Public health nursing clientele shared with social assistance: proportions, characteristics and policy implications

This study was designed to determine (1) the extent to which public health nursing visits and social services income programs serve the same population (shared clientele), (2) whether shared and unshared clientele differ in their characteristics, and (3) whether those who use both these services are high users of other health and social services. A computerized record linkage showed that 17% of individual public health nursing clients were shared with social services. Shared clientele had more social, perinatal, emotional and mental health problems. It is these characteristics, rather than the simultaneous use of both services, that were associated with more public health nursing visits, days in care, and use of all other health providers. The trend away from in-home nursing visits may create a situation of unmet need. While health and social resources are expended on persons with children with greater risk circumstances, the question remains about the efficacy and efficiency of this mix of service for parents and children receiving social assistance.