There’s a radical shift taking place in health care and public health nurses, like Lt. Shauna Mettee at the Centers for Disease Control and Prevention, are leading the way.
In 2011, the U.S. Department of Health and Human Services released its National Prevention Strategy with an overall goal of increasing the number of Americans who are healthy at every stage of life.
“This strategy and the National Prevention Council created through the Affordable Care Act are helping to move our nation away from a health care system focused on sickness and disease to one focused on wellness and prevention,” said Mettee, public health adviser with the CDC’s new Office of Health System Collaboration.
To create a prevention-oriented and healthier society, the National Prevention Strategy has identified four strategic directions: healthy and safe community environments; clinical and community preventive services; empowered people (who have the knowledge and encouragement to make healthy choices); and the elimination of health disparities.
The strategy has also identified seven priorities that are most likely to reduce the leading causes of preventable death and major illness: tobacco-free living; preventing drug abuse and excessive alcohol use; healthy eating; active living; injury- and violence-free living; reproductive and sexual health; and mental and emotional well-being.
“People need safe environments, clean air and water, healthy food and good transportation options — for example, sidewalks so that students can safely walk to school,” said Mettee, RN, MSN, MPH, president-elect of the CDC/ATSDR Nurses Work Group.
The definition of public health is expanding, Mettee said.
“We’ve been used to viewing ourselves in silos in health care, but we’re beginning to look at ourselves as one large health system, and to create linkages,” she explained. “Public health and health care collaboration could enhance the capacity of both sectors to improve the nation’s health and well-being.”
The Affordable Care Act’s new care coordination models — such as Accountable Care Organizations — are one example of this collaboration. Another is the CDC Nursing Symposium that was organized by the CDC/ATSDR Nurses Work Group last May. The symposium brought together 200 clinical, academic and public health nurses from Georgia to network and discuss ways they could work together better.
“As trained systems leaders, nurses are poised to be innovative leaders in these new patient-centered, team-based models of care. Nurses can bridge the cultural gap between public health and clinical care, and they remain the most trusted professionals in the country,” Mettee said.
There has been progress in Georgia, Mettee said. More hospitals and county public health departments are collaborating to assess the greatest health needs in their communities.
With the Georgia Telehealth Initiative, all Georgia counties will have telemedicine systems in public health offices by the end of 2013, which will give the state’s rural populations greater access to medical specialists.
“This collaboration gives more Georgians access to care without having to travel to doctor’s offices, and public health nurses are providing the coordination of that care,” Mettee said.
By embracing prevention, public health takes on a larger spectrum that embraces all aspects of life — where people live, learn, work and play.
“Anyone can get involved with public health by sharing information and supporting initiatives. We all have a role to play,” Mettee said.
Mettee, who began her career as an emergency room nurse, earned master’s degrees in international nursing and public health from Emory University in 2009. From 2009 to 2011, she served in the U.S. Public Health Service as an epidemic intelligence service officer at the CDC, where she investigated food and waterborne disease outbreaks. In 2011, she was the first nurse accepted into CDC’s Preventive Medicine Residency/Fellowship program and was assigned to a three-county health district. In 2012, she served as a public health adviser in the CDC’s Office of the National Prevention Strategy.
“I had no idea that I would head in this direction. Public health found me, and I just dove into it,” Mettee said. “It’s an exciting time for nurses and mid-level providers. We are aware of the changes and have the opportunity to create ways for public health and health care to work together.”
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