Lesson 2: The Legacy and Future of Black Public Health Nurses
Standards (AACN entry and advanced)
Domain 1 - Knowledge for Nursing Practice
1.1c Understand the historical foundation of nursing as the relationship developed between the individual and nurse. (Entry-Level)
1.1g Integrate an understanding of nursing history in advancing nursing’s influence in health care.(Advanced-Level)
1.2a Apply or employ knowledge from nursing science as well as the natural, physical, and social sciences to build an understanding of the human experience and nursing practice. (Entry-Level)
Domain 3 - Population Health
3.4b Describe the impact of policies on population outcomes, including social justice and health equity. (entry-level)
3.4g Design comprehensive advocacy strategies to support the policy process. (advanced)
3.5a Articulate a need for change (entry-level)
3.5i Demonstrate leadership skills to promote advocacy efforts that include principles of social justice, diversity, equity, and inclusion. (advanced)
Associated Nursing History Framework
- Pedagogy - Shape the nurse’s identity and role within public health.
- Evidence - Bears witness and gives voice to experiences of Black providers and patients
- Explanation - Provides context for ongoing discussions in health care related to racism and discrimination.
- Evidence - Bears witness to the critical role of nurses for public health
Essential Questions
- What significant events and achievements marked the development of Black nursing in the U.S.?
- How has the role of nurses differed from other healthcare professionals historically?
- How does that history impact the role and identity of nurses today?
- How has history helped to construct the role and identity of Black nurses both within and outside of the Black community?
- How does the history of racism impact considerations for all nurses in nursing practice today?
- What roles have Black nurses played in advancing research on health equity and social determinants of health?
- How can advocacy by Black nurses help address health disparities and promote social justice in healthcare?
Learning Objectives
- Evaluate the Impact of Historic and Modern Black Public Health Nurses: Students will evaluate the historic and contemporary impact of Black public health nurses in addressing social determinants of health and promoting health equity during the contemporary period (AACN 1.1c, 1.1g, 1.2a, 3.4b).
- Promote the Contributions of Black Public Health Nurses: Students will advocate for the recognition and continuation of the roles and contributions of Black public health nurses in addressing social determinants of health and promoting health equity (AACN 3.4g, 3.5a, 3.5i).
Introduction (Faculty)
In this lesson, students will explore the role of Black public health nurses in addressing issues of health equity during the Jim Crow era. Students will understand both the historical role of nurses in public health as well as the unique role of Black nurses in the Black community. Also, students will compare past and present health care equity challenges and consider lessons that apply from historical Black public health nurses in developing their own nursing practice.Within the Teaching Care sequence, this lesson can be an introductory lesson to the entire Teaching Care unit. This lesson can also be paired with the Teaching Care lessons about the COVID-19 pandemic and the work of contemporary Black public health nurses.
Historical/Conceptual Background (for Faculty) (adapted from Mapping Care website)
In the early twentieth century, disease and death was increasing among Black Americans at an alarming rate compared to their white counterparts. Black people living in the rural South lived far from most medical care. Black Americans seeking new opportunities in northern cities like Chicago found themselves living in crowded, segregated communities where disease spread quickly. Black patients often could not be admitted to public hospitals or were sent to segregated wards. Most hospitals refused to train Black nurses or doctors, yet many white healthcare workers refused to care for Black patients. When they received hospital treatment, Black people were often treated by racist white medical staff, creating a deep distrust within the Black community regarding the healthcare system.
The situation of Black Chicagoans in this period presents a very stark case of the impacts of Social Determinants of Health (SDoH). Overtly racist policies restricting transportation, housing availability, health care access, employment and educational opportunities had tremendous impacts on the health and well being of Black Chicagoans. At this time, most Black nurses were employed in the communities, as even (often) racist white politicians and city leaders recognized that infectious disease did not adhere to their strict social color-lines. These nurses worked in TB sanatoriums as well as visiting the sick in their homes in segregated Black communities, where white nurses refused to go.
Black public health nurses (“visiting nurses”) often served as the sole trusted healthcare presence in many Black communities. They entered Black homes and schools, building connections with members of the community.
They taught nutrition and hygiene, vaccinated schoolchildren, and supported expecting mothers by visiting them in their homes. Additionally, they championed improved living conditions, safer working and learning environments, and greater access to essential resources like adequate housing, food, and education. Through health education on infant care, infection control, and household hygiene, Black public health nurses became vital community advocates, working to ensure the well-being and resilience of Black Chicagoans amid systemic inequalities.
For more resources on this subject, see:
Access to Quality Healthcare: The Jim Crow Years (1870’s-1960’s)
Access to quality healthcare 1970-present
Note on terminology: Historically, “negro” or “colored” were often terms used to refer to Black Americans in historical publications and documents. Please take time to explain that although historically accurate and relevant, when talking or writing about Black Americans in the present time, it is unacceptable to use this term. Encourage them to use “Black” or “people/person of color” instead. Students may appropriately use these terms in their writing if quoting a source document and including [sic] following the term, to signify that the term is used to preserve historical accuracy. They may also need to use the term when citing or listing references, in which case they should follow standard practice for the chosen citation style. For more information, you can read this explanation, A Note on Historical Language.
Read/Watch/Listen (Resources from the Mapping Care website)
- Access to Quality Healthcare: The Jim Crow Years (1870’s-1960’s)
- Access to quality healthcare 1970-present
- Black Nurses in Public Health in Today
- Black Public Health Nurses in History
Supplemental Resources
- Social Determinants of Health and Health Equity - The Future of Nursing 2020-2030 - NCBI Bookshelf
- Social Determinants of Health - Healthy People 2030 | health.gov
- Social Determinants of Health | NCHHSTP Health Equity | CDC
- Schlabach, E. (2019). The influenza epidemic and Jim Crow public health policies and practices in Chicago, 1917–1921. The Journal of African American History, 104(1), 31-58.
- Elman, C., Feltey, K. M., Wittman, B., Stevens, C., & Hartsough, M. B. (2024). How the Struggle for Public Health in the Jim Crow South Reflected and Reinforced Systemic Racial Health Inequality. Du Bois Review: Social Science Research on Race, 1–25. doi:10.1017/S1742058X24000092
- Kearns, L. (2013). Revisiting Nurse Rivers. Voices in Bioethics.
- Mosley, M. O. (1994). Jessie Sleet Scales: first black public health nurse. The ABNF Journal: Official Journal of the Association of Black Nursing Faculty in Higher Education, Inc, 5(2), 45-51.
- Jim Crow Laws Are Gone But They’re Still Making Black People Sick
Books
Activities Summary: The following is a brief summary of activities included in this lesson. Faculty are encouraged to pick and choose the activities that work best for their students and course. Faculty may also modify activities through adding readings or changing learning modalities, instructions, or evaluation criteria as they see fit.
- Evaluate the Impact of Role of Black Public Health Nurses: Students will research and present on the contributions of a specific Black public health nurse the contemporary period, focusing on their strategies for addressing social determinants of health in their communities.
- Historic of Black Public Health Nurses: Students will create a multimedia project (e.g., video documentary, website) that compares the work of Black public health nurses during the Jim Crow era and today, advocating for greater support and funding for public health initiatives led by nurses of color.
Activity Plan 1 The Impact of Modern Black Public Health Nurses (Group, in-class or online, Presentation, and Group discussion /Time 5-6 hrs)
Preparation
- Pre-reading & Review of Reading (3-4hrs) :
Contemporary Resources (2-3hrs)
- Social Determinants of Health and Health Equity - The Future of Nursing 2020-2030 - NCBI Bookshelf (7536 words)
- Social Determinants of Health - Healthy People 2030 | health.gov (157 words)
- Social Determinants of Health | NCHHSTP Health Equity | CDC (279 words)
- Black Nurses in Public Health in Today (1270 words)
- Access to quality healthcare 1970-present (1390 words)
Main activity: Group Research and Presentation (1hr)
- Using the provided oral history excerpt and full oral history interviews, student groups will select two Black public health nurses from the contemporary to research. They will gather information on the nurse’s background, the challenges they faced, and their contributions to public health from the suggested oral history sources: PublicHealth-OralHistories-NS
- Full interview list:
Faculty can opt for students to create a presentation, paper, or share their findings orally
- Students will be prepared to share the following with the class:
- The nurse’s biography and background.
- Key contributions to public health and strategies used to address SDoH.
- The impact of their work on their community and health equity.
- How do contemporary public health nurses continue to address these issues?
Students should integrate and cite sources from the oral histories with the historical and contemporary resources assigned in preparation for the activity. Students will present their findings to the class. Each presentation should be followed by a Q&A session to engage the audience and encourage discussion.
Online option: Ask students to post their findings on a discussion board and ask students to read and comment on other student’s posts.
Evaluation
- Rubric for group presentation
Activity Plan 2 Historic Contributions of Black Public Health Nurses (Group, in-class/online, Multimedia Project, Group Presentations)
Preparation
Readings (Mapping Care Project):
- Black Public Health Nurses in History
- Access to Quality Healthcare: The Jim Crow Years (1870’s-1960’s)
Supplemental Resources:
- Schlabach, E. (2019). The influenza epidemic and Jim Crow public health policies and practices in Chicago, 1917–1921. The Journal of African American History, 104(1), 31-58.
- Elman, C., Feltey, K. M., Wittman, B., Stevens, C., & Hartsough, M. B. (2024). How the Struggle for Public Health in the Jim Crow South Reflected and Reinforced Systemic Racial Health Inequality. Du Bois Review: Social Science Research on Race, 1–25. doi:10.1017/S1742058X24000092
- Kearns, L. (2013). Revisiting Nurse Rivers. Voices in Bioethics.
- Mosley, M. O. (1994). Jessie Sleet Scales: first black public health nurse. The ABNF Journal: Official Journal of the Association of Black Nursing Faculty in Higher Education, Inc, 5(2), 45-51.
- Jim Crow Laws Are Gone But They’re Still Making Black People Sick
- Planning the multimedia project
- What is an Infographic? Examples, Templates, Design Tips
- How to Make a Great Infographic With Google Slides Templates
- Creating an Infographic in PowerPoint
- Padlet
Main activity: Multimedia Project on Black Public Health Nurses: Past and Present
- Multimedia project: Students will begin creating content for their multimedia projects. This includes collecting and organizing relevant images, documents, and other material.
- Students will start developing their projects by integrating the gathered content. They should focus on:
- Creating a compelling narrative that describes the work of Black public health nurses during the Jim Crow era, within an appropriate historical context
- Detailing specific challenges Black communities faced in advancing health during the Jim Crow Era, and their strategies to overcome these challenges.
- Highlighting key contributions and advocacy efforts of Public Health nurses at the time, and its impact on the community.
- Discuss the lasting impact of Jim Crow segregation laws on the public health of Black Americans.
- Presenting the projects: Each group will post or present their multimedia project to the class. The presentation should include:
- Answers to the above prompts regarding public health nursing during the Jim Crow Era
- A list of references inclusive of the preparatory readings and additional outside historic references.
Discussion and Feedback:
- Discussion and Reflection
- What new insights did you gain about the contributions of Black public health nurses?
- How do the historical and contemporary roles of these nurses compare?
- Why is it important to advocate for greater support and funding for public health initiatives led by nurses of color?
Evaluation
- Rubric for multimedia group presentation and reflection
Assess the group presentations using a Multimedia Group Project Rubric to assess the quality and depth of students' multimedia projects on the contributions of Black public health nurses.