Massachusetts Statewide Effort to Document the Work of Public Health Nurses

by Laura K. Suzuki, MPH, RN, CPH

As we approach the third year of the global COVID-19 pandemic, it has become apparent that public health nurses serve a vital role in combatting the spread of the virus at the local level, keeping communities safe, and minimizing the adverse effects on vulnerable populations. In Massachusetts, local public health nurses have engaged in large-scale contact tracing efforts, organized and managed testing clinics, educated the community, planned and staffed large-scale vaccination clinics, conducted home visits to vaccinate the homebound, and advocated for those left out of mainstream vaccination efforts. All while attending to persistent pre-COVID public health issues: flu, tuberculosis, mosquito and tick-borne diseases, sexually transmitted disease, and the list goes on. However, the work of public health nurses is often invisible. Historically, enumeration efforts have not adequately captured the roles and functions of public health nurses, and integration of their work into existing public health systems is lacking.

Currently, in Massachusetts, an effort is underway to capture the work of public health nurses across the state. Massachusetts is unique in that 351 local Boards of Health represent each of the towns, cities, and localities that make up the Commonwealth. Therefore, each Board of Health is authorized and responsible for public health services in their community. As a result, public health nursing services are highly variable, from the types of services provided to the type of training and credentials of nurses and the structure and level of their compensation. Building on a previous workforce survey completed several years ago, the Massachusetts Department of Health, in partnership with the Massachusetts Public Health Nurses Association, is conducting a statewide survey to document the services provided by local public health nurses and to understand better communities’ health needs and priorities that can be served through public health nursing services. This effort to quantify public health nurses’ contributions will help identify areas in which they can be better utilized, practice to the full extent of their training and expertise, and become better integrated into a comprehensive public health system. This survey will provide quantifiable information on the work public health nurses do and are the kind of information we need to be part of the conversation of what public health should be in a post-COVID world. It will also allow the nursing profession to position itself as an equal partner, working alongside the myriad professionals in public health as we shape the future of public health together. We anticipate that the preliminary survey results will be released in spring 2022.

Massachusetts is currently in the process of critically reviewing the public health system and is engaged in a legislative battle to secure $250 million through the State Action of Public Health Excellence Act (SAPHE) for local public health for the next three years. Now, as the pandemic continues to impact our communities profoundly and shape our vision of what public health can and should do, this enumeration of public health nurses and the contributions of local public health nurses comes at a critical time.

More information on the SAPHE 2.0 Act:

MA Public Health Nurses Association:

Laura Suzuki, MPH, RN, CPH is a public health nurse with 20+ years of experience at the local, state, federal, and international levels. Most recently she served as a COVID-19 Vaccination Nurse Educator with the Immunization Division of the Massachusetts Department of Public Health providing training and technical assistance to vaccination providers throughout the state. Her areas of expertise include communicable disease, epidemiology, immunizations, maternal-child health, and public health program management.

Laura has held an adjunct faculty position in the Public Health Program at the University of Massachusetts Lowell and is a PhD Candidate in Nursing at Boston College. She currently is serving a 3-year term as Section Councilor of the Public Health Nursing Section of the American Public Health Association. 

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