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Objective: To evaluate the relationship between nurse to population ratio and population health, as indicated by state health ranking.

Design: Secondary analysis correlational design.

Sample: The sample consisted of all fifty states in the U.S.

Measurements: Data sources included the United Health Foundation’s 2006 state health rankings, the 2004 National Sample Survey for Registered Nurses, and the U.S. Health Workforce Profile from the New York Center for Health Workforce Studies.

Results: Significant relationships between nurse to population ratio and state health ranking (rho = -.446, p =.001) and 11 of the 18 components of the overall ranking (motor vehicle death rate, high school graduation rate, violent crime rate, infectious disease rate, percentage of children in poverty, percentage of uninsured residents, immunization rate, adequacy of prenatal care, number of poor mental health days, number of poor physical health days, and premature death rate) with higher nurse to population ratios associated with higher health rankings were found. Physician to population ratios were also significantly related to state health ranking, but were associated with different components.

Conclusions: These findings suggest that greater nurses per capita may be uniquely associated with healthier communities, however further multivariate research is needed.

Copyright Statement

This is an author-produced, peer-reviewed version of this article. The final, definitive version of this document can be found online at Public Health Nursing, published by Blackwell Publishing. Copyright restrictions may apply. DOI: 10.1111/j.1525-1446.2008.00701.x