Copyright © 2008 Delmar. All rights reserved. Part I Public Health Basics

Copyright © 2008 Delmar. All rights reserved.

Part I

Public Health Basics


Chapter 1

A History of Public Health Nursing


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Establishment of the Science of Public Health

• Public health is a collective effort of a society to support the health of the population

• Early sanitation– Ancient civilization (1000-2000 years BC)

• Sewers and bathing facilities• Airs, Waters, and Places


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Establishment of the Science of Public Health

• Middle Ages – Roman sanitation system– Monastery retreats

– 1500-1800• Miasma theory• Anatomy and physiology• Leeuwenhoek, John Snow


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Growing Science of Public Health

• Enlightenment and revolutionary era– Middle class movement

• Victorian period

• Industrial Revolution– Rapid population increase, overcrowding– High infant mortality rate among poor– Unhealthy living environments, poverty


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Response to Disease Transmission

• Growing awareness of prevention

• Mechanism for disease transmission unknown– Leprosy– Bubonic plague

• Legal authority for sequestering


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• Small pox – Endemic Europe 1700s

• Syphilis– Middle class morality


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• Historical antecedents– Nursing historically a female role– Role of early religious orders– Disease statistics


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Social Change

• Abundance of factory jobs, inadequate housing– Health conditions – Tenement housing

• Sanitary era mid 19th century– Germ theory– Chadwick Report


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Social Change

• Florence Nightingale– Refused germ theory– Positive influence

• Social Darwinism– Charitable organizations– Moral uplift


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Early Public Health Nursing

• Charitable nursing– Philanthropic service

• Ladies Benevolent Society

• District nursing– Precursor to public health nursing

• William Rathbone and Florence Nightingale• Lillian Wald and Visiting Nurses (U.S.)


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• Lillian Wald – Henry Street Settlement

• Took nursing services into the home• Form of service for those living in poverty


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• Financing early public health– Nursing services sponsored by

• Philanthropic charities• Religious groups• Local governments


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• Progressive movement– Immigration and industrialization– Slavery and freedom– Epidemiological research– New roles for women– Suffrage


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• Social issues– Population level, health, war– Child labor, unsafe working conditions


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• Risks of reform– Spider Web Pamphlet 1922– 19th Amendment– Sheppard-Towner Act 1921– Movement


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• National Organization of Public Health Nurses (NOPHN)– Institutional racism– Segregated training schools– National Association of Colored Graduate

Nurses (NACGN)

• National Association of Nursing Alumnae


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• American Red Cross

• Metropolitan Life Insurance Company

• Middle 20th Century Public Health Nursing– Hospital-based care

• Changes in funding– Great Depression


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• Changing profession– Generalist public health nurse– National League of Nursing Education– Association of Collegiate Schools of

Nursing


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• Social reform and feminism– McCarthyism associated with communism

• Professionalism– Standards, training, leadership

• Public health today– Work in government and academic settings


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• Unresolved controversies– Development of Quad Council of Public

Health Nursing Organizations– Funding, Code of Ethics– Direct service provider versus community

mobilizer, social reformer– Professionalism versus radicalism

Documents

Copyright © 2008 Delmar. All rights reserved. Part I Public Health Basics