Academy Statement - Surgeon General's Call to Action: "Community Health and Prosperity"

Posted 11 months ago

American Academy of Nursing Releases Statement in Response to Surgeon General's Call to Action: "Community Health and Prosperity"

Washington, DC (October 24, 2018) -- Based on the expertise and recommendation of its Environmental and Public Health Expert Panel, the American Academy of Nursing has submitted the following statement in response to the Surgeon General's Call to Action: "Community Health and Prosperity". The Academy encourages its fellows to submit their own comments as individuals on how investments in community health aid in the prosperity and overall health of communities.   Comments will be accepted through November 5, 2018.

Community Health Impacts on Well-being and Economic Prosperity
American Academy of Nursing Statement of Support

Nursing is not new to population health or to investing in communities to promote health. In fact, in the late 1800s, Lillian Wald, founder of public health nursing, lived and worked in the impoverished community where she served so that she could recognize and address social and economic determinants of health. In the 1920s, Mary Breckinridge, a nurse midwife, founded Frontier Nursing Service in the remote mountains of Appalachia. Even though Breckinridge and other Frontier nurses traveled on horseback, they delivered the best evidence-based care of the day to isolated families with no other access to health care. These nurse-driven community health initiatives were not designed to be highly profitable; instead, they were designed to use prevention and community investment to save lives.

Today, nurses continue to provide essential leadership in prevention and community health promotion. For example, the American Academy of Nursing (Academy) urges investment in the public health nursing infrastructure and education of nurses for new roles in population health management (Kub, Kulbok, Miner, & Merrill, 2017). The Academy also promotes nursing leadership in dealing with health factors related to the physical environment. The Academy calls for policies to address: “(a) upstream opportunities to reduce pollution and create the best possible climate scenarios for future generations, and (b) downstream needs related to all phases of disaster response and the essential role of the nursing workforce in saving lives during extreme weather events” (Leffers & Butterfield, 2018).

Investment in community health is essential for a healthy economy. The U.S. Chamber of Commerce Foundation Corporate Citizenship Center (USCCF) and the Action Collaborative on Business Engagement in Building Healthy Commu­nities (the Collaborative) cite the toll that rising levels of obesity, smoking, heavy drinking, and depression are taking on business (Zellner & Bowdish, 2017). They urge businesses to address the social and economic factors, which according to the Community Health Rankings and Roadmaps program (Robert Wood Johnson Foundation & University of Wisconsin, n.d.) represent 40% of the factors that influence health. When businesses invest in community health, their ROI includes: increased cost savings over time, improved satisfaction and health of employees, and healthy communities that draw new talent and retain current workers (Zellner & Bowdish, 2017).

Based on Nursing’s longstanding expertise in community health, the American Academy of Nursing believes that investments in community health have the potential to improve the health and prosperity of communities. Nursing has a demonstrated history of successful community partnerships and effective implementation of population health initiatives. The Academy calls upon business leaders and policy makers to invest in communities, promote research on effective ways to address social and structural determinants of health, and work in partnership with the nursing profession to improve community health.




Breckinridge, M. (1952). Wide neighborhoods: A story of the Frontier Nursing Service. Lexington, KY: University Press of Kentucky.


Kub, J. E., Kulbok, P. A., & Merrill, J. A. (2017). Increasing the capacity of public health nursing to strengthen the public health infrastructure and to promote and protect the health of communities and populations. Nursing Outlook, 65(5), 661-664.

Leffers, J, & Butterfield, P. (2018). Nurses play essential roles in reducing health problems due to climate change. Nursing Outlook, 66(2), 210-213,

Robert Wood Johnson Foundation & University of Wisconsin Population Health Institute. (n.d.). County health rankings and roadmapsretrieved from

Wald, L. (1915). The house on Henry Street. New York, NY: Henry Holt

Zeller, S., & Bowdish, L. (2017). The ROI of health and well-being: Business investment in healthier communities. NAM Perspectives.Discussion Paper, National Academy of Medicine, Washington, DC.https://nam. edu/the-roi-of-health-and-well-being-business-in­vestment-in-healthier-communities.


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