RN-to-Population Ratio and Population Health: A Multifactorial Study

Jeri L. Bigbee, Sandra Evans, Bonnie Lind, Susan Perez, Lissette Jacobo, Estella M. Geraghty

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


The purpose of this study was to explore the relationship between registered nurse (RN)-to-population ratio and population health indices. A cross-sectional secondary analysis of existing national data was conducted, using counties as the unit of analysis. Data based on 1,929,414 RNs in 33 states in 2012 were obtained from the National Council of State Boards of Nursing's Nursys® database, and county health data were obtained from 2,016 counties from the 2012 County Health Rankings database. Regression analysis indicated that the RN-to-population ratio along with nurse education (percentage of RNs with a BSN or higher degree) and experience (number of years since graduation) was significantly associated with the self-rated health (percentage of adults reporting fair or poor health), mammography screening rates, and teenage birth rates. The associations were all positive: Greater numbers of nurses per capita were associated with better population health indices. These results are consistent with the Nurse Dose concept and support the need for enhanced recognition and policy changes regarding the contribution of nurses to the health of the population. Implications for nursing regulation include the need for sustained and coordinated efforts to support the health of the population through the recruitment and maintenance of a well-educated and experienced nursing workforce.

Original languageEnglish (US)
Pages (from-to)11-17
Number of pages7
JournalJournal of Nursing Regulation
Issue number1
StatePublished - Apr 2014
Externally publishedYes

ASJC Scopus subject areas

  • Issues, ethics and legal aspects
  • Nursing (miscellaneous)


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