This chapter explores the relationship between primary health care (PHC), health literacy and health education with empowering individuals, groups and communities to improve and maintain optimum health. PHC philosophy encompasses principles of accessibility, affordability, sustainability, social justice and equity, self-determination, community participation and intersectoral collaboration, which drive health care service delivery and health care reform. Empowerment is a fundamental component of social justice, which seeks to redistribute power so those who are disadvantaged can have more control of the factors that influence their lives. Lack of empowerment is linked to poorer health outcomes due to limited control or agency, associated with poorer social determinants of health. This influences personal resources, agency and participation, as well as limited capacity to access services and opportunities. Health care professionals and systems need to work in ways to promote the empowerment of individuals, groups and communities to achieve better health outcomes.

Good nursing practice is based on evidence, and undertaking a community health needs assessment is a means of providing evidence to guide community nursing practice. A community health needs assessment is a process that examines the health status and social needs of a particular population. It may be conducted at a whole-of-community level, a sub-community level or even a subsystem level. Nursing practice frequently involves gathering data and assessing individuals or families to determine appropriate nursing interventions. This concept is transferable to an identified community when the community itself is viewed as the client.

Sex and gender have a significant relationship to health and health outcomes for women, men, and sexually and gender-diverse people. Sex relates to biological attributes, whether born female or male, while gender identity relates to how someone feels and experiences their gender, which may or may not be different to their physiology or sex at birth. Biological characteristics expose women and men to different health risks and health conditions. Gender also exposes people to different health risks, and gender inequity impacts on their potential to achieve health and well-being.

Chronic conditions, or non-communicable diseases, are the leading cause of death worldwide. Chronic conditions are responsible for 41 million deaths and 17 million premature deaths across the world each year. Most of these deaths are due to four major conditions: cardiovascular disease, cancer, chronic respiratory disease and diabetes. However, other chronic conditions, including injuries that result in persistent disability and mental health disorders, also contribute to increased morbidity and mortality. The significant increase in preventable chronic conditions and the need to manage these are major healthcare concerns of the industrialised world.

Primary health care (PHC) is a philosophy or approach to health care where health is acknowledged as a fundamental right, as well as an individual and collective responsibility. A PHC approach to health and health care engages multisectoral policy and action which aims to address the broader determinants of health; the empowerment of individuals, families and communities in health decision making; and meeting people’s essential health needs throughout their life course. A key goal of PHC is universal health coverage, which means that all people have access to the full range of quality health services that they need, when and where they need them, without financial hardship.

In the ‘classic’ sense, health professionals often view the health of individuals from a three-part biopsychosocial model of health. In this case, the ‘psych’ part relates directly to ‘mental health’. However, it is important to resist the temptation to separate this part from the bio and social aspects of the well-established model. Instead, it is best to view all parts of the established model as equally important and inter-related to each other. For instance, it is difficult to maintain good mental health and well-being if we lack either good social or ‘bio’ (physical) health. Traditionally, however, health professionals have tended to focus on the physical health component of the biopsychosocial model, especially those working in acute hospital/clinic environments. From a primary health care perspective, the ‘social’ (community development-focused) aspect is supposed to be the most dominant part of the model.

Sexual health nurses are employed to work in a range of practice settings and work with diverse population groups. Sexual and reproductive health care is considered a human right and is fundamental to positive well-being. The nurses role in sexual and reproductive health varies between settings within and across different jurisdictons. Work settings include dedicated sexual health clinics, family planning services, community health centres, women’s health services, correctional services, general practices and tertiary education settings. In some juristictions, nurses also provide care in publicly funded sexual health clinics aimed at providing services to specific priority population groups to increase their access to services and reduce the prevalence of adverse sexual and reproductive health outcomes including sexually transmitted infections and unplanned pregnancy.

Home-based care is common practice in many countries and has had a long tradition in Australia and Aotearoa New Zealand. Home-based care now takes many forms, including the acute care program Hospital in the Home, a range of chronic disease programs and community aged care. Home-based care provides many benefits to consumers, reducing their need to travel to services and associated costs. It also allows the health care provider to have a holistic picture of the consumers and for the consumers to feel empowered to manage their health care issues in their own homes, while continuing with normal daily activities in a setting that they are comfortable in.

Approximately one in every six people have some form of disability and about one-third of these people have a severe or profound limitation to their daily activities and function. As a subgroup, they are some of the most marginalised and disadvantaged, often experiencing disparate chronic and complex health problems when compared to the general population. In addition, they sometimes encounter disabling challenges accessing the health system and have experienced poor quality care from health professionals whose capacity to understand their needs, and how to best respond to them, is limited. This chapter seeks to inform health care professionals about the intersection of health and disability so that they can better work with people with a disability no matter the health context.

The terms ‘health promotion’ and ‘health education’ are often used interchangeably. Often this is a problem as they are distinct and different concepts. Whitehead attempted to overcome this problem by separating and defining the terms. When it comes to primary health care program planning and evaluation, the terms health promotion and health education are also often used interchangeably but this is less of a problem in this specific case than already stated. Health promotion approaches, often by default, include health education interventions. Reflecting this, many ‘health’ planning and evaluation tools and models incorporate health promotion and health education processes.

This chapter introduces First Nations approaches to health care that have relevance for the Australian and Aotearoa New Zealand contexts. It examines the historical influences that impacted the health and well-being of First Nations in these countries and considers the need for adopting First Nations approaches to health care practice such as cultural safety, cultural responsiveness and other cultural frameworks. Several of the principles for practice are transferrable to international First Nations communities as well as culturally and linguistically diverse populations.

The school nurse is a nurse who works in a range of education settings, across all age groups. While Australia does not have a formal national school health service, nurses have worked in schools for over a century. Today, they are employed in various independent schools, colleges and fragmented programs within government schools. There has been interest in recent years in growing the presence of nurses in Australian schools to facilitate access to health care for students from disadvantaged backgrounds.