Nursing's position in local health care has reportedly been undermined by role confusion and fragmented delivery of services. A review of public health nursing history uncovered a strong model for relevant practice, role expansion, and program definition. This research considered current practice in relation to the time-honored model developed by Lillian Wald. The study described public health nursing practice in 15 municipal and district health departments in Connecticut that have primary foci of health promotion and disease prevention. We found that wide diversity in program responsibility followed variable local health care delivery patterns and resulted in disparate breadth and depth of service components. However, there was general recognition of factors that affect service delivery, such as increased numbers of children attending day-care; growing populations of elderly, chronically ill, and handicapped persons; and the mainstreaming of special-education students. The educational level of nursing personnel was close to the national average. Characteristics of current practice were then correlated to those of the past. The essence of public health nursing remained strong, and the initiatives of the early pioneers were relevant guide-posts for strengthening contemporary practice and community leadership.