Public Health Nursing

History

Public health nursing evolved in the United States in the late 19th and early 20th centuries. Lillian Wald emerged as a leader in the field because of her pioneering work in public health nursing in New York City. Growing up in Rochester, New York, Wald worked as a nurse tending to immigrant families on the Lower East Side of New York. Her experiences provided evidence that many injustices existed in society with differences in health care for those individuals who were able to pay for care versus those who were poor and unable to pay. Wald could not tolerate situations where poor people had no access to health care. With the support of others, Wald moved to the Lower East Side of New York and began campaigning for health-promoting social policies to improve environmental and social conditions affecting health. As author of The House on Henry Street, Wald described her work as a public health nurse as well as the development of payment by life insurance companies for nursing services. The Henry Street Settlement, established in New York City, is an example of [Page 861]a settlement house or neighborhood center that serves as a center for health care and social welfare programs. At Henry Street Settlement, nurses took care of the sick in their homes and tended to the overall population of low-income people in the community. Wald believed that the beginning efforts at Henry Street Settlement needed to be associated with an official health agency. The establishment of rural health nursing services through the American Red Cross was led by Wald, and it addressed public health issues such as tuberculosis, pneumonia, and typhoid fever in areas outside large cities.

Public health nursing was recognized as a legitimate specialty within public health early in the development of the profession and remains an important part of public health practice today. In 1872, the American Public Health Association (APHA) was established to facilitate interdisciplinary efforts and promote the practice of public hygiene. In 1923, the Public Health Nursing Section was formed within APHA to provide a national forum for discussion of strategies for public health nurses within the context of the larger public health organization. By 1981, APHA affirmed the importance of public health nursing and defined it as a specialty that brings together knowledge from the public health sciences and nursing to improve the health of the community.

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