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Public health nurses have been working as community advocates, educators, and providers of critical public health services since 1893. One of the first public health nursing practices was the Henry Street Settlement in New York City where Lillian Wald and other nurses provided home visits, health education, and community development support to immigrant communities on the Lower East Side. The Henry Street Settlement later became the Visiting Nurse Service of New York, a non-profit organization that continues to provide public health nursing and healthcare services to all New York residents.

Public health nurses are the largest group of providers of public health services. They provide a variety of essential services to the communities in which they work. Public health nurses are qualified to deliver clinical services such as immunizations, well-baby care, senior home visits, and school health visits. They also work in teams that monitor community health trends and risk factors, help communities set local health priorities, and design and implement health education programs to minimize health risks. Advanced practice public health nurses may serve as leaders of community and state health departments and have responsibilities for planning and implementing programs to support the health of the population.

The U.S. Patient Protection and Affordable Care Act passed in 2010 expands public health and prevention programs to support communities and individuals. This law also establishes a National Prevention and Public Health Council to provide coordination across all federal agencies and government programs concerned with public health, health education and disease prevention services. The emphasis on public health in this legislation signals a significant federal commitment to support the work of health departments and public health professionals throughout the United States.


The primary role of the public health nurse is to work within the community to support population health and deliver preventive health care services. Public health nurses use their skills to support population health in eight domains of practice:

  • Analysis and assessment of communities using available data and collecting additional data to provide the information necessary to assess, plan, implement and evaluate community health.
  • Program planning and policy development to support the health of communities, families and individuals.
  • Communication with community stakeholders, families and individuals to determine knowledge and attitudes about needed and available health and health services.
  • Cultural competency that enables effective practice with diverse individuals, families, and groups within the community of care.
  • Community dimensions of practice including health service planning, advocacy, and program effectiveness evaluation within and for the community.
  • Public health sciences including the utilization of available research, the design and implementation of new research, and the use of epidemiology and other research methods to understand the distribution and determinants of disease in the community.
  • Financial management and planning skills to support careful budget management and use of public resources.
  • Leadership and systems thinking skills to enable professional practice and development of the public health team.


Public health nursing is recognized as a specialty nursing area and is supported by the Quad Council of Public Health Nursing Organizations composed of: The Association of Community Health Nurse Educators (ACHNE); The Association of State and Territorial Directors of Nursing (ASTDN); The American Public Health Association, Public Health Nursing Section (APHA), and The American Nurses Association's Congress on Nursing Practice and Economics (ANA). The Quad Council of Public Health Nursing Organizations (Quad Council) provides voice and visibility for public health nurses, sets a national policy agenda on issues related to public health nursing and advocates for excellence in public health nursing education, practice, leadership, and research. National certification as an advanced public health nurse, board certified (APHN-BC) is available from the American Nurse Credentialing Center.


A BSN degree is not universally required to work as a public health nurse although it is required by the U.S. Public Health Service, the U.S. Military, the Department of Veteran's Affairs, some hospitals and some county and state health departments. Certification as an advanced public health nurse requires a master's degree with a specialization in public health nursing.

Practice Settings:

  • County health departments
  • State health departments
  • Federal health agencies, departments and centers
  • The U.S. Military and Veteran's Affairs
  • Community service agencies
  • Municipal health departments and agencies
  • Community outreach services within hospitals, clinics, and other health service providers
  • Non-profit organizations focused on health or community service

    Salary Range:

    According to a recent survey by the Robert Wood Johnson Foundation, the average annual salaries in state health departments for Nursing Directors range from $70,903 to $97,456, Managers/Supervisors range from $56,859 to $88,961, Coordinator/Practice Specialists range from $52,597 to $76,338, Public Health/Community Health Nurse salaries range from $45,089 to $73,852.


    Many public health nurses begin their practice with an Associate's degree. Most public health experts suggest that nurses wishing to specialize in public health continue their education and earn a baccalaureate degree in nursing at a minimum. Those nurses wishing to progress to supervisory and management positions should consider a graduate degree that qualifies them for APHN-BC certification. Nurses wishing to do research and program design or management will need doctoral preparation in nursing either as a DNP or PhD.


    American Public Health Association. Public Health Nursing Section
    800 I Street, NW
    Washington, D.C. 20001-3710
    Telephone: (202) 777-2742
    Fax: (202)-777-2534

    Association of Community Health Nursing Educators (ACHNE)
    10200 West 44th Avenue, Suite 304
    Wheat Ridge, CO 80033
    Office: (303)422-0769
    FAX: (303)422-8894
    Web site:

    Association of Public Health Nurses
    P.O. Box 7440
    Oklahoma City, OK 73153
    Office: 405-271-9444 ext 56531
    Web site:

    Quad Council of Public Health Nursing Organizations
    Web Site: