Cornerstone Documents, Milestones, and Policies

Shaping the Direction of Public Health Nursing 1950-2015

Pamela A. Kulbok, DNSc, RN, APHN-BC, FAAN; Joan Kub, PhD, RN, PHCNS-BC, FAAN; Doris F. Glick, PhD, RN


Online J Issues Nurs. 2017;22(2) 

In This Article

Abstract and Introduction


Ruth Hubbard, a public health nursing (PHN) leader in 1950, offered a timeless comment, "To each age comes its own peculiar problems and challenges, but to it also comes the necessary vision and strength" (p. 608). Similar to the 1950s, from 1950 to 2015 unique healthcare and workforce issues continued to arise calling for public health nurses to respond with vision and strength. In Part Two of a three-part series on PHN history, we examine seminal documents, events, and policies that influenced practice. We begin by considering the time period 1950 to 1975, and then discuss healthcare transitions; social activism and community health planning; and concerns from the years 1975 to 2000 and 2000 to 2015. These milestones reflected challenges of emerging chronic diseases, re-emerging infectious diseases, immigration and terrorism, as well as post-war prosperity and improvements in health care. As in the early 20th century, response to challenges included periods of expansion and recession. We conclude by considering the past as prologue, discussing prospects for present and future PHN.


In the 50th Anniversary Issue of the American Journal of Nursing, a distinguished public health nursing (PHN) leader, Ruth Hubbard, offered a timeless comment, "To each age comes its own peculiar problems and challenges, but to it also comes the necessary vision and strength" (1950, p. 608). Miss Hubbard's statement guided her article on the history of public health nursing (PHN) in the United States (US). As in Ms. Hubbard's day, unique problems and issues to which public health nurses responded with distinguishing vision and strength characterized the late 20th and early 21st centuries. The purpose of this article, part two of a three-part series (Kub, Kulbok, & Glick, 2015; Kulbok, Kub, & Glick, 2017) on the history of PHN, is to examine landmark social and political documents, events, and policies from 1950 to 2015 which influenced the environment and context in which public health nurses practice.

Challenges included an emergence of chronic diseases, re-emergence of infectious diseases, global conflicts, immigration, and terrorism. This was also a time of prosperity and advances in healthcare delivery. In the following sections, we chronicle the landmark documents, events, and policies, and discuss how these shaped the evolution of PHN practice from 1950 to 2015. In part three of this series, we will examine the resultant influence of cornerstone documents and events on the changing definitions and context of PHN practice.