAND Corporation and National Center for Health Research
- Nonprofit organizations: American Red Cross, Bill & Melinda Gates Foundation, Elizabeth Glaser Pediatric AIDS Foundation and the Hispanic Association of Colleges and Universities
- Government agencies: Centers for Disease Control and Prevention (CDC), Centers for Medicaid and Medicare, National Cancer Institute and U.S. Peace Corps
- Hospitals and health care organizations: Blue Cross Blue Shield, Covance, HealthCore and IMS Health
Benefits of Having Public Health Workers in the Community
- Improving global health: Public health nurses research diseases such as AIDs, cholera and influenza and work to contain and eliminate them. They might also be involved in writing policies that help governments establish procedures and rules with regard to health care and eradicating diseases.
- Improving environmental health: Nurses who work in public environmental health are looking at the relationship between industrialization, its impact on the environment and how that affects the health of communities.
- Improving community health: Public health nurses who work at the community level focus on groups of people who are particularly at risk for diseases such as diabetes, heart disease and cancer because of lifestyle choices or socioeconomic circumstances.
- Reducing the impact of natural disasters: When wildfires, hurricanes and other natural disasters affect a community, public health organizations like the American Red Cross will help protect the people who live in these areas from contagious diseases.
- Addressing disparities in health: Public health nurses who work in this area study populations to look for disparities in health and wellness based on ethnicity, race and social class.
Public Health Nurse Salary
The U.S. Bureau of Labor Statistics (BLS) presents typical salaries for a variety of professions, including nurses; however, they do not provide salary information for specific job titles such as “public health nurse.” The information below is from the BLS Occupational Outlook Handbook section on registered nurses.
Registered Nurses Salaries
The 2018 median pay for registered nurses was $71,730. By employment sector, RNs earn a median annual salary of:
- $78,390 in government
- $73,650 in hospitals
- $68,320 in ambulatory care (including physician offices)
- $63,990 in nursing and residential care
- $61,850 in educational services
In terms of annual mean wages, top-paying states for registered nurses are California, Hawaii, District of Columbia, Massachusetts and Oregon.