HEALTHY COMMUNITIES START WITH NURSES By Cindy Zolnierek, PhD, RN, Executive Director, Texas Nurses Association
To the three-legged stool of health care — quality, costs, outcomes — a fourth leg has been added. Care of the provider acknowledges that without healthy providers, optimal delivery of care cannot occur. Care of the provider begins with self-care. THE AMERICAN PUBLIC HEALTH Association defines public health as the promotion and protection of the health of people and the communities where they live, learn, work, and play. Injury and disease prevention, wellness promotion, and healthy community development are all within the sphere of public health. And while public health can be thought of as macro perspectives, e.g. population health, actual public health interventions most often occur on a micro level in local communities — tobacco-free environments, lighted sidewalks that allow people to walk in their communities, and availability of local fresh produce and fluoridated water.
Many have recognized that a focus on community/public health holds promise for bending the curve on chronic disease and quality of life. In 2015, the Robert Wood Johnson Foundation redirected its efforts toward building A Culture of Health. The American Public Health Association initiated a project Healthy Community 50. The Centers for Disease Control implemented a Healthy Communities Program. And, the Centers for Medicaid and Medicare Services launched an Accountable Health Communities model. Additionally, near the end of 2016 the surgeon general released the first report
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to frame addiction as a public health issue and suggest that the solution lies within a public health framework. Suicide, at a 30-year high, has been declared an epidemic, a major public health issue. Preventable chronic diseases (e.g. obesity, diabetes, heart disease) impact quality of life as well as longevity and medical costs for an increasing number of Americans; these diseases are public health issues. Bending the curve on chronic disease and building healthy communities requires nursing involvement at the macro and micro levels. Nurses are called to be active in their professional associations,
