Why Public Health Nurses Matter: Bringing Specialized Knowledge and Skills to Advancing Health Equity.

Research is needed to better understand how public health nurses (PHNs) contribute to promoting health equity in communities. Our study aimed to fill this gap by exploring what activities PHNs describe they undertake in advancing health equity as well as examining their skills, proficiencies, and training needs specific to health equity work. We collected qualitative data via interviews with 18 PHNs across the US and developed major themes using a thematic analysis approach. We also analyzed quantitative survey data to compare health equity competencies among PHNs versus non-PHNs in local health departments. Most participants identified as female (N = 15); years of experience as a PHN ranged from 1 to 37. Participants described four major themes related to their health equity work: foundational elements of health equity work, components of health equity work, how nurses are equipped to do health equity work, and barriers to engaging in health equity work, which included a need for a more diverse PHN workforce and the opportunity to practice at the top of their scope. Quantitative analyses highlighted PHNs confidence in addressing core health equity concepts, such as the social determinants of health. Findings provide a deeper understanding of how PHNs contribute to advancing health equity, underscoring the value they bring to public health and demonstrating ways that health equity is at the core of what they do. Further work is needed to address barriers, including establishing recruitment pathways for those from diverse backgrounds to facilitate growth of this valuable sector of the public health workforce.