Note: The CPHNO encourages any nurse considering a run for public office to familiarize themself with applicable local, state, and federal statutes or policies that may restrict eligibility for public office or require resignation, leave, or other conditions related to their current employment.
Public health nurses understand that health is shaped long before individuals enter clinical care. Housing, transportation, food systems, land use, and community design all influence population health outcomes. Yet nurses are often absent from the local governance spaces where these upstream decisions are made— spaces where prevention-oriented decisions with lasting population impact occur.
This blog argues that local governance is a legitimate—and necessary—domain of public health nursing practice. The Council of Public Health Nursing Organizations (CPHNO) has long identified policy development, advocacy, and systems change as foundational public health nursing responsibilities. When nurses participate directly in governance, they bring population-level data, prevention frameworks, and ethical commitments into arenas where structural determinants of health are shaped.
Using a township land-use planning initiative as an example, this blog illustrates how public health nursing knowledge informs local policy and how running for township trustee emerged as a systems-level public health intervention when governance structures failed to reflect community values. This approach aligns with solution-focused prevention at the systems level, as described in the Minnesota Public Health Intervention Wheel, and with evidence-based structural change strategies outlined in the University of Kansas Community Tool Box (https://ctb.ku.edu/en).
Why Local Policy Matters to Public Health Nursing
Local governments make daily decisions that affect social and environmental determinants of health—an emphasis consistently reflected in public health nurses’ collective policy and advocacy priorities. Zoning ordinances influence housing density and food access. Infrastructure planning affects transportation safety and physical activity. Land-use decisions shape environmental exposures and long-term sustainability.
For public health nurses, these decisions are not abstract. They define the conditions under which health is produced or constrained. When nurses are absent from decision-making spaces, community health priorities risk being subordinated to political, economic, or expedient considerations rather than evidence-informed prevention.
Practice Examples: Land-Use Planning as Nursing Assessment and Policy Engagement
In my community, increasing pressure associated with development raised concerns about preserving agricultural land, managing growth responsibly, and maintaining environmental sustainability. Recognizing these issues as public health concerns, I engaged in the township’s land-use planning process as a form of community-level health assessment and policy engagement. In fact, I served as a zoning commissioner chairwoman and participated in a steering committee designated to advance a new land use plan for its unincorporated section of the township.
Nursing students enrolled in a course focused on public health nursing in a political system, conducted door-to-door surveys to assess resident values related to agricultural preservation and growth. This activity was explicitly designed as a nonpartisan community assessment, consistent with ethical public health nursing practice. Students were prohibited from campaigns or partisan activities. Their role was to listen, document, and analyze—core public health nursing competencies that align with population-focused assessment and community engagement functions. Their findings validated residents valued a no development mentality.
When Community Voice Is Ignored: Running for Office as a Public Health Intervention
Despite extensive community engagement and formal recommendations from the township zoning commission, the final land-use plan did not reflect resident values related to environmental protection, agricultural preservation, and long-term population health. This disconnect revealed a structural failure between assessment and policy action.
In response, I ran for township trustee, reframing civic candidacy as a deliberate public health nursing intervention rather than a personal political act. Entering governance represented systems-level prevention—addressing upstream determinants of health by participating directly in the decision-making structure responsible for them. This action operationalized policy advocacy as a core public health nursing function, emphasizing influence on policy and systems as essential to advancing population health.
Ethical and Practical Considerations for Nurses Considering Public Office
My experience in running for office taught me that nurses who opt to run for public office should familiarize themselves with applicable local, state, and federal statutes or policies that may restrict eligibility for office or require resignation, leave, or other employment-related conditions. Further, consultation with employer’s legal counsel, human resources department—and, when applicable, union representatives—is crucial to ensure compliance with employment contracts and collective bargaining agreements. Nurses may also benefit from collaborating with personal attorneys, local policymakers, or colleagues who have held or pursued elected offices to navigate ethical boundaries, time commitments, and role clarity. Be mindful that campaign activities must remain clearly separate from professional responsibilities—especially in academic settings, where maintaining nonpartisanship and avoiding the use of classrooms or students for political purposes is vital to ethical public health nursing practice. Four practical considerations include: (1) understanding local board of election policies and procedures for petitioning to appear on the ballot; (2) determining whether your state offers ethics or legal courses, training programs, or certifications for elected officials and completing them prior to launching your campaign; (3) obtaining a mentor—preferably a nurse who has held elected office—to provide guidance on campaign-related decision-making; and, (4) securing major contributions from landowners and business leaders to signal strong political backing.
Public Health Nursing Education in Policy Contexts
These approaches demonstrate how public health nursing education can prepare nurses for policy engagement while maintaining ethical integrity and professional judgment. Students learned that policy engagement—including governance roles—is an extension of public health nursing practice, not a departure from it.
By witnessing how community priorities were assessed, elevated, and ultimately discounted, students gained insight into the realities of policy processes and the necessity of nursing leadership within them. They learned to translate population-level data into policy-relevant insights—an essential workforce competency and for strengthening the public health nursing role to advance population health.
Policy Without Partisanship: Clarifying the Public Health Nursing Role
A persistent barrier to nursing engagement in governance is the belief that policy work is inherently political or inappropriate. This example challenges that assumption. Public health nursing has always been policy-oriented, from sanitation reform to maternal-child health protections.
Engaging in land-use planning—and ultimately running for office—did not require partisan advocacy. It required nursing assessment, ethical reasoning, accountability to community voice, and responsibility for population health outcomes. These are foundational elements of public health nursing practice. Moving into political space requires new skills sets such as unwavering confidence, political astuteness, and savvy.
Implications for the Public Health Nursing Workforce
Regardless, if public health nurses are to influence the conditions that shape population health, they must be present where policy decisions are made—including elected and appointed governance roles. Running for office represents one pathway through which nurses can fulfill their professional mandate for upstream prevention.
For public health nursing leaders and educators, this example raises critical questions about workforce preparation that mirrors ongoing efforts to strengthen the public health nursing workforce through leadership development, education, and policy engagement. Are nurses being prepared to serve on boards and commissions? Are governance roles recognized as legitimate public health nursing practice? Are students taught how to navigate policy contexts ethically and effectively?
A Call to Action for Public Health Nurses
The Council of Public Health Nursing Organizations (CPHNO) has long advocated for policies that improve population health. Recognizing local governance—and when necessary, elected office—as a site of public health nursing practice strengthens this mission.
Public health nurses bring essential perspectives to local decision making— perspectives grounded in prevention, equity, and community engagement. When nurses participate in governance, policy decisions are more likely to reflect population health priorities and community values
Closing Reflection
Recognizing local governance as a site of public health nursing practice affirms the profession’s longstanding commitment to prevention, equity, and upstream action. It also reflects a call for CPHNO members and public health nurses to engage policy contexts where population health is most powerfully shaped. Running for office, when governance structures fail to honor community voice, is a legitimate expression of public health nursing leadership.
Local governance is not ancillary to public health nursing; it is central to it. Land-use planning, zoning, and budgeting decisions shape the environments in which people live, work, and thrive. When public health nurses engage in these spaces, they enact their professional mandate to protect and promote the health of the public.
Ann M. Stalter, PhD, RN., MSN, M. Ed
Association of Community Health Nursing Education (ACHNE), Research Committee Co-Chair and Policy Committee member
Feel free to contact Ann at drannmariestalter@gmail.com
This blog reflects my professional experience and perspectives; I used an AI tool for drafting support and to assist with organization, clarity, and grammar.
