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Massachusetts: Outlook and Challenges for Public Health Nurses

Higher Education Articles October 6, 2013

What Does a Public Health Nurse Do?

While the common conception of a nurse is a person who cares for individual patients, a Massachusetts public health nurse is one who works, with an entire community, to implement large-scale health initiatives.

Public health nurses are responsible for working with communities in order to increase the general level of health and safety, to improve the community’s access to care, and, perhaps most importantly, to promote health education programs.

What Education and Professional Experience is Needed to Become a Public Health Nurse?

In order to become a public health nurse, one must, first and foremost, be a Registered Nurse (RN). One does not need to possess anything more than associate’s in order to become an RN, but many communities may prefer a public health nurse with a Bachelor’s degree in Nursing. Potential public health nurses must also have some educational background that transcends nursing, and should include studies in public health, public policy and health administration.

One should also possess some experience working with neighborhood associations or volunteering with community groups, home healthcare providers, or hospice organizations. Other qualifications include:

•The ability to work in a large group
•The Desire to work with low-income and under-served individuals and families
•An aptitude for using limited resources in creative and spontaneous ways
•A deep sensitivity to cultural differences

Massachusetts: Challenges a Public Health Nurse May Face

The nation’s public health centers are non-profit organizations that provide services and care to the underprivileged, under-served and uninsured. As of 2010, such organizations provided care for just fewer than 20 million Americans. These services include, but are not limited to:

•Primary care services
•Diagnostic and radiology services
•Preventative services
•Prenatal and perinatal services
•Chronic disease management
•Immunizations
•Eye, ear and dental screenings for children

The federal government is now attempting to measure the quality of care at these facilities to determine whether patients are receiving the appropriate level of care. The tables below illustrate their findings.

The population:

Number of federally-supported health centers: 303
Total Patients: 588,064
Number of Seasonal Farm Worker Patients: 2,402
Number of Homeless Patients: 31,205

Massachusetts: Community Health Center Clientele Data

Category Health Care Center Population State Population U.S. Population
Percent at or below 100% of Poverty 65% 15% 21%
Percent at or below 200% of Poverty 90% 32% 40%
Percent Uninsured 20% 5% 16%

Health Challenges

The patients seeking care from Massachusetts public health centers exceed the national average in most regards. There are far more patients in Massachusetts who have their diabetes under control. Massachusetts adults with hypertension also have their blood pressure under better control than the national average, but not by as wide a margin.

There are more women who are utilizing prenatal care, fewer babies who are born with low birth weights and more children under the age of 2 who have received their federally recommended vaccinations. There are also a far greater number of women undergoing Pap tests in order to detect the onset of cervical cancer, and, in fact, Massachusetts leads all states in this regard.

The only area of concern pertains to patients with asthma, who are not receiving treatment as regularly as the national average.

Massachusetts: What Public Health Nurses Can Expect at Community Health Centers

Diabetes Control Timely Prenatal Care Hypertension Control Low Birth Weight Childhood Immunization Cervical Cancer Screening Asthma Therapy
Massachusetts 77.02% 78.25% 65.97% 6.68% 45.66% 68.96% 59.04%
U.S. Average 70.9% 70.0% 63.3% 7.4% 43.8% 57.8% 69.1%

What the Numbers Mean

Diabetes Control: The percentage of adults, age 18 to 75, with diabetes who have their blood sugar under control, defined as an HbA1c under 9 percent.

Timely Prenatal Care: The percentage of pregnant women receiving prenatal care in the first trimester.

Hypertension Control: The percentage of adults, age 18 to 85, with hypertension who have their blood pressure under control, defined as under 140/90.

Low Birth Weight: The percentage of babies born with birth weight below 2,500 grams.

Childhood Immunization: The percentage of children who receive 10 federally recommended vaccines by 2 years of age.

Cervical Cancer Screening: The percentage of women, age 24 to 64, with at least one Pap test in the prior three years.

Asthma Therapy: The percentage of patients age 5 to 40 who have persistent asthma who receive asthma drugs.

Job Outlook for a Public Health Nurse

Based on data from 2012, the demand for RNs is set to increase by 26% by 2020. This exceeds the national average for job growth by 12%. Furthermore, since public health nurses earn, on average, $51,000 per year, they also exceed the national average in annual salary by approximately $18,000.

With an increasing number of jobs opening up for nurses, as more communities realize how invaluable public health nurses are to the areas they serve, the outlook for public health nursing is excellent.

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