Four general stages mark the development of community health/public health nursing:

1) The early home-care stage (before the mid-1800s) emphasized care to the sick
poor in their homes by various lay and religious orders.

2) The district nursing stage (mid-1800s) included voluntary home nursing care for
the poor by specialists or “health nurses” who treated the sick and taught
wholesome living to patients.

3) The public health nursing stage (1900 to 1970) was characterized by an increased
concern for the health of the general public.

4) The community health nursing stage (1970 to the present) includes increased
recognition of community health nursing as a specialty field, with focus on
communities and populations.
1
2
Societal Influences On The Development Of Community Health Nursing

Many factors have influenced the growth of community health

nursing.
Six are particularly significant:
1) Advanced technology,
2) Progress in causal thinking,
3) Changes in education,
4) Demographic changes and the role of women,
5) The consumer movement,
6) Economic factors.
3
 Advanced Technology

♣ Advanced technology has contributed in many ways to shaping the

practice of community health nursing.
♣ For example, technologic innovation has greatly improved health care,
nutrition, and lifestyle and has caused a concomitant increase in life
expectancy.
♣ Better meeting the needs of the elderly population and addressing
chronic conditions.
♣ Advanced technology has been a strong force behind industrialization,
large-scale employment, and urbanization. We are now primarily
an urban society, with approximately 75% of the world’s population
living in urban or suburban areas.

4
However:
♣ Population density leads to many health-related problems, particularly the
spread of diseases and increased stress.
♣ In addition, changes in transportation and energy sources in industry also
have increased environmental pollution and industrial hazards.
♣ Community health nurses are learning how to combat these urban health
problems.
♣ Community health nurses now are in the business of information
distribution, and they use computer technologies to enhance the efficiency
and effectiveness of their services.
♣ Geographic Information Systems (GIS) is an example of emerging
computer technology that the community health nurse can use to design
and evaluate population-focused programs. 5