Mapping Care Project: The History of Black Nurses in Chicago

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


Essential Questions

Learning Objectives 
  1. 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).
  2. 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)
Supplemental Resources
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. 
  1. 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. 
  2. 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)

PreparationHave students review the following material. Take some time to check for students’ understanding and questions. Faculty are welcome to add or remove resources based on their own needs for the course.
Contemporary Resources (2-3hrs)Historical Resources (From the Mapping Care website) (1 hrs)
Main activity: Group Research and Presentation (1hr)Sandra Webb Booker
Faculty can opt for students to create a presentation, paper, or share their findings orally
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.

EvaluationAssess the group presentations using a  Presentation Rubric Rubric that assesses the depth of analysis in five key areas: the nurse's biography and background, key contributions and strategies addressing Social Determinants of Health (SDoH), the impact on community and health equity, how contemporary public health nurses continue to address these issues, and the integration of historical, contemporary, and oral history references. Each area is scored from 1 to 5, focusing on the accuracy, depth, and clarity of content, as well as the ability to connect historical and current public health practices.


Activity Plan 2 Historic Contributions of Black Public Health Nurses (Group, in-class/online, Multimedia Project, Group Presentations)

Preparation
Readings (Mapping Care Project):
Supplemental Resources: Each student will be assigned to a group of three to five students. Students will plan their multimedia project by deciding on the format (Infographic) and its outline. They will outline the content to be included, assign roles, and set a timeline for completing each part of the project.
 
Main activity: Multimedia Project on Black Public Health Nurses: Past and Present 
Discussion and Feedback:After the presentations, students will engage in a class discussion and write a brief reflection on the following prompts:
Evaluation 

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.
 

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