Nurse‑Led Public Health: Advancing Equity and Gender‑Affirming Care in the USA
Why a Nursing Lens Matters in Public Health
Public health is often framed in terms of population statistics, policy analysis, and epidemiological modeling. Yet the day‑to‑day realities of patient care—how a nurse interacts with a patient, how a clinician interprets symptoms, and how a health system responds to community needs—are the building blocks that shape those statistics. When nurses bring their frontline experience into the public‑health arena, they add a critical perspective that can uncover hidden inequities and drive more effective interventions.
Ellie Spoering: From Hospital Bedside to Health‑Equity Advocate
Ellie Spoering ’25, a registered nurse with 16 years of experience, exemplifies how a nursing background can inform public‑health practice. While treating traumatic brain injuries in a Colorado hospital, Spoering noticed a disproportionate number of patients with marginalized identities. This observation sparked her interest in health equity and led her to pursue an online Master of Public Health at Simmons University.
Her journey illustrates a common pathway for nurses: identifying gaps in care, seeking broader systemic solutions, and applying evidence‑based strategies to improve outcomes for underserved populations.
Gender‑Affirming Care: A Case Study in Equity
One of Spoering’s most impactful projects was the development of a virtual training module for nurses on gender‑affirming care. The training addresses a critical gap—most nursing curricula allocate less than two hours to LGBTQ health, and even less to transgender‑specific care. The result is a resource that equips nurses with:
- Active listening techniques tailored to trans patients
- Clinical protocols that avoid misattributing symptoms to gender transition
- Strategies for creating a welcoming environment that reduces healthcare‑related trauma
By integrating these practices, nurses can help reduce the five‑fold higher mortality rate observed among transgender individuals in the U.S., a figure that stems from a combination of medical, social, and systemic factors.
Applying an Equity Lens to Everyday Nursing Practice
Public‑health training encourages nurses to look beyond individual cases and consider the social determinants that shape health outcomes. For example, epidemiology courses at Simmons explore how historical redlining contributed to higher COVID‑19 mortality in certain neighborhoods. Nurses who understand these patterns can:
- Advocate for targeted resource allocation in high‑risk communities.
- Collaborate with local organizations to address barriers to primary care.
- Design culturally competent education materials that resonate with diverse populations.
Immersion Experiences: Bridging Theory and Practice
Simmons’ Master of Public Health program includes two immersion courses—“Racism, Health & Equity” and “Arizona” (focused on migrant health). These field experiences provide nurses with firsthand exposure to the challenges faced by marginalized groups and the policy environments that shape their health.
During the Arizona immersion, students examined how border policies affect migrant health and how public health initiatives can be weaponized against vulnerable populations. The insights gained from such trips translate into actionable strategies when nurses return to their clinical settings.
Building Community Partnerships
Effective public‑health interventions rely on collaboration. Nurses can partner with community organizations to:
- Conduct health screenings in underserved neighborhoods.
- Develop educational workshops on preventive care.
- Advocate for policy changes that improve access to services.
These partnerships not only extend the reach of healthcare but also empower communities to take ownership of their health outcomes.
Practical Steps for Nurses to Drive Public‑Health Change
1. Integrate Equity Training into Your Practice
Enroll in continuing‑education courses that focus on health equity, gender‑affirming care, and cultural competency. Many professional nursing associations offer accredited modules that can be completed online.
2. Leverage Data to Identify Gaps
Use electronic health record (EHR) data to track disparities in diagnosis, treatment, and outcomes. Share findings with your institution’s quality improvement team to inform targeted interventions.
3. Advocate for Systemic Change
Participate in hospital committees that shape policies on patient safety, diversity, and inclusion. Present evidence from public‑health research to support initiatives such as inclusive intake forms and staff training.
4. Engage in Community Outreach
Volunteer with local health fairs, tree‑planting projects, or migrant health clinics. These activities broaden your perspective and build trust with the populations you serve.
5. Mentor the Next Generation
Share your experiences with nursing students and new graduates. Encourage them to pursue public‑health electives or dual degrees that combine clinical practice with population‑level thinking.
Call to Action: Shape the Future of Health Equity
As a nurse, you have the unique ability to influence both individual patient outcomes and broader public‑health trends. By embracing an equity mindset, pursuing targeted training, and fostering community partnerships, you can help create a healthcare system that serves all patients fairly.
Ready to take the next step? Explore Simmons’ online Master of Public Health program and discover how you can expand your impact beyond the bedside.
Have questions about integrating gender‑affirming care into your practice? Learn more about the Human Rights Campaign’s resources and start building a more inclusive care environment today.
Share your experiences in the comments below or connect with fellow nurses on our LinkedIn group to discuss best practices and new ideas.
For more insights on health equity and nursing leadership, read our related articles and stay informed about the latest research and initiatives.
