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North Carolina: Outlook and Challenges for Public Health Nurses

Higher Education Articles October 6, 2013

What does a Public Health Nurse do?

The role of a North Carolina public health nurse is quite different from that of most nurses, which care for patients on an individual basis. A North Carolina public health nurse provides primary care management services and health education for a population.

Put another way, “By working with whole communities, public health nurses are able to educate people about health issues, improve community health and safety, and increase access to care.”

What Education, Professional Experience do you need to become a Public Health Nurse?

At a minimum, a public health nurse in North Carolina will need an associate’s degree as a licensed registered nurse (RN). However, most public health nurses in the North Carolina have four to six years of education, in addition to some level of experience working as a nurse.

Many public health nurses have a bachelor or master degree, and preference is given to applicants with more advanced degrees and/or language skills.

North Carolina: Challenges a Public Health Nurse May Face

A federally-funded community health clinic is focused on providing primary mental health, dental, and medical services using a sliding fee scale. This is to ensure services are available without regard to a patient’s ability to pay. Public health nurses will often work in federally-funded community health clinics with patients in “medically underserved areas”.

The federal funding of these community health clinics is only designed to be a portion of the total budget. Therefore, these clinics are continually looking for ways to leverage additional resources in their community, to meet their goals.

Federally-funded community health clinics in North Carolina work with a disproportionate number of patients living at or below the poverty level when compared with the state or national population figures. Additionally, there is a much higher rate of uninsured patients at the North Carolina community health centers.

North Carolina: Community Health Center Basics

Number of federally-supported health centers 162
Total Patients 409,709
Seasonal Farm worker Patients 52,961
Homeless Patients 5,725

North Carolina: Community Health Center Clientele Data

Category Health Care Center Population State Population U.S. Population
Percent at or below 100% of Poverty 73% 22% 21%
Percent at or below 200% of Poverty 95% 42% 40%
Percent Uninsured 52% 18% 16%

North Carolina: Health Challenges

Community health centers have a few things going well when compared with average figures for the United States as a whole. The figures for low birth weight and asthma therapy are on par with the national average. Additionally, the numbers look very good for diabetes control, timely prenatal care, and childhood immunizations.

However, public health nurses in North Carolina can expect to put some work into improving hypertension control and cervical cancer screening figures compared with the national averages.

North Carolina: 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
North Carolina 76.74% 76.36% 57.05% 7.71% 45.20% 50.61% 71.13%
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

The U.S. Bureau of Labor Statistics has a very bright outlook for public health nurses. An average salary of $64,690, with an associate degree being the entry level educational requirement, and a faster than average (26%) job outlook expected until 2020. All this makes a career as a public health nurse an enticing option.

This expectation is also held by, although they do point out that you could increase your earning potential and marketability with a bachelor or master degree and by becoming bilingual (Spanish/English).

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