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PUBLIC HEALTH COMPETENCIES

A. BIOSTATISTICS
Biostatistics is the development and application of statistical reasoning and
methods in addressing, analyzing and solving problems in public health; health care;
and biomedical, clinical and population-based research.


Competencies: Upon graduation a student with an MPH should be able to…

A. 1. Describe the roles biostatistics serves in the discipline of public health.
A. 2. Describe basic concepts of probability, random variation and commonly used statistical probability distributions.
A. 3. Describe preferred methodological alternatives to commonly used statistical methods when assumptions are not met.
A. 4. Distinguish among the different measurement scales and the implications for selection of statistical methods to be used based on these distinctions.
A. 5. Apply descriptive techniques commonly used to summarize public health data.
A. 6. Apply common statistical methods for inference.
A. 7. Apply descriptive and inferential methodologies according to the type of study design for answering a particular research question.
A. 8. Apply basic informatics techniques with vital statistics and public health records in the description of public health characteristics and in public health research and evaluation.
A. 9. Interpret results of statistical analyses found in public health studies.
A. 10. Develop written and oral presentations based on statistical analyses for both public health professionals and educated lay audiences.

B. ENVIRONMENTAL HEALTH SCIENCES
Environmental health sciences represent the study of environmental factors including
biological, physical and chemical factors that affect the health of a community.


Competencies: Upon graduation a student with an MPH should be able to…

B. 1. Describe the direct and indirect human, ecological and safety effects of major environmental and occupational agents.
B. 2. Describe genetic, physiologic and psychosocial factors that affect susceptibility to adverse health outcomes following exposure to environmental hazards.
B. 3. Describe federal and state regulatory programs, guidelines and authorities that control environmental health issues.
B. 4. Specify current environmental risk assessment methods.
B. 5. Specify approaches for assessing, preventing and controlling environmental hazards that pose risks to human health and safety.
B. 6. Explain the general mechanisms of toxicity in eliciting a toxic response to various environmental exposures.
B. 7. Discuss various risk management and risk communication approaches in relation to issues of environmental justice and equity.
B. 8. Develop a testable model of environmental insult.

C. EPIDEMIOLOGY
Epidemiology is the study of patterns of disease and injury in human populations
and the application of this study to the control of health problems.


Competencies: Upon graduation a student with an MPH should be able to…

C. 1. Identify key sources of data for epidemiologic purposes.
C. 2. Identify the principles and limitations of public health screening programs.
C. 3. Describe a public health problem in terms of magnitude, person, time and place.
C. 4. Explain the importance of epidemiology for informing scientific, ethical, economic and political discussion of health issues.
C. 5. Comprehend basic ethical and legal principles pertaining to the collection, maintenance, use and dissemination of epidemiologic data.
C. 6. Apply the basic terminology and definitions of epidemiology.
C. 7. Calculate basic epidemiology measures.
C. 8. Communicate epidemiologic information to lay and professional audiences.
C. 9. Draw appropriate inferences from epidemiologic data.
C. 10. Evaluate the strengths and limitations of epidemiologic reports.

D. HEALTH POLICY AND MANAGEMENT
Health policy and management is a multidisciplinary field of inquiry and practice concerned with the delivery, quality and costs of health care for individuals and populations. This definition assumes both a managerial and a policy concern with the structure, process and outcomes of health services including the costs, financing, organization, outcomes and accessibility of care.


Competencies: Upon graduation a student with an MPH should be able to…

D. 1. Identify the main components and issues of the organization, financing and delivery of health services and public health systems in the US.
D. 2. Describe the legal and ethical bases for public health and health services.
D. 3. Explain methods of ensuring community health safety and preparedness.
D. 4. Discuss the policy process for improving the health status of populations.
D. 5. Apply the principles of program planning, development, budgeting, management and evaluation in organizational and community initiatives.
D. 6. Apply principles of strategic planning and marketing to public health.
D. 7. Apply quality and performance improvement concepts to address organizational performance issues.
D. 8. Apply "systems thinking" for resolving organizational problems.
D. 9. Communicate health policy and management issues using appropriate channels and technologies.
D. 10. Demonstrate leadership skills for building partnerships.

E. SOCIAL AND BEHAVIORAL SCIENCES
The social and behavioral sciences in public health address the behavioral,
social and cultural factors related to individual and population health and
health disparities over the life course. Research and practice in this area
contributes to the development, administration and evaluation of programs and
policies in public health and health services to promote and sustain
healthy environments and healthy lives for individuals and populations.


Competencies: Upon graduation a student with an MPH should be able to…

E. 1. Identify basic theories, concepts and models from a range of social and behavioral disciplines that are used in public health research and practice.
E. 2. Identify the causes of social and behavioral factors that affect health of individuals and populations.
E. 3. Identify individual, organizational and community concerns, assets, resources and deficits for social and behavioral science interventions.
E. 4. Identify critical stakeholders for the planning, implementation and evaluation of public health programs, policies and interventions.
E. 5. Describe steps and procedures for the planning, implementation and evaluation of public health programs, policies and interventions.
E. 6. Describe the role of social and community factors in both the onset and solution of public health problems.
E. 7. Describe the merits of social and behavioral science interventions and policies.
E. 8. Apply evidence-based approaches in the development and evaluation of social and behavioral science interventions.
E. 9. Apply ethical principles to public health program planning, implementation and evaluation.
E. 10. Specify multiple targets and levels of intervention for social and behavioral science programs and/or policies.

F. COMMUNICATION AND INFORMATICS
The ability to collect, manage and organize data to produce information and meaning
that is exchanged by use of signs and symbols; to gather, process, and
present information to different audiences in-person, through information technologies, or through media channels; and to strategically design the information and knowledge
exchange process to achieve specific objectives.



Competencies: Upon graduation, it is increasingly important that a student with an MPH be able to…

F. 1. Describe how the public health information infrastructure is used to collect, process, maintain, and disseminate data.
F. 2. Describe how societal, organizational, and individual factors influence and are influenced by public health communications.
F. 3. Discuss the influences of social, organizational and individual factors on the use of information technology by end users.
F. 4. Apply theory and strategy-based communication principles across different settings and audiences.
F. 5. Apply legal and ethical principles to the use of information technology and resources in public health settings.
F. 6. Collaborate with communication and informatics specialists in the process of design, implementation, and evaluation of public health programs.
F. 7. Demonstrate effective written and oral skills for communicating with different audiences in the context of professional public health activities.
F. 8. Use information technology to access, evaluate, and interpret public health data.
F. 9. Use informatics methods and resources as strategic tools to promote public health.
F. 10. Use informatics and communication methods to advocate for community public health programs and policies.

G. DIVERSITY AND CULTURE
The ability to interact with both diverse individuals and communities to produce or impact an intended public health outcome.


Competencies: Upon graduation, it is increasingly important that a student with an MPH be able to…

G. 1. Describe the roles of, history, power, privilege and structural inequality in producing health disparities.
G. 2. Explain how professional ethics and practices relate to equity and accountability in diverse community settings.
G. 3. Explain why cultural competence alone cannot address health disparity.
G. 4. Discuss the importance and characteristics of a sustainable diverse public health workforce.
G. 5. Use the basic concepts and skills involved in culturally appropriate community engagement and empowerment with diverse communities.
G. 6. Apply the principles of community-based participatory research to improve health in diverse populations.
G. 7. Differentiate among availability, acceptability, and accessibility of health care across diverse populations.
G. 8. Differentiate between linguistic competence, cultural competency, and health literacy in public health practice.
G. 9. Cite examples of situations where consideration of culture-specific needs resulted in a more effective modification or adaptation of a health intervention.
G. 10. Develop public health programs and strategies responsive to the diverse cultural values and traditions of the communities being served.

H. LEADERSHIP
The ability to create and communicate a shared vision for a changing future; champion solutions to organizational and community challenges; and energize commitment to goals.


Competencies: Upon graduation, it is increasingly important that a student with an MPH be able to…

H. 1. Describe the attributes of leadership in public health.
H. 2. Describe alternative strategies for collaboration and partnership among organizations, focused on public health goals.
H. 3. Articulate an achievable mission, set of core values, and vision.
H. 4. Engage in dialogue and learning from others to advance public health goals.
H. 5. Demonstrate team building, negotiation, and conflict management skills.
H. 6. Demonstrate transparency, integrity, and honesty in all actions.
H. 7. Use collaborative methods for achieving organizational and community health goals.
H. 8. Apply social justice and human rights principles when addressing community needs.
H. 9. Develop strategies to motivate others for collaborative problem solving, decision-making, and evaluation.

I. PUBLIC HEALTH BIOLOGY
The ability to incorporate public health biology - the biological and molecular context of public health - into public health practice.


Competencies: Upon graduation, it is increasingly important that a student with an MPH be able to…

I. 1. Specify the role of the immune system in population health.
I. 2. Describe how behavior alters human biology.
I. 3. Identify the ethical, social and legal issues implied by public health biology.
I. 4. Explain the biological and molecular basis of public health.
I. 5. Explain the role of biology in the ecological model of population-based health.
I. 6. Explain how genetics and genomics affect disease processes and public health policy and practice.
I. 7. Articulate how biological, chemical and physical agents affect human health.
I. 8. Apply biological principles to development and implementation of disease prevention, control, or management programs.
I. 9. Apply evidence-based biological and molecular concepts to inform public health laws, policies, and regulations.
I. 10. Integrate general biological and molecular concepts into public health.

Public Health Biology Illustrative Sub-competencies are available at http://www.asph.org/document.cfm?page=928.

J. PROFESSIONALISM
The ability to demonstrate ethical choices, values and professional practices implicit in public health decisions; consider the effect of choices on community stewardship, equity, social justice and accountability; and to commit to personal and institutional development.


Competencies: Upon graduation, it is increasingly important that a student with an MPH be able to…

J. 1. Discuss sentinel events in the history and development of the public health profession and their relevance for practice in the field.
J. 2. Apply basic principles of ethical analysis (e.g. the Public Health Code of Ethics, human rights framework, other moral theories) to issues of public health practice and policy.
J. 3. Apply evidence-based principles and the scientific knowledge base to critical evaluation and decision-making in public health.
J. 4. Apply the core functions of assessment, policy development, and assurance in the analysis of public health problems and their solutions.
J. 5. Promote high standards of personal and organizational integrity, compassion, honesty and respect for all people.
J. 6. Analyze determinants of health and disease using an ecological framework.
J. 7. Analyze the potential impacts of legal and regulatory environments on the conduct of ethical public health research and practice.
J. 8. Distinguish between population and individual ethical considerations in relation to the benefits, costs, and burdens of public health programs.
J. 9. Embrace a definition of public health that captures the unique characteristics of the field (e.g., population-focused, community-oriented, prevention-motivated and rooted in social justice) and how these contribute to professional practice.
J. 10. Appreciate the importance of working collaboratively with diverse communities and constituencies (e.g. researchers, practitioners, agencies and organizations).
J. 11. Value commitment to lifelong learning and professional service including active participation in professional organizations.

K. PROGRAM PLANNING
The ability to plan for the design, development, implementation, and evaluation of strategies to improve individual and community health.


Competencies: Upon graduation, it is increasingly important that a student with an MPH be able to…

K. 1. Describe how social, behavioral, environmental, and biological factors contribute to specific individual and community health outcomes.
K. 2. Describe the tasks necessary to assure that program implementation occurs as intended.
K. 3. Explain how the findings of a program evaluation can be used.
K. 4. Explain the contribution of logic models in program development, implementation, and evaluation.
K. 5. Differentiate among goals, measurable objectives, related activities, and expected outcomes for a public health program.
K. 6. Differentiate the purposes of formative, process, and outcome evaluation.
K. 7. Differentiate between qualitative and quantitative evaluation methods in relation to their strengths, limitations, and appropriate uses, and emphases on reliability and validity.
K. 8. Prepare a program budget with justification.
K. 9. In collaboration with others, prioritize individual, organizational, and community concerns and resources for public health programs.
K. 10. Assess evaluation reports in relation to their quality, utility, and impact on public health.

L. SYSTEMS THINKING
The ability to recognize system level properties that result from dynamic interactions among human and social systems and how they affect the relationships among individuals, groups, organizations, communities, and environments.


Competencies: Upon graduation, it is increasingly important that a student with an MPH be able to…

L. 1. Identify characteristics of a system.
L. 2. Identify unintended consequences produced by changes made to a public health system.
L. 3. Provide examples of feedback loops and “stocks and flows” within a public health system.
L. 4. Explain how systems (e.g. individuals, social networks, organizations, and communities) may be viewed as systems within systems in the analysis of public health problems.
L. 5. Explain how systems models can be tested and validated.
L. 6. Explain how the contexts of gender, race, poverty, history, migration, and culture are important in the design of interventions within public health systems.
L. 7. Illustrate how changes in public health systems (including input, processes, and output) can be measured.
L. 8. Analyze inter-relationships among systems that influence the quality of life of people in their communities.
L. 9. Analyze the effects of political, social and economic policies on public health systems at the local, state, national and international levels.
L. 10. Analyze the impact of global trends and interdependencies on public health related problems and systems.
L. 11. Assess strengths and weaknesses of applying the systems approach to public health problems.

More information about Systems Thinking is available at http://www.asph.org/document.cfm?page=898

The Council on Linkages Between Academia and Public Health Practice has recommended that public health practitioners become and remain competent in eight core areas to practice effectively. They are listed as domains as follows:

Domain #1: Analytic Assessment Skill
Domain #2: Policy Development/Program Planning Skills
Domain #3: Communication Skills
Domain #4: Cultural Competency Skills
Domain #5: Community Dimensions of Practice Skills
Domain #6: Basic Public Health Sciences Skills
Domain #7: Financial Planning and Management Skills
Domain #8: Leadership and Systems Thinking Skills

Details on skill levels for each domain (competency) can be found on the Council’s website: www.TrainingFinder.org


The following is taken verbatim from the Council’s website:

About the Council on Linkages Between Academia and Public Health Practice
The Council on Linkages Between Academia and Public Health Practice is comprised of leaders from national organizations representing the public health practice and academic communities. The Council grew out of the Public Health Faculty/Agency Forum, which developed recommendations for improving the relevance of public health education to the demands of public health in the practice sector. The need for this improvement, and for public health professionals to place a higher value on practice-specific training and research, were documented by the Institute of Medicine report, The Future of Public Health. This project is supported under a cooperative agreement from the Health Resources and Services Administration.

The Council's Mission: To improve public health practice and education by refining and implementing recommendations of the Public Health Faculty/Agency Forum, establishing links between academia and the agencies of the public health community, and creating a process for continuing public health education throughout one's career.

Member Organizations:
American Association of Health Plans
www.aahp.org

American College of Preventive Medicine
www.acpm.org

American Public Health Association
www.apha.org

Association of Schools of Public Health
www.asph.org

Association of State and Territorial Health Officials
www.astho.org

Association of Teachers of Preventive Medicine
www.atpm.org

Association of University Programs in Health Administration
www.aupha.org

Centers for Disease Control and Prevention
www.phppo.cdc.gov

Health Resources and Services Administration
www.hrsa.gov

National Association of County and City Health Officials
www.naccho.org

National Association of Local Boards of Health
www.nalboh.org

National Environmental Health Association
www.neha.org

QUAD Council of Public Health Nursing Organizations
no web address

Society for Public Health Education
www.sophe.org

Prologue to the Core Competencies
The Council on Linkages Between Academia and Public Health Practice is committed to assisting the U.S. Public Health Service in efforts to implement components of The Public Health Workforce: An Agenda for the 21st Century report pertaining to public health competencies. To this end the Council developed a list of core competencies for public health professionals. This list represents ten years of work on this subject by the Council and numerous other organizations and individuals in public health academia and practice settings. Their work has been compiled from various source documents and cross-walked with the Essential Public Health Services. This cross-walk ensures that the competencies help build the skills necessary for providing these essential services.

The list has also been reviewed by over 1,000 public health professionals during a public comment period. The Council utilized several mechanisms to receive feedback from reviewers, including e-mail, focus groups, sessions at various conferences, and the competencies web site. The comments from public health professionals in a broad array of disciplines and practice settings have led to this consensus set of core competencies for guiding public health workforce development efforts. These competencies will ultimately help guide curriculum and content development of public health education and training programs for preparation of practitioners and for the ongoing development of practitioners in the field. The competencies may also be used by those in practice settings as a framework for hiring and evaluating staff.

The core competencies represent a set of skills, knowledge, and attitudes necessary for the broad practice of public health. They transcend the boundaries of the specific disciplines within public health and help to unify the profession. However, because the list only captures the cross-cutting competencies for public health practice, it may not contain competencies that are specific to certain disciplines within the field. Discipline specific competencies are necessary for specialized roles within public health. These core competencies for all public health professionals may be used to drive the development of such discipline specific competencies. Moreover, because this list is meant to represent the core, it may not contain many skills that are necessary for the performance of certain jobs within certain practice settings. Individuals, employers, educators, and trainers should use this list as a starting point for developing a modified list of competencies that matches their needs. When applied in the work setting, the competencies listed here as separate are, in fact, practiced in combinations that are dynamic. Therefore, for hiring, performance evaluation, or training, users of the competency list will begin to recognize typical or recurring clusters of competencies that define performance quality in various programs and job categories.

The competencies are divided into the following eight domains: Analytic Assessment Skills, Basic Public Health Sciences Skills, Cultural Competency Skills, Communication Skills, Community Dimensions of Practice Skills, Financial Planning and Management Skills, Leadership and Systems Thinking Skills, Policy Development/Program Planning Skills. Skills and knowledge levels are listed first within each domain, followed by important attitudes relevant to the practice of public health. While attitudes may be more difficult to measure, they can be part of what is taught and should be included in curriculum and content development efforts.

This effort of the Council focuses on core competencies as they apply to front line staff, senior level staff, and supervisory and management staff. Definitions for these job categories follow. The Council acknowledges that these job categories are defined broadly and the lines of distinction between them are not always clear. However, the categories are meant to be flexible and adaptable to the evolving profession. While core competencies for clerical or support staff (e.g. clerks; dental, lab, or nursing assistants; data entry staff; etc.) are also important, they are not part of this current effort. Including clerical and support staff would extend the project beyond its scope. The Council also recognizes that, in many public health settings, job category is often related to educational background. However, educational level and years of experience are not included in the job category definitions because they do not necessarily dictate function within an organization.

Levels of skill have been assigned to each competency based on the job category of the public health professional. The three skill levels are aware, knowledgeable, and proficient. The skill levels for each competency by job category represent the majority opinion of reviewers of the web site. When almost an equal number of responses for two consecutive skill levels occurred, the Council has indicated this by reporting both skill levels. In these cases the actual level of skill for that competency falls along the continuum between the two skill levels. A difference of 10% or less between the number of responses for two consecutive skill levels was used as the threshold to determine what is an equal number of responses. Although skill levels do vary by job category, all public health professionals should at least be aware of these core competencies.