Public Health Nursing
Section Newsletter
Winter 2011

Message from the Chair

Susan ColemanWelcome to the PHN Section! I am thrilled and honored to serve APHA and the Section as chair during this coming year. It promises to be an exciting and active time for Public Health Nursing. The incredible energy of the Section was so evident during the Annual Meeting in Denver. Thank you to all those who contributed to make the 138th meeting such a success! I would particularly like to thank Ruth O’Brien, Joni Reynolds and the Local Arrangements Committee and our Program Planners, Huey-Shys Chen and Cecelia Venzon, in addition to our past Section Chair Linda Olson Keller, Secretary Donna Westawski and the entire leadership group. I am grateful to be working with such a committed group of Public Health Nursing colleagues.


In 2011, we have the opportunity to move last year’s theme of visibility to an action-oriented agenda. We have talked about a PROACTIVE rather than reactive agenda. By the time this newsletter is published, we will have started a dialogue within the Section about the PHN role in the Future of Nursing Report, specifically relating to the IOM/RWJ Initiative. It is my hope we will work towards defining our future, with our partners, in a collaborative and inclusive way. I welcome your thoughts and ideas as we look and move forward!


This year it is also the PHN Section’s turn to lead the QUAD Council of Nursing Organizations. In an effort to distribute the work of leadership effectively, the PHN Section has adapted the practice of ACHNE and ASTDN and elected our immediate past chair, Linda Olson Keller, to the position of QUAD Council Chair. In addition, each of these organizations has three representatives on the Council to ensure engagement and continuity.  Our three PHN representatives are Linda Olson Keller (immediate past-chair), David Reyes (chair-elect) and me as Section chair.


I would like to congratulate our Section, the Governing Councilors, and especially the tremendous efforts of Jo Anne Bennett in the passage of the resolution requiring mandatory influenza immunization of health care workers. The resolution started as a brief late-breaker resolution proposed by the PHN Section in 2009 but then became a collaboration among members from several Sections and produced a broad position statement adopted by the APHA Governing Council in Denver, read the full story here.


Nurses across APHA affiliates were strong advocates, along with colleagues from various Sections and SPIGs (Epidemiology, School Health Education & Services, HIV/AIDS, Health Law, Health Administration, Maternal & Child Health, Medical Care, Vision Care, Aging & Public Health, Environment, Ethics, and Community Health Planning & Policy Development). An additional success, in an 82 percent vote, the Governing Council explicitly rejected allowing declination for non-medical reasons. Access the complete policy statement, which emphasizes worker safety, patient safety, and social justice, along with the other policies adopted by APHA at the Denver meeting.


The deadline for abstract submission for the 139th Annual Meeting was Feb. 11, and the review team is at work. Anyone wishing to review abstracts should send an e-mail to Gail Spencer at with a statement saying that you agree to serve as an abstract reviewer, your name, e-mail address, place of employment, background, area of specialization, and degrees.


The Development Committee is already hard at work soliciting donors for the 139th Annual Meeting in Washington, D.C. If you or anyone you know has an idea or lead, the committee would be glad to follow-up. Please e-mail Rita Lourie at


Congratulations to the winners of the PHN Section 2010 Awards!  Please read about these incredible contributors to Public Health Nursing in this issue of the newsletter. The Awards Committee is also accepting nominations for 2011 awards. The criteria and nominations form are available as well.

As we look forward to National Public Health Week (NPHW) April 4-10, please consider how you might enhance the vision, voice and future of public health nursing. Please let me know your ideas and I will pass them along to the Membership Committee.

Please watch for upcoming PHN Section Conference Calls! I encourage your involvement and look forward to working with you.


Susan V. Coleman

PHN Section Chair

Obama Taps Public Health Nurse for Federal Advisory Group

Susan Swider, PhD, APHN-BC, is one of five APHA members appointed by President Obama to the Advisory Group on Prevention, Health Promotion and Integrative and Public Health. The advisory group, created in January as part of the Affordable Care Act, is charged to work with the U.S. Surgeon General to identify more effective prevention priorities and create national disease strategy initiatives. Dr. Swider is a professor in the Community Systems and Mental Health Nursing Department of the College of Nursing at Rush University, Chicago and is current president of the Association of Community Health Nursing Educators .

WPHA Announces Carol Graham Memorial Award

Public Health lost a great champion on Nov. 13, 2010 with the passing of PHN Section member Carol M. Graham. As a tribute to her legacy, the Wisconsin Public Health Association (WPHA) has instituted a memorial award to help fund public health nurses to the WPHA annual conference and to build PHN leadership in Wisconsin. In order to contribute to the award fund, or to nominate a recipient, please contact: Eric Osternann at .

2010 Distinguished PHN Practice Awards Presented

Three awards for distinguished public health nursing practice were presented during the annual PHN luncheon at the APHA Annual Meeting in Denver.  The recipients of these awards have more than 70 years of combined service improving the health of populations through public health nursing.  Dr. Elizabeth Reifsnider, representing the Awards Committee, reviewed the recipients' career achievements and qualifications, and made the award presentations to each recipient during the luncheon.


Marilyn Bosenbecker, BSN, MPA, RN, nursing director of the El Paso County Colorado County Department of Health and Environment and the Program Director for the Breast and Cervical Cancer Screening Program, received the 2010 Lillian Wald Service Award.  Lillian Wald described public health nurses as having an “organic relationship with the neighborhood,” providing “universal service to the region” and having the ability to facilitate social “betterment” (Heinrich, 1983).


Marilyn embodies Lillian Wald’s ideal public health nurse with her years of selfless service to improve the health of those in her community and state. She is a community activist working with the local school district to establish healthier schools, develop strategies for affordable housing, and establish a statewide asthma plan.  Marilyn was the local winner of the Nightingale Award for the Colorado Nurses Foundation.  She is an alumni member of the Association of State and Territorial Directors of Nursing and the former secretary and Executive Board member of APHA.  Marilyn is an educational volunteer for the Susan G. Komen for the Cure and is a frequent guest on radio and local TV stations advocating for cervical cancer prevention.


Elizabeth (Betty) Barnes Daniels, assistant professor at the School of Nursing, Medical College of Georgia, received the 2010 Public Health Nurse Creative Achievement Award.  Betty typifies PHN in her ability to mobilize others to advance the care of populations she serves.   Betty has consistently made creative contributions to PHN for over three decades integrating leadership, practice, and education.  She has championed the care of vulnerable populations in the state of Georgia in her roles as maternal health consultant, PHN, care consultant, school health nurse and faculty member.  Betty has an impressive 18 year leadership and service record with APHA as secretary elect, secretary, PHN Section Governing Council, Nominations Committee, PHN Section Counselor, Local Arrangements Committee chair, PHN newsletter co-editor, Program Committee, PHN Section membership chair, and currently serves on the APHA Action Board.  She has enriched PHN by serving as mentor in the Betty Flynn Mentor Program, Georgia Students Nurses Organization Chapter Advisor, and Class Advisor.


Karen S. Martin, MS, RN, FAAN, currently is a health care consultant, is chair of the Omaha System advisory board, has been co-chairing the Omaha System international conferences since 2001, and is the author of the 2005 Omaha System book.  Karen was the former director of research at the Visiting Nurse Association of Omaha for 16 years and is the 2010 recipient of the 2010 Ruth B. Freeman Award. 

Ruth Freeman’s significant contributions to PHN include acting as nursing service administrator, educator, and the author of several textbooks.  Her most notable work, Public Health Nursing Practice, was translated into several languages (Chesney, 1999).  Among Karen’s many awards, she received the Midwest Nursing Research Society Informatics Section Distinguished Researcher Award, Honorary Fellow at the Hong Kong Polytechnic University School of Nursing, and Fellow in the American Academy of Nursing since 1988.  She has had more than 400 presentations and her authorship includes more than 100 articles, six books and 70 editorials. Karen’s distinguished career represents exemplary and significant contributions in PHN practice, administration, research and policy at the local, state, national and international levels.  Her efforts to develop and disseminate the Omaha System follows in the footsteps of Ruth B. Freeman, and have given a voice to PHN – our clients, our interventions and our outcomes.



            Chesney, A. M. (1999). The Ruth B. Freeman collection.  Retrieved January 26, 2011, from


            Heinrich, J. (1983). Historical perspectives on public health nursing. Nursing Outlook, 31(6), 317-320.

Recognizing Public Health Nursing Research

Research Committee Continues to Address Capacity Building


The PHN Section Research Committee sponsored two sessions in November 2010 at APHA's Annual Meeting in Denver as part of its continued focus on building capacity for population-focused nursing research.  The first session emphasized the importance of scientific critique, through consideration of the PHN scientist’s place in the community of science, scientists’ role in challenging ideas, and the benefits of critique in the development of PHN-related research.


Shawn Kneipp, Carolyn Blue and Betty Bekemeier described how an evidence base is built: by both asking questions and questioning answers. They then discussed recent efforts and accomplishments in building the science of public health nursing practice.


Attendees next divided into four four groups for roundtable discussions of strategies for refining and implementing a research agenda for quality and safety in population-focused practice.  Michele Issel,  University of Illinois - Chicago School of Public Health, launched the discussions with an overview of a consensus agenda developed at an AHRQ-sponsored PHN research agenda setting conference held in October 2010 in Chicago.  In the future, the committee plans to examine how to use existing sources of funding to set a more PHN-focused set of research initiatives into action.


Karen Monsen Recognized for Work with Omaha Data System


The PHN Section Junior Investigator Award was presented to Karen Monsen for her report, Problem Stabilization in Public Health Nursing Home-Visiting Intervention Trajectories.  Dr. Monson’s research uses Omaha System data to assess home visiting intervention effectiveness in public health and home care.  She received research funding from the Midwest Nursing Research Society.


Dr. Monsen is currently an assistant professor at the University of Minnesota School of Nursing. She has many years of practice as a public health nurse and manager at a local public health department.


Selection for the Junior Investigator Award is made through a two-step, blind peer review by members of the Research Committee.  The 2010 awardee was selected from more than 30 eligible studies.


An Innovative Preventive Care Model For Young Children


The Public Health Nursing Section’s Maternal and Child Health Working Group of the Practice Committee worked with Michael Barth, a representative of Healthy Steps, between 2007 and 2008 to develop a plan for public health nurses to use the Healthy Steps model to link public health and primary care in order to improve health outcomes for young children. Healthy Steps remains a viable model for improving childhood health outcomes, but faces funding obstacles.


A study of the status of the currently operating Healthy Steps sites (N=50) has recently been published on the Commonwealth Fund’s website. The document, Healthy Steps: A Public Health Approach, is posted on our Section website here. The full report includes operational details, which may be of interest to Section members involved in maternal and child health programming. To access the full report click the link here:


Please feel free to contact Joyce Edmonds if you are interested in further discussion about the linkage of public health and primary care for young children at


Joyce K. Edmonds, RN, MPH, PhD

College of Nursing and Health Sciences

University of Massachusetts Boston

Public Health Nurse Ready

The Center for Public Health Continuing Education is proud to announce a FREE online certificate designed to enhance the skill of nurses working in public health, whether they are new to the work force or are PHNs looking to improve their skills.

Public Health Nurse Ready (PHN Ready) is an online learning program for RNs who are new to public health. The courses in this certificate provide a foundation of core public health nursing concepts and practices. Topics include cultural competency, public health literacy, public health policy, basic epidemiology, and the core functions and essential services of public health. These courses reflect the core public health competencies set forth by the Quad Council of Public Health Nursing Organizations.

PHN Ready also includes modules designed to assist PHNs seeking to advance their careers and ready themselves for supervisory positions.

All courses are self-paced and online, with most providing FREE continuing education credits.

For additional information about PHN Ready or to enroll, please visit our website: Click here to view the brochure.

*This project was funded by a grant awarded under the President’s High Growth Job Training Initiative as implemented by the U.S. Department of Labor’s Employment & Training Administration (Award 49688).

This is an equal opportunity program.

Core Competency Model for Public Health Preparedness & Response

PHNs from across the country participated in a national effort to develop emergency response competencies for public health workers. Spearheaded by the Association of Schools of Public Health, partners in the initiative included APHA and its state affiliates, NACCHO, ASTHO, CDC's Center for Public Health Preparedness, NIH's Institute of Environmental Health Sciences, the Public Health Foundation, and the Council on Linkages Between Academia and Public Health Practice. The competency model is a proposed national standard for the workforce to prepare for and respond to all-hazards scenarios.


Eight workgroups drafted competencies addressing, respectively, communications, epidemiology, hazard vulnerability and risk assessment, interventions, leadership, legal authority, planning and improvement, and worker health and safety.  Each draft then underwent two electronic rounds of assessment, critique, editing and further tweaking.  The two-year effort fulfills a mandate in the 2006 Pandemic and All-Hazards Preparedness Act to develop “a competency-based training program to train public health practitioners” for all hazards scenarios. The model, published in December, provides a national standard of behaviorally-based, observable skills.  Access it at .  A complete report is scheduled for publication in early spring.  To view a list of public health nurses who contributed to this work, click here.

AHRQ Statistical Briefs Released

The Agency for Healthcare Research and Quality has released Healthcare Cost and Utilization Project (HCUP) reports from the HCUP Statistical Brief series.


More than One in Five Hospital Patients in 2008 Were Born in 1933 or Earlier


Twenty-two percent of all admissions to U.S. hospitals in 2008 were for patients born the year that Franklin D. Roosevelt was first inaugurated president of the United States or earlier, according to a recent report from the Agency for Healthcare Research and Quality.


Those who ranged in age from 75 to 84 years accounted for almost 14 percent of the 40 million admissions to U.S. hospitals that year, while patients age 85 and over made up another 8 percent.


Together these most senior of America's seniors accounted for 8.7 million hospital admissions in 2008 compared with the 5.3 million admissions of relatively younger seniors-those between 65 and 74 years of age.


The federal agency also found that in U.S. hospitals in 2008:


·        Treating patients age 75 and older cost hospitals more than $92 billion, compared with $65 billion for patients ages 65 to 74.


·        People age 85 and older were more than twice as likely to be hospitalized as people age 65 to 74 (577 versus 264 stays per 1,000 population). They were also nearly three times more likely to require nursing home or other type of long-term care after leaving the hospital.


·        Congestive heart failure was the number one reason for hospitalizing people age 85 and older — 44 stays per 1,000 population. Other leading reasons were pneumonia, blood poisoning, urinary tract infections, and heart rhythm disorders — 36, 27, 24, and 23 stays per 1,000 population, respectively.


·        For people age 75 to 84, the top five reasons for hospitalization per 1,000 population were: congestive heart failure (23 stays); pneumonia (20 stays); heart rhythm disorders (17 stays); blood poisoning (16 stays); and osteoarthritis (15 stays).


These findings are based on data described in Hospital Utilization among Oldest Adults, 2008. The report uses data from the 2008 Nationwide Inpatient Sample, a database of hospital 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 patients, regardless of insurance type, as well as the uninsured.


Four Million Hospital Admissions Potentially Unnecessary


About 1 in 10 of the nearly 40 million hospitalizations in 2008 was potentially avoidable, according to another recent AHRQ report. The admissions were for conditions such as diabetes, dehydration and certain heart conditions and infections for which hospitalization can be avoided if treated with appropriate outpatient care.


Data from the federal agency also found that:


·        Rural hospitals had nearly twice as many potentially preventable admissions than urban hospitals (16 percent versus 9 percent).


·        People from lower-income communities accounted for nearly one-third more potentially preventable hospital admissions than patients from higher-income communities (12 percent versus 8 percent).


·        Hospitals in the West had the fewest potentially preventable admissions (8 percent), while those in the South had the most (11 percent).


·        Patients age 65 and older accounted for 60 percent of the potentially preventable hospitalizations.


These findings are based on data in Potentially Preventable Hospitalizations for Acute and Chronic Conditions, 2008. The also report uses data from the 2008 Nationwide Inpatient Sample.



Rates of Hospital Emergency Department Use Greater Among Women and Low-Income, Older, and Rural Americans


Americans age 18 and older made over 98 million trips to hospital emergency departments in 2008 for problems ranging from broken bones to heart attacks, according to another recent AHRQ report. This represents 78 percent of the overall nearly 125 million visits that year.


AHRQ also found that injuries and abdominal pain were among the most frequent acute conditions seen in hospital emergency departments, while heart problems and diabetes were among the chronic conditions most commonly seen.


The federal agency's analysis also found that rates of emergency department visits were:


·        90 percent higher for Americans living in low-income areas compared to those living in the highest income areas (544 visits versus 287 visits per 1,000 adults).


·        24 percent higher for Americans age 65 and older compared to those ages 18 to 44 (550 visits versus 444 visits per 1,000 adults in each age group).


·        39 percent higher for Americans living in rural areas compared to those living in urban areas (515 visits versus 372 visits per 1,000 adults).


·        26 percent higher for women than for men (477 visits versus 378 visits per 1,000 women and men, respectively).


These findings also are based on data in Emergency Department Visits for Adults in Community Hospitals, 2008. The report uses statistics from the 2008 Nationwide Emergency Department Sample, a new AHRQ database that is nationally representative of emergency department visits in short-term, community non-federal hospitals. The Nationwide Emergency Department Sample contains 26 million records from emergency department visits from approximately 1,000 hospitals nationwide. This represents 20 percent of all U.S. hospital emergency departments.

A Call to Advocacy

Nurses, and particularly public health nurses, are highly respected members of our communities.  We are entering an era when many of our programs  are going to be under attack in an attempt to reduce local, state and federal funding.  It is important that we educate governmental decision makers about the impact their decisions related to public health programs will have on our communities.  We have a wealth of stories that communicate how many of our programs help the people in our communities.

Please take some time in the upcoming months to stay abreast of decisions that are being made in the health arena.  One easy way to find out what’s happening on the federal level is to read and respond to the action alerts that are sent out by APHA.  To sign up of e-mail alerts regarding federal legislation, go to the APHA home page (  Click on the Advocacy and Policy tab.

In the dropdown window select “Advocacy Tips.”  This will take you to a page full of information and tips for communicating with legislators.  One of the options is “Take Action!”

Use this navigation to learn more and to sign up for future Action Alerts.

Many of the Affiliates also have support for keeping you aware of health issues on your state and local levels.

The main point is that YOU CAN MAKE A DIFFERENCE by communicating what we know.  Our patients and communities are relying on us to advocate for their better health.

Betty Daniels
PHN Section Action Board Representative


Call for PHN Distinguished Practice Award Nominees

The Public Health Nursing Section of the APHA is calling for nominations for awards to be presented at the 2011 Annual Meeting in Washington, D.C. The Ruth B. Freeman Award honors a person who has had a distinguished career in public health administration, education, policy, practice or research. The Public Health Nurse Creative Achievement Award is bestowed in recognition of an individual's exceptional and creative contribution to public health nursing administration, education, practice or research. The Lillian Wald Service Award is awarded to agencies, individuals, organizations or media for depicting exemplary public health nursing especially through legislative, professional or public advocacy.

Nominees must be members of the APHA and voting members of the Public Health Nursing Section. If the nominee is a group, at least one member of the group must be a paid member of the APHA and a voting member of the Public Health Nursing Section. The Awards Committee encourages nominations and is happy to answer questions regarding preparation of materials. For questions, please contact Elizabeth Reifsnider, Chair of the APHA PHN Section Awards Committee, at the address or numbers listed below. For complete details about eligibility for the 2011 PHN Section Awards, click here.  For a PDF™ version of the awards application, click here.  For a Word™ version of the awards application, click here. 


Elizabeth Reifsnider PhD, RN, WHNP, PHCNS-BC

Constance Brewer Koomey Professor

Associate Dean for Research

School of Nursing

University of Texas Medical Branch

301 University Blvd.

Galveston, TX 77444-1029

(409) 772-8262

(409) 747-1554 Fax


Call for APHA Fellowship in Government Applicaions

APHA announces the call for applications for the 2012 APHA Public Health Fellowship in Government.

Candidates must have strong public health credentials and be interested in spending one year in Washington, D.C., working in a congressional office on legislative and policy issues related to health, the environment or other public health concerns. The fellowship will begin in January 2012 and continue through December 2012. The fellowship provides a unique learning experience for a public health professional to gain practical knowledge in government and see how the legislative and public policy process works.


pplications and additional information are available at Hard copies of the application, including a CV and three letters of recommendation, are due to APHA by April 4, 2011.

Candidates qualifications:

1.    must be APHA members (membership information).

2.    must have five years or more experience in a public health setting. Internships, graduate assistantships and residencies do not count toward the five year requirement.

3.    must have a master's degree or doctorate in a public health or related discipline.

For more information, contact Susan Polan at or (202) 777-2510.

2011 ASTDN Annual Meeting

ASTDN Annual Meeting to be held in Columbus Ohio May 2 - 4, 2011


We look forward to seeing you all for the annual ASTDN meeting in Columbus, Ohio, May 2-4, 2011, at the beautiful Hyatt Hotel, Capitol Square.  For those arriving early we will be hosting a Welcome Reception at the Hyatt from 7:00-9:00 p.m.; light refreshments and beverages will be served. This will be a wonderful opportunity to network with colleagues.  


The conference kicks off at 9:30 a.m. Monday, May 2, with an orientation session for new members and alumni. ASTDN President Clair Millet will welcome participants and conduct the annual business meeting. The annual State gift exchange will occur during lunch and the day will conclude with the Public Health Nursing Leadership dinner.


May 3 offers an exciting continuing education agenda featuring presentations from Kaye Bender on Public Health Accreditation, Sharon Stanley on the American Red Cross Sheltering, and Lisa Frazier of the Ohio Health Policy Institute will address Health Care Reform. Posters presentations from our ASTDN colleagues, as well as, local and national exhibitors will be sharing their products and services during day. Many of you look forward to our annual excursion and dinner this year we have an exciting evening planned. Join us for a special time together and experience local cuisine.


May 4 concludes the annual meeting with Clair Millet reconvening the business meeting and presenting the new officer election results.  The day will include the ASTDN recognition luncheon of our alumni and presentation of the annual ASTDN awards.   


We hope you all can join us for a memorable ASTDN annual meeting in Columbus, Ohio, this May 2011!  


Submitted by:


Glynnis LaRosa, MPH, RN

Co-chair, ASTDN Conference Planning Committee

21st Annual APHA Public Health Materials Contest

The APHA Public Health Education and Health Promotion section is soliciting your best health education, promotion and communication materials for the 21st annual competition. The contest provides a forum to showcase public health materials during the APHA Annual Meeting and recognizes professionals for their hard work.


All winners will be selected by panels of expert judges prior to the 139th APHA Annual Meeting in Washington, D.C.  A session will be held at the Annual Meeting to recognize winners, during which one representative from the top materials selected in each category will give a presentation about the winning material.


Entries will be accepted in three categories; printed materials, electronic materials, and other materials. Entries for the contest are due by March 25, 2011.  Please contact Stephanie Parsons at for additional contest entry information.

Registration Now Open for APHA Midyear Meeting

"Implementing Health Reform: A Public Health Approach"


Registration is now open for APHA’s Midyear Meeting: Implementing Health Reform — A Public Health Approach. Join public health colleagues and partners in Chicago, June 23-25, to better understand the health reform law and its implications from a public health perspective. Gain the tools needed for implementing the provisions of the Affordable Care Act and for improving health outcomes in communities across the country. The early-bird registration deadline is April 15. To register or for more information, visit



Visibility and Voice in Public Health Nursing: 2nd International PHN Conference


Join nurses from around the world at the 2nd International Public Health Nursing Conference in St. Paul, Minnesota, Oct. 10-11, 2011. Today’s world is global – any infectious disease is only a plane ride away - and our solutions must also be global. Despite the fact that almost every nation utilizes public health nurses in its health care system, PHNs around the globe have not collectively worked together as a discipline. In October 2009, a group of public health nurses from 10 countries met in Oslo, Norway. This meeting generated tremendous energy and a commitment to move the idea of international cooperation forward. In October 2011, the  2nd International Public Health Nursing Conference will host public health nurses from across the globe in St. Paul, Minnesota. Public health nurse leaders from New Zealand, Norway, The Netherlands and the United Sates will address “Visibility and Voice in Public Health Nursing.” The conference will identify similarities and differences in the health policies, PHN practices, and health outcomes between countries. An ultimate goal of the conference is to establish an international association of public health nursing that will sustain the initiatives generated from the conference. The registration website and call for abstracts will open March 15. For more information, contact Linda Olson Keller at

Get Involved Today

The Policy and Resolutions Committee is looking for new members or past members who are interested in participating in the work of this Committee. If you have interest and/or expertise in drafting or critiquing policies, we want to work with you!! If interested, please contact Marylyn Morris McEwen at and Nonie Mendias at

Become A PHN Section Member!