Design, Setting, and Participants: A cross-sectional observational study using data with information on local health department staff- and organizational-level characteristics collected from across the United States in 2021. We used logistic regression to estimate the association between 2 binary nurse-specific predictors—(1) whether the staff person was a nurse and (2) whether the staff worked in a local health department that was “nurse-led” (directed by a nurse)—and reported proficiencies important to the COVID-19 response. Models controlled for relevant local health department and community characteristics.
Results: In the sample, 19% were nurses and 37% were at nurse-led health departments. Nurse versus nonnurse staff had higher odds of reporting proficiencies in skills related to Justice, Equity, Diversity, and Inclusion and in the skill “identifying/applying evidence-based approaches to address public health issues.” However, nurses, compared with their nonnurse peers, had higher odds of reporting training needs in domains related to community engagement, policy engagement, and cross-sectoral collaboration. Conversely, staff at nurse-led health departments, compared with non–nurse-led staff, had higher odds of reporting proficiencies in many of these same areas, including “collaborating across the public health system” and “influencing policies external to the organization that affect community health.” There were no areas in which nurse-led staff had lower odds of reporting proficiencies or higher odds of identifying training needs.
Conclusions: Findings from this study highlight areas of strength for public health nurses, particularly strengths related to diversity, equity, and inclusion, as well as areas where more training is needed. Such findings can help guide future public health nurse workforce development as well as underscore the value of public health nursing leadership and staff at local health departments for supporting community health.