Public health nurse educators’ conceptualisation of public health as a strategy to reduce health inequalities: a qualitative study

BACKGROUND: Nurses have long been identified as key contributors to strategies to reduce health inequalities. However, health inequalities are increasing in the UK despite policy measures put in place to reduce them. This raises questions about: convergence between policy makers’ and nurses’ understanding of how inequalities in health are created and sustained and educational preparation for the role as contributors in reducing health inequalities. AIM: The aim of this qualitative research project is to determine public health nurse educators’ understanding of public health as a strategy to reduce health inequalities. METHOD: 26 semi-structured interviews were conducted with higher education institution-based public health nurse educators. FINDINGS: Public health nurse educators described health inequalities as the foundation on which a public health framework should be built. Two distinct views emerged of how health inequalities should be tackled: some proposed a population approach focusing on upstream preventive strategies, whilst others proposed behavioural approaches focusing on empowering vulnerable individuals to improve their own health. CONCLUSION: Despite upstream interventions to reduce inequalities in health being proved to have more leverage than individual behavioural interventions in tackling the fundamental causes of health inequalities, some nurses have a better understanding of individual interventions than take population approaches.