During a strategic planning session in 2019, the Environmental Health Coalition (EH Coalition*) discussed the state of the environmental health workforce. Specifically, we wondered if the people entering the field were well-prepared for their job. We decided to review existing workforce competencies as well as disseminate a survey to discover how employers felt about the people applying for environmental health jobs.
Our review uncovered two main sets of environmental health competencies – one developed by the US Centers for Disease Control and Prevention (2001) and another from the National Public Health Institute of Québec (2012). We found that Québec’s competencies, though more condensed than CDC’s, were less useful and readable. However, Quebec’s competencies included a large quantity of related information on knowledge, attitudes, skills and resources for each competency.
Another point that emerged was the importance of cultural sensitivity as a competency. Although the CDC authors extensively discussed the theme of cultural sensitivity, it was not named as an explicit competency. In comparison, the public health competency framework from the Canadian Public Health Agency (2008) featured a “Diversity and inclusiveness” category with the following competencies:
- Address population diversity when planning, implementing, adapting, and evaluating public health programs and policies
- Apply culturally relevant and appropriate approaches with people from diverse cultural, socioeconomic, and educational backgrounds, and persons of all ages, genders, health status, sexual orientations, and abilities
The survey gathered information from over 50 respondents recruited by EH Coalition members who shared it with their networks. From the results, we found:
- A low number of available qualified applicants for entry-level EH positions.
- Fifty percent of respondents report entry-level EH employees are not prepared in the EH practice areas most relevant to the respondent’s job (including onsite wastewater, public swimming pools, lead prevention, daycare/early child development facilities, body art, campgrounds, and recreational vehicles, soils, public drinking water systems, other recreational water, and healthy homes).
- At least 40% of respondents find entry-level EH employees not proficient in the EH practice areas most relevant to their job (including assessment and analysis, community engagement, conflict resolution, cross-sector resolution, GIS, organization behavior, risk communication, systems thinking, and toxicology)
- 40% or more respondents find entry-level hires proficient in collaboration, communication, community engagement, conflict resolution, and cultural sensitivity, while just over 35% find proficiency in structural racism.
- Over 45% of employers encourage or provide EH competency-based training for new hires.
Given the age of the competencies, we highly recommend that CDC take another look at them; as the 20th anniversary of 2021 presents a good opportunity to do so. Such a revision could include:
- additional resources similar to the information supplied by Quebec.
- a competency focused on maintaining activity over the long run (to complement the mobilizing resources one)
- adding the ability to maintain relationships to the “Collaboration” competency
- A competency focusing on cultural sensitivity and inclusivity
- a health equity lens infused throughout
We encourage universities that offer environmental health programming to look at any revised environmental health competencies and consider incorporating those into their strategic and educational planning. Where gaps still remain (we doubt universities will train students on how to inspect restaurants or pools), we recommend that non-profits engaged in training and credentialing (such as the National Environmental Health Association) incorporate these findings into their planning processes.
Lastly, the Coalition recommends that CDC consider reinvigorating the EH Workforce Coalition that used to talk about such topics regularly.
* The Environmental Health Coalition is a group of environmental health professionals acting as a unified voice for environmental health. The Coalition promotes environmental health through resource-sharing and coordinating efforts around these priority areas: climate; environmental health awareness and communication; environmental health workforce and education; systems and infrastructure. Coalition Co-Chairs include Jennifer Li, the National Association of County & City Health Officials, and Kristie Trousdale, Children's Environmental Health Network.