Public Health Nursing
Section Newsletter
Fall 2009

Message from the Chair

 Dear PHN Colleagues:


As the world waits to see the global impact of the H1N1 virus this fall, public health nurses worldwide prepare to serve their communities. Earlier this spring this country witnessed firsthand the critical importance of public health nurses in detecting, tracking, and managing outbreaks of H1N1 across the country.  This emerging pandemic provides yet one more example of the critical importance of retaining and recruiting nurses into public health positions increasingly threatened by the recession and broken state budgets.


I have had an exhilarating year as your chair, and I urge you to seek leadership roles in our Public Health Nursing (PHN) Section and the American Public Health Association (APHA).  APHA provides a wonderful opportunity to expand your horizons and interact with other section leaders throughout the organization. The voice and leadership of our Section resonates within APHA.  We need all your knowledge, skills and wisdom as the country struggles to pass health reform legislation, and to actualize its potential by creating healthier communities.


I would like to thank our newly elected officers and councilors of the Public Health Nursing Section who are joining the Section’s current leadership following the 137th Annual Meeting in Philadelphia:


Chair Elect: Susan Coleman, MPH, BSN, RN

Secretary Elect: Jo Anne Bennett, PhD, RN, ACRN

Section Councilors: Carol M. Graham, MS, BSN, RN

                             Jeanne Matthews, PhD, RN


Governing Councilors: Carol Easley Allen, PhD, MA, BS, RN

                                 Rachel Kauffman, RN, MSN/MPH (C)

                                 Cynthia Stone, DrPH, MSN, BSN, BC


These individuals stepped up to the plate during a year in which “volunteering” and adding something more to an already stressed professional plate is a great challenge. Others wished to serve I know, but work obligations or family obligations simply precluded service this year. We thank all of you who ran, and I encourage all of you to run in the future!


During this past year, the PHN Section was well represented and engaged.  We collaborated and added our voice with the Quad Council to ensure that health reform legislation includes population based health promotion and disease prevention language.  Susan Zahner and Betty Daniels fabulously serve as Quad Council liaisons to the Task Force on Community Preventive Services.  Adrienne Wald will represent the Section on the Public Health Working Group of the National Physical Activity Plan Coordinating Committee.  Through my position on the Steering Committee of the Alliance for Nurses for a Healthy Environment, the Section has added its voice to the passage of legislation to ensure a chemically safer environment for children and for the new EPA leadership to display true environmental health action.


As APHA prepares for their 137th Annual Meeting in Philadelphia, the Public Health Nursing Sections prepares for an outstanding program. This year’s theme is Water and Public Health, and I certainly do not need tell this audience the indisputable correlation between the opportunity to enjoy good health and the ability to access adequate supplies of safe drinking water. We hope that you will all gather Sunday evening at the Quad Council event to hear the keynote speaker Brenda M Afzal, RN, MS from the University of Maryland’s School of Nursing’s Environmental Health Education Center.


Finally, thank you all for the opportunity to serve as your Section chair this year. As I prepare to turn the leadership over to the very capable hands of Linda Olson Keller and her elected officers in November, I can assure you that we all continue to provide a vocal and insistent voice for the critical role public health nurses play in the restoration of health to America’s communities.


See you in Philadelphia!



137th Annual Meeting Update

We the Public Health Nurses, ” and thousands of other public health professionals, will convene in historic Philadelphia for the 137th Annual Meeting of the American Public Health Association!


Nov. 7 – 11, 2009 is fast approaching! Have you registered and made your travel plans to visit the birthplace of American democracy? How appropriate it is to meet in the city where the Declaration of Independence was signed and at a time when we currently struggle to improve the rights of people to “life, liberty and the pursuit of happiness.”  This year’s theme is critical to those rights as well -- Water and Public Health: The 21st Century Challenge. The conference promises to be an exciting time to participate with about 13,000 other public health professionals and advocates to discuss ways to protect precious environmental resources, improve our health care system, advocate effectively, strengthen the public health infrastructure, apply new evidence in practice to improve the health of communities…..and the list goes on!


Our Public Health Nursing Section has been hard at work to plan an informative conference. So many people have contributed to this work – the Local Arrangements Committee, the Program Committee, our Section’s Education Committee, APHA staff members, colleagues from other Sections, SPIGs, and Caucuses…and to each person who submitted an abstract for consideration.  I send my heartfelt thanks to each of you for taking time from your busy schedules to contribute to the success of the Annual Meeting.


All of our PHN Section business meetings, the scientific sessions we sponsor, the PHN Section Luncheon, and the “Public Health Nursing Emerging Leaders Recognition and Reception” take place at the Philadelphia Loews at 1200 Market Street.  How do you find out where everything is and what to attend?  Visit the Annual Meeting Highlights here.  From this Web site you are just a click away from registering for the conference, reserving a hotel room, reviewing the online program and scientific sessions, reading about the opening and closing general ceremonies, learning how you can hear more sessions after you get home by signing up for E-ssential Learning, and how to obtain continuing education credit.


To see the a daily list of all PHN Section business meetings, scientific sessions, the PHN Awards Luncheon, and the Monday evening reception, click hereYou can click on specific sessions and the individual abstracts to help you decide what to attend.  The sessions that are not italicized are the ones that our Section organized. The sessions in italics are ones that we have endorsed.


The PHN Section activities get in high gear on Sunday, Nov. 8, beginning with a business meeting 8 a.m. – 11:30 a.m.  Three of the poster sessions our Section organized will be held 2:30 – 3:30 p.m. Please encourage all nursing students to attend the first PHN Student Business meeting from 3:00 – 4:00 p.m.  You’ll want to attend the Quad Council Learning Institute titled “And Drink Plenty of Water” that is scheduled for 5:00 – 6:30 p.m.  Then take an hour to enjoy the Sounds of Philadelphia Show (you need to indicate you’d like to attend this program when you register for the conference). 


I was going to list all of the invited sessions that members helped organize this year but realize that the list gets lengthy and every contributed session is also special.  Spend some time reviewing the abstracts to decide which sessions to attend. I know it will not be easy as we have so many great choices to consider! We will have a one page flier with the PHN Section organized sessions and activities at the PHN Section Booth in the Exposition Hall in case you want to use that as a guide once you get to the conference.


If you are a first time conference participant you would like some help, please contact me. We are happy to help provide tips and guidance! Some good advice from frequent conference participants include: wear comfortable walking shoes; use a back pack or rolling bag and minimize what you bring as you’ll be tempted to pick up lots of things in the Exposition Hall; tuck in a healthy snack like a granola bar or fresh fruit in case you need a quick energy source; carry a water bottle, and don’t forget to take some time to enjoy Philadelphia!  There will be a visitor’s information center at the convention hall. Philadelphia has numerous historical attractions, art museums, botanical gardens, tax free clothing and shoes, more than 200 Center City restaurants, lots of sports events…..and the list goes on!


See you in Philadelphia!


Sonda Oppewal

PHN Section Program Chair

(919) 843-6169


Bring Your Own Pretzels


As most of us know, the current financial picture of many of the institutions that usually support the Annual Meeting is dismal.  As a result, the funds to support the PHN Section meetings and receptions are MUCH lower than expected.  If ANYONE has an idea or a connection for outside or personal funding contributions, please contact either contact Rita Munley Gallagher at, or Rita Lourie at and we will follow up immediately.


Thank you in advance! 


PHN Section Development Committee Co-Chairs


Rita Gallagher                             Rita Lourie  

(301) 628-5062                           (610) 348 9695

Fax: (240) 363-4919


APHA Career Guidance Center

Don't miss this opportunity! Sign up now for a one-on-one or a group session with a professional career coach at the APHA Annual Meeting & Exposition. These coaches can guide you in strategizing the next phase of your career and help you define your goals. Select a 45-minute individual session or a 90-minute group session. The group sessions are designed according to your career needs. To see which session is the best fit for you, please read about each coach's experience and education before setting an appointment. If you have never experienced coaching before, this is a wonderful introduction to what may become a useful service for your career! The Career Guidance Center can be found by clicking here.


AACN Invites Review of Essentials of Master’s Education in Nursing


The American Association of Colleges of Nursing invites stakeholders to attend one of four regional meetings to review and provide feedback regarding the draft Essentials of Master’s Education in Nursing.  This document includes the end-of-program outcomes for master's nursing education across all practice settings.  AACN members, faculty, students, practicing nurses and representatives of other health care and education organizations are invited to participate.  This is an opportunity for public health nursing to provide feedback for nursing education at the master’s level.  The draft Essentials document is available here on the AACN Web site.


Meeting Dates, Hotel Locations, and Registration:


Baltimore, Maryland – Oct. 8-9, 2009 – Baltimore Marriott Waterfront Hotel


Chicago, Illinois – Nov. 18-19, 2009 – Westin Chicago River North
(precedes the Baccalaureate Education Conference, Nov. 19-21, 2009)


San Diego, California – Jan. 20-21, 2010 - Town and Country Resort
(precedes the CNL Summit, Jan. 21-23, 2010)


New Orleans, Louisiana – Feb. 24-25, 2010 – Royal Sonesta Hotel
(precedes the Master's Education Conference, Feb. 25-27, 2010)

ANHE Releases Wingspread Statement on the Environment

On July 1, 2009, the Alliance of Nurses for Healthy Environments (ANHE) released its Wingspread Statement on Nursing, Health and the Environment.  The ANHE Steering Committee of the newly established organization gathered in Racine, Wisc., and brought together concerned nursing researchers, educators, practitioners and advocates to map the future of Environmental Health Nursing.  Download a copy of the Wingspread Statement here.  To read the full media release click here.  For more information, contact Robyn Gilden at .

Task Force on Community Preventive Services Report

The Quad Council of Public Health Nursing Organizations was recently invited to participate as a liaison organization in the work of the Task Force on Community Preventive Services.  The Task Force leads the work of The Guide to Community Preventive Services, also known as  “The Community Guide,” which is an online and print resource to help public health practitioners and communities identify evidence-based interventions for community health improvement.  The Task Force is composed of non-federal experts from diverse backgrounds who work with staff in the  Center for Disease Control and Prevention  Community Guide Branch of the National Center for Health Marketing to conduct systematic reviews of the effectiveness of population-based and public health interventions and to make recommendations for implementation of effective interventions.  The Task Force also conducts economic evaluations of effective interventions and has begun to conduct comparative effectiveness evaluations across types of interventions.  The results of the reviews and recommendations are found on The Community Guide Web site ( ) and other publications.   The purposes of organization liaisons are to: 1) apprise the Task Force of their organizational member’s views, priorities, current issues and projects relevant to the work of the Task Force; and 2) share information from the Task Force and Community Guide within their organizations and among their members/constituencies.  Susan Zahner, University of Wisconsin-Madison, was appointed by the Quad Council as the liaison to the Community Guide, and Betty Daniels, Medical College of Georgia, was appointed as an alternate liaison.  Members of the Quad Council organizations are invited to contact the liaisons with questions about The Community Guide and recommendations for the Task Force or Community Guide staff.  If you have further questions about the Task Force contact your liaisons:


Susan Zahner, DrPH, RN               Betty Daniels, MN, RN             

(608) 263-5282                             (706) 542-9320

What Kind of Change?

As discussion of health care reform continues, it is exciting to see health promotion mentioned as an essential component of any change.  The question to ask, however, is: which components of health promotion will be used?   Certainly, decades of research exist on the impact of health promotion/education on disease management, yet there is some confusion on the context and definition of health promotion versus health education (Whitehead, 2009).   The one-to-one practice of acute care nurses and an increasing number of public health nurses (Grumbach, Miller, Mertz & Finnochio, 2004) may focus more on the traditional model of providing health information within individual care.  Health promotion is possible in individual care when health communication and theoretical foundations of behavior change are considered.  Unfortunately, as in the past (Whitehead, 1999), current health promotion implementation faces roadblocks from health policy, work setting, and provider understanding of these concepts.


While the provision of advice and information is found in nursing practice, theoretical underpinnings, effective communication, and health promotion strategies are less obvious.  As frontline health care personnel and with the current focus on health behavior related issues, it is crucial nurses have an understanding of health promotion and effective health communication strategies.  One approach to guide this understanding is to use theory to navigate the behaviors associated with lifestyle choices (Linden & Roberts, 2004).  Translating behavior change models to a format encouraging exploration of the personal change process allows nurses to work with patients more effectively. The focus becomes one of planting seeds and encouraging growth rather than pushing individual change in a prescribed timeframe. 


Needless to say, pushing someone to change increases resistance, which decreases movement toward change and often “non-compliant” becomes the new patient descriptor (Hettema, Steele & Miller, 2005).  This creates a situation where motivated clients are preferred by health care providers and when faced with less motivated clients, frustration ensues.  Yet, a look at the Adopters probability curve (Roger, 1983) or Golwitz’s (1999) inclined actor/disinclined-actor quadrants, suggests the less motivated client may account for as much as 75 percent of the patient population.  Having a theoretical underpinning to successfully work with the full range of motivation in clients may reduce frustration.


A second strategy focuses on health communication, an important concept reaching beyond understanding behavioral choices to giving providers a tool that bridges the gap between health information and facilitating patient change (Fishbein & Capella, 2006; Linden, Butterworth & Roberts, 2006).  Motivational Interviewing (MI) is a guiding communication style that has demonstrated significant impact in multiple trials on patient change and goes beyond traditional advice giving (Miller & Rollnick, 2002).  In one meta-analysis, behavior change was demonstrated in 64 percent of studies using one 15-minute MI intervention (Rubak, Sandboek, Lauritsen, Christensen, 2005).


Motivational Interviewing is relatively new to nursing with few studies to assess fit, although this research is beginning (Bennet, Perrin, Hanson, Bennet, Gaynor, Flaherty-Robb, Joseph, Butterworth, & Potempa, 2005).  One area of study should include nurses' beliefs about using MI. However, a frequently shared comment speaks of this:  “It is such a relief to not be responsible for solving all the patient’s problems.”  The patient’s positive emotions are also increased (Wagner & Ingersoll, 2008), perhaps leading to increased satisfaction with the provided health care.  Anecdotally, nurses suggest that finding an effective balance with this situation increases satisfaction in their practice.  With all the talk of change in health care, as well as the future of nursing and public health, the question of “What kind of change?” perhaps has relevance to individual practice beyond the discussion of paying for prevention.


Submitted by:


Kathlynn Northrup-Snyder, PhD, CNS, RN


(Click here for a list of references)


EPA-DOT Sustainability Partnership Announced

On June 16, 2009, EPA Administrator Lisa Jackson, DOT Secretary Ray LaHood and HUD Secretary Shaun Donovan Announced an Interagency Partnership for Sustainable Communities.  This partnership sets forth six 'livability principles' to coordinate policy to help improve access to affordable housing, more transportation options, and lower transportation costs while protecting the environment in communities nationwide. Testifying together at a Senate Banking, Housing, and Urban Affairs Committee hearing chaired by U.S. Sen. Christopher J. Dodd, LaHood, Donovan and  Jackson outlined the six guiding 'livability principles' they will use to coordinate federal transportation, environmental protection, and housing investments at their respective agencies.

The Partnership for Sustainable Communities established six livability principles that will act as a foundation for interagency coordination:

1. Provide more transportation choices - Develop safe, reliable and economical transportation choices to decrease household transportation costs, reduce our nation's dependence on foreign oil, improve air quality, reduce greenhouse gas emissions and
promote public health.

2. Promote equitable, affordable housing - Expand location - and energy-efficient housing choices  - for people of all ages, incomes, races and ethnicities to increase mobility and lower the combined cost of housing and transportation.

3. Enhance economic competitiveness - Improve economic competitiveness through reliable and timely access to employment centers, educational opportunities, services and other basic needs by workers as well as expanded business access to markets.

4. Support existing communities - Target federal funding toward existing communities through such strategies as transit-oriented, mixed-use development and land recycling to increase community revitalization, improve the efficiency of public works investments, and safeguard rural landscapes.

5. Coordinate policies and leverage investment - Align federal policies and funding to remove barriers to collaboration, leverage funding and increase the accountability and effectiveness of all levels of government to plan for future growth, including making smart energy choices such as locally generated renewable energy.

6. Value communities and neighborhoods - Enhance the unique characteristics of all communities by investing in healthy, safe and walkable neighborhoods - rural, urban or suburban.

For more information on the Interagency Partnership go to the following Web sites:


Symposium on Quality Improvement to Prevent Prematurity

The Community Health Planning and Policy Development Section of APHA announces that the Symposium on Quality Improvement to Prevent Prematurity will be held on Oct. 8-9, 2009, at the Hyatt Regency Crystal City in Arlington, Via.  The symposium is organized by the March of Dimes, the American College of Obstetricians & Gynecologists, the American Academy of Pediatrics, the American College of Nurse-Midwives, and the Association of Women’s Health, Obstetric and Neonatal Nurses.  For more information and to register go to .  If you have questions, e-mail the March of Dimes at

In the NEWS

RADM Nesseler Appointed USPHS Chief Nurse Officer


The Public Health Nursing Section welcomes the US Public Health Services’ incoming Chief Nurse Officer, Rear Admiral Paige Nesseler, who assumes her new position on Nov. 1, 2009, relieving outgoing Chief Nurse Officer Rear Admiral Carol Romano.


Women Prisoners & Health Justice Book Released

Women Prisoners & Health Justice, a new book examining the health of incarcerated and formerly incarcerated women, has been published by Radcliffe Publishing. The book is edited by Diane C. Hatton, Professor, School of Nursing at San Diego State University, and Anastasia Fisher, Associate Professor, School of Nursing at San Francisco State University, the outcome of an international, interdisciplinary meeting organized by both at the Rockefeller Foundation's Study and Conference Center in Bellagio, Italy. For more information about the book click here or contact Diane Hatton at or Anastasia Fisher at


Cynthia Stone Selected to Attend ANA Advocacy Institute


Cynthia L. Stone, DrPH, RN, Associate Professor, Department of Public Health at Indiana University School of Medicine, will represent the Indiana State Nurses Association at the American Nurses Association Advocacy Institute in Washington, D.C., Oct. 25-27, 2009. This new ANA program seeks to prepare nurses to be political advocates at the state and national levels.


HHS Announces $13.4 Million in Financial Assistance to Support Nurses

On August 12, 2009, U.S. Health and Human Services Deputy Secretary Bill Corr announced on the release of $13.4 million for loan repayments to nurses who agree to practice in facilities with critical shortages and for schools of nursing to provide loans to students who will become nurse faculty.  The funds were made available by the American Recovery and Reinvestment Act, signed Feb. 17, 2009, by President Obama.  To see the full text of the announcement click here.  For additional information about the Loan Repayment Program and other Recovery Act programs for health care professionals, see

The Health Resources and Services Administration is part of the U.S. Department of Health and Human Services. HRSA is the primary federal agency responsible for improving access to health care services for people who are uninsured, isolated, or medically vulnerable. For more information about HRSA and its programs, visit


APHA Press Announces New Book Releases


APHA Press has three books in production of interest to epidemiologists and other health professionals that will be available at the Annual Meeting.  They include: Chronic Disease Epidemiology and Control, 3rd edition by Patrick Remington, Ross Brownson and Mark Wegner and two books by Steven S. Coughlin, Ethics in Epidemiology and Public Health Practice, 2nd Edition and Case Studies in Public Health Ethics, 2nd edition.


Nina Tristani

Director of Publications



AHRQ Announcements


Childbirth Injuries Fall Sharply but More Could Be Prevented


Injuries to mothers during childbirth decreased significantly between 2000 and 2006, according to the latest report from the Agency for Healthcare Research and Quality (AHRQ). The number of mothers who experienced injuries while giving birth vaginally without the use of forceps or other instruments dropped by 30 percent. For mothers giving birth vaginally with the use of instruments or by cesarean section, injuries declined about 20 percent.


Despite the declines, nearly 158,000 potentially preventable injuries occurred to mothers and infants during childbirth in U.S. hospitals in 2006. Specifically:

  • Women covered by Medicaid were less likely to be injured while giving birth than privately insured mothers (127 vs. 185 injuries per 1,000 vaginal deliveries with instruments, respectively).
  • Mothers ages 25 to 34 had the highest rate of injury during vaginal delivery with instruments (193 per 1,000 such deliveries) and mothers ages 15 to 17 had the highest rate of injury during vaginal delivery without instruments (48 per 1,000). Mothers ages 35 to 54 had the highest rate of injury during cesarean section (5.5 per 1,000).
  • Mothers living in the highest income communities suffered 44 percent more obstetric injuries during vaginal delivery than those from the poorest communities. Black and Hispanic mothers experienced fewer childbirth-related injuries than whites (108, 130, and 162 per 1,000 vaginal deliveries with instrument, respectively). Asian-American mothers had the highest rate of childbirth-related injuries (203 per 1,000 vaginal deliveries with instrument).

AHRQ had more limited data on injuries to newborns during childbirth. The Agency found that:

  • Injuries were highest to infants born in rural areas (2 per 1,000 deliveries for rural areas vs. 1.5 per 1,000 for large metropolitan areas) and the Northeast (2 injuries per 1,000) vs. the West (1.4 per 1,000).
  • White infants had higher injury rates than other racial groups (1.9 per 1000 vs. 1.4 to 1.5 per 1,000).
  • Injury rates were higher for infants with Medicaid coverage than those with private insurance (1.7 per 1,000 vs. 1.5. per 1,000).

These findings are based on data presented in Potentially Avoidable Injuries to Mothers and Newborns During Childbirth, 2006 (HCUP Statistical Brief #74). The report uses statistics from the 2006 Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured. The report also uses statistics from a special disparities analysis file created from the Healthcare Cost and Utilization Project 2006 State Inpatient Databases.



Sports Injuries Caused 1 in 5 Emergency Department Visits for Kids


Sports-related injuries such as bruises, scrapes, and broken bones accounted for 22 percent of hospital emergency department visits for children ages 5 to 17 in 2006, according to another recent report from AHRQ.


The agency's analysis also shows that in 2006:

  • Boys had three times more visits to treat sports injuries than did girls (147 visits per 10,000 children vs. 50 visits per 10,000 children).
  • Teens were five times more likely than children to be treated for sports injuries in emergency departments (154 visits per 10,000 15 to 17 year-olds vs. 30 visits per 10,000 5 to 9 year-olds).
  • Some 81 percent of all visits were for bruises, sprains and strains, arm fractures, or cuts and scrapes to the head, neck or chest.
  • Only 1.3 percent of visits resulted in hospital admissions, mostly for leg and arm fractures. In nearly 99 percent of visits, the children were treated and released.

These findings are based on data presented in Sports Injuries in Children Requiring Hospital Emergency Care, 2006 (HCUP Statistical Brief #75). The report uses statistics from the 2006 Nationwide Inpatient Sample.



Osteoporosis-Linked Fractures Rise Dramatically


The hospitalization rate of patients admitted for treatment of hip, pelvis and other fractures associated with osteoporosis increased by 55 percent between 1995 and 2006, according to another new AHRQ report.


An estimated 10 million Americans suffer from osteoporosis, which causes bones to become brittle and weak. Fractures associated with osteoporosis can be slow to heal, and they also can cause debilitating pain, disability, deformities, and occasionally death.


The agency's study also found that fractures associated with osteoporosis:

  • Accounted for one-fourth of the roughly 1 million hospitalizations in 2006 of patients with osteoporosis.
  • Cost hospitals $2.4 billion in 2006.
  • Caused women to be six times more likely to be hospitalized than men.
  • Involved mostly older patients: 90 percent of hospitalizations were for age 65 and older and 37 percent for patients age 85 and older.
  • Were highest in the Midwest (107 per 100,000 people) and lowest in the West (68 per 100,000 people).

These findings are based on data presented in U.S. Hospitalizations Involving Osteoporosis and Injury, 2006 (HCUP Statistical Brief #76). The report uses statistics from the 2006 Nationwide Inpatient Sample.



Hospitalization of the Poor Much Higher for Asthma, Diabetes, Other Potentially Preventable Diseases


Hospital admissions of Americans from the poorest communities for asthma and diabetes were 87 percent and 77 percent higher, respectively, than admissions for patients from wealthier areas for the same diseases, according to another AHRQ report.


Asthma and diabetes are potentially preventable conditions because good outpatient care can help to prevent the need for hospitalization. Despite national efforts to eliminate health care disparities, low-income Americans continue to have higher hospital admission rates for asthma and many other conditions.


AHRQ's analysis found that compared to Americans from wealthier areas:


  • Patients from the poorest communities were more likely to be hospitalized for chronic obstructive pulmonary disease (69 percent higher); congestive heart failure (51 percent higher); skin infections (49 percent higher); and dehydration (38 percent higher).
  • In addition, patients from the poorest communities were more likely to be admitted for severe blood infection, stroke, and depression.
  • Furthermore, hospitalized Americans from the poorest communities were 80 percent more likely to receive hemodialysis for kidney failure, and they were more likely to undergo procedures often done on an outpatient basis, such as eye and ear procedures (81 percent more likely). Infants from poor areas were 47 percent more likely to be vaccinated for hepatitis B.


These findings are based on data from Hospital Stays among People Living in the Poorest Communities, 2006 (HCUP Statistical Brief #73). The report uses statistics from the 2006 Nationwide Inpatient Sample.



HCUP's 2007 NIS Released!


The Agency for Healthcare Research and Quality is pleased to announce the release of the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) featuring 2007 data.  The NIS is the largest all-payer inpatient care database in the United States and is updated annually.  It is available from 1988 to 2007, allowing analysis of trends over time.

The NIS is nationally representative of all short-term, non-Federal hospitals in the United States.  It approximates a 20 percent stratified sample of hospitals in the United States and is drawn from the HCUP State Inpatient Databases (SID) which include 90 percent of all discharges in the United States. The NIS includes all patients from each sampled hospital, regardless of payer-including persons covered by Medicare, Medicaid, private insurance and the uninsured.


The data can be weighted to produce national estimates, allowing researchers and policy-makers to use the NIS to identify, track, and analyze national trends in health care utilization, access, charges, quality and outcomes.  The vast size of the NIS enables analyses of infrequent conditions, such as rare cancers; uncommon treatments, such as organ transplantation; and special patient populations, like the uninsured.  Its size also allows for the study of topics at both national and regional levels.  In addition, NIS data are standardized across years to facilitate ease of use.

The 2007 NIS contains data from over 8 million hospital stays.  It encompasses all discharge data from more than 1,000 hospitals in 40 states.  For most hospitals, the NIS includes identifiers that allow linkages to the American Hospital Association's Annual Survey Database and county identifiers that permit linkages to the the Health Resources and Services Administration's Area Resource File (ARF).  The NIS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources).

As part of the HCUP database family, the NIS is considered by health services researchers to be one of the most reliable and affordable databases for studying important health care topics.


The 2007 NIS can be purchased through the HCUP Central Distributor.  Some 2007 NIS data are available in HCUPnet, a free online query system.  More information about the NIS and other HCUP products can be found on the HCUP-US Web site.  If you have questions, please contact HCUP user support at



HCUP's New 2006 Nationwide Emergency Department Sample Released!


The Agency for Healthcare Research and Quality is pleased to announce the release of its newest Healthcare Cost and Utilization Project (HCUP) database, the 2006 Nationwide Emergency Department Sample (NEDS). The NEDS is the largest all-payer emergency department (ED) database in the United States.  The NEDS was created to enable analyses of ED utilization patterns and to support public health professionals, administrators, policymakers, and clinicians in their understanding and decision-making regarding this critical source of health care. 


The NEDS has many research applications as it contains information on hospital characteristics, patient characteristics, geographic region and the nature of the ED visits (e.g., common reasons for ED visits, including injuries).  The database includes information on all visits to the ED, regardless of payer-including persons covered by Medicare, Medicaid, private insurance and the uninsured. 

The 2006 NEDS contains data from 26 million ED visits, and encompasses all encounter data from nearly 1,000 hospital-based EDs in 24 states.  The NEDS approximates a 20-percent stratified sample of EDs from community hospitals.  Weights are provided to calculate national estimates pertaining to the 120 million ED visits that took place in 2006.  The database was constructed using records from both the HCUP State Emergency Department Databases (SEDD) and the State Inpatient Databases (SID).  The NEDS provides information on "treat-and-release" ED visits, as well as ED visits in which the patient was admitted to the same hospital for further care.

The 2006 NEDS can be purchased through the HCUP Central Distributor. Some 2006 NEDS data are available in HCUPnet, a free online query system.  More information about the NEDS and other HCUP products can be found on the HCUP-US Web site.  If you have questions, please contact HCUP user support at

APHA Annual Meeting & Exposition

Register for the meeting   and make your hotel reservation soon (advance registration closes Oct. 2, housing closes Oct. 9). Note: Presenters must be individual members of APHA to present their paper(s) and must register in advance for the meeting. Session organizers and moderators are also required to be members and pay the appropriate registration fee. Hope to see you in Philadelphia!

Join the PHN Section Today!

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