Environmental Health Competency Project: Draft Recommendations for Non-Technical Competencies at the Local Level

The goal of this project is to provide broadly accepted guidelines and recommendations to local public health leaders on the core non-technical competencies needed by local environmental health practitioners working in local health departments (LHDs), to strengthen their capacities to anticipate, recognize, and respond to environmental health challenges.

This report is based on a meeting in Washington, DC, and subsequent discussions with partner organizations and representatives. The meeting was convened to build on existing work in the field of environmental health competencies and to outline the core non-technical competencies needed to effectively carry out environmental health programs at the local level. These non-technical competencies are seen as complementary to the technical competencies developed by the National Environmental Health Association (NEHA) and are considered necessary regardless of the setting --rural or urban-- for environmental health practitioners in local health departments.

By attempting to identify the core non-technical competencies necessary to be effective in environmental health at the local level, and beginning to develop consensus on their acceptance, we can make major strides to strengthen the environmental health infrastructure and build the capacity of local programs.

For purposes of this project, the panel adopted the definition of a competency as follows:

    "a cluster of related knowledge, skills, and attitudes that affects a major part of one's job (a role or responsibility), that correlates with performance on the job, that can be measured against well-accepted standards, and that can be improved via training and development."1

Comments on the competencies are welcome and can be forwarded to Annette Ferebee at Annette.ferebee@apha.org.

II. Recommended Competencies

A set of 13 non-technical competencies for environmental health practitioners is presented here, based on the work done by the Expert Panel at its February meeting and subsequent revisions and incorporated comments by the panel. The competencies are categorized into the three primary functions of an environmental health program.

  1. Assessment
  2. Management
  3. Communication
  4. Traits and Characteristics

A set of desirable traits and characteristics is listed as well. Short descriptions of each competency are provided below.

There was much discussion concerning Cultural Sensitivity as a competency. All participants thought it important and central to being effective, and while not an explicit competency, it is felt to be a part of all that is done in environmental health and protection. It includes, but is not limited to: understanding the dynamics formed by cultural diversity (race, ethnicity, economics); linking with others inside and outside the agency to enhance the receptivity of the workplace to a multicultural environment; acting with sensitivity and understanding; and developing and adapting approaches to problems that take into account cultural differences.


A. Assessment

    Research: The capacity to identify and compile relevant information to solve a problem, and the knowledge of where to go to obtain the relevant information.

    • Research literature through the Internet, for example, in response to a telephone call asking about fecal contamination of a swimming pool.
    • Knowing when to consult with experts in the field, such as toxicologists, epidemiologists, forensic specialists, environmental engineers, etc.
    • Be able to find and use appropriate reference material (statutes, regulations, reference books, journals).
    Data Analysis and Interpretation: The capacity to analyze data, recognize meaningful test results, interpret results, and present the results in a meaningful way to different types of audiences.

    • Read and summarize technical papers, understand tabular and graphical presentations of data, and translate them for a non-technical audience. An example would be reading papers published in academic journals and translating the data into public information materials.
    • Analyze data generated internally using simple statistics (percentages, averages, medians, etc.). Understand how statistical surveys are performed and what results mean.
    • Represent results in a meaningful way to different types of lay and practitioner audiences, using appropriate graphics. Examples would be: summarizing inspection reports for a particular location on a spreadsheet, then using Excel to create a graphic for a public meeting; developing slide presentations on well water contamination for homeowner meetings; or presenting graphs of daily results to the Board of Health.
    Evaluation: The capacity to evaluate the effectiveness or performance of procedures, interventions, and programs.

    • Evaluate the agency's procedures against a given set of standards, such as state requirements.
    • Evaluate the results of particular interventions, such as working with a group of restaurant managers to deal with a food service issue, and determining what improvements have been made after three or six months.
    • Evaluate the overall EH program in which the practitioner is working, in terms of inputs (such as number of inspections, number of hotline calls processed) or outcomes (real-world results, progress). Solo EH practitioners may have more occasions to undertake program evaluations than EH practitioners working in larger agencies.


B. Management

    Problem Solving: The capacity to understand and solve problems.

    • Determine the nature of a problem in broader context by asking appropriate questions and reviewing documentation.
    • Clearly articulate problem.
    • Take appropriate measures to resolve the problem and/or present a range of solutions.
    • Collaborate in decision-making process.
    Economic and Political Issues: The capacity to understand and appropriately utilize information concerning the economic and political implications of decisions.

    • Understand and maintain awareness of basic economic issues, for example, in dealing with small business owners and communities.
    • Understand local history and community demographics, as well as cultural and political issues and sensitivities.
    • Enforce regulations equitably and consistently - but with an awareness of the political realities of the work.
    • Develop and present options and recommendations that demonstrate an understanding of economic and political conditions, in an effort to find appropriate solutions and prioritize actions.
    • Understand the economic and political underpinnings and implications of broader agency priorities/decisions.
    Organizational Knowledge and Behavior: The capacity to function effectively within the culture of the organization and to be an effective team player.

    • Understand the formal legislative/administrative system within which the agency operates.
    • Be aware of internal agency functions, priorities, and dynamics.
    • Identify and recognize "agendas" (how they are set, pursued, and how they impact public health).
    • Inform supervisor and other appropriate persons regarding political issues as they arise ("heads up").
    Managing Work: The capacity to plan, implement, and maintain fiscally responsible programs/projects using appropriate skills, and prioritize projects across the employee's entire workload.

    • Formulate goals and objectives. Understand what's necessary to get things done, internally and externally.
    • Design action steps, using a wide variety of resources as needed.
    • Establish appropriate timelines and deadlines.
    • Balance the workload when involved in multiple projects
    • Measure outcomes for the program.
    • Understand and work effectively within the constraints of fiscal realities.
    • Manage programs within budgetary constraints.
    • Prioritization for budget decisions.
    • Monitor expenditures/revenues.
    • Recognize opportunities for external funding and pursue as appropriate.
    • Understand the agency's finance system, including purchase requisitions, purchase orders, unencumbered/encumbered funds, allocations, and budget revision.
    Computer/Information Technology (IT): The capacity to utilize information technology as needed to produce work products.

    • Use software available within the agency to perform research, record keeping, communication (e-mail, word processing programs), data analysis and interpretation (including simple spreadsheet programs), and reporting tasks.
    • Use Web-based applications as needed, such as searching and retrieving information.
    Reporting, Documentation, and Record-Keeping: The capacity to produce reports to document actions, keep records, and inform appropriate parties.

    • Generate an inspection report.
    • Produce a periodic (e.g., quarterly) activity report.
    • Generate a progress report for a grant.
    • Maintain organized, accurate, and up-to-date files and records (electronic and/or hard copy).
    • Prepare evidence for a court case.
    Partnering: The capacity to form partnerships and alliances with other individuals and organizations in order to enhance performance on the job.

    • Identify key individuals in organizations, community, and media. Networks may be internal to the agency (e.g., with epidemiologists; public health nurses and educators; in-house laboratories; plumbing, electrical, and building inspectors) community-wide (e.g., with non-governmental organizations, industry, academia, labs) or within the government's public health/environmental protection system (EPA, CDC, other federal agencies; state offices such as State Engineer, Attorney General; and local agencies).
    • Cultivate effective linkages and partnerships (including those with whom there is limited agreement) by using communications skills, maintaining regular/periodic contact, participating in practitioner organizations, and providing reciprocal help, service, and support.


C. Ccommunication

    Education: The capacity to use the environmental health practitioner's front-line role to effectively educate the public on environmental health issues.

    • Identify "teaching moments" as part of regulatory function, and opportunities to share "lessons learned."
    • Provide accurate information and demonstrate desired action. Present information in a culturally appropriate manner.
    • Recognizing dynamic state of knowledge and information in the field, stay abreast of, and appropriately utilize new information.
    • Emphasize prevention, for example, in explaining to homeowners and grounds managers how to minimize use of pesticides and fertilizers.
    • Seek continual learning and educational, as well as mentoring, opportunities.
    Communication: The capacity to effectively communicate risk and exchange information with colleagues, other practitioners, clients, policy-makers, interest groups, media, and the public through public speaking, print and electronic media, and interpersonal relations.

    • Handle all forms of communication promptly, politely, and professionally. These include letter and e-mail correspondence, telephone calls, site visits, group discussions, meetings, and presentations.
    • Explain complicated issues and procedures simply and accurately. Identify the target audience and deliver the message appropriately.
    • Handle interactions with the public (and media, when necessary) using tactful, objective, non-confrontational, culturally sensitive language. Interactions may include receiving complaints and providing feedback to complainants, sharing information with clients and citizen groups, motivating clients to bring about desired changes, resolving conflicts within a community on use of natural resources, presenting a case against a restaurant that has been closed down to a hearing officer in court, etc.
    • Seek opportunities for public speaking in order to broaden the audience on environmental health issues. Examples include making speeches to school groups on food safety or to swimming pool and apartment building owners and managers, conducting food handler training, giving presentations to the Chamber of Commerce. Public speaking skills can be enhanced through a variety of resources, including participation in Toastmasters, learning PowerPoint and other slide presentation software, mentoring.
    Conflict Resolution: The capacity to facilitate the resolution of conflicts within the agency, in the community, and with regulated parties.

    • Know when conflict resolution can be used and when it cannot, either because of a lack of authority or because of the intractable nature of the conflict. Recognize the limits of authority and flexibility at hand. Typical conflicts that arise involve complaint investigations or disagreements over a regulation, where clients might inform the EH practitioner that they have done business a certain way for years and see no reason to change, and then announce their intention to seek redress from elected officials.
    • Use effective listening skills.
    • Exhibit respect for diversity.
    • Understand the history and context of the conflict.
    • Identify the nucleus of problem, separate from symptoms.
    • Find common ground and areas of agreement, as well as non-negotiable areas.
    • Determine the willingness of the parties involved to negotiate and promote that willingness.
    • Obtain the necessary resources to bring conflict to a resolution (e.g., use of facilitators, mediators, etc.).
    Marketing Environmental/Public Health as a Service: The ability to articulate basic concepts of environmental health and public health and convey an understanding of their value and importance to clients and the public.

    • Articulate the goals, purposes, problems, and needs of environmental health.
    • Provide solutions to EH problems that obtain "buy-in" from clients and increase their understanding of EH issues and concerns.
    • Explain the rationale for environmental health regulatory requirements and the value produced by a healthy environment (less disease, less health care costs, etc.).


D. Traits and Characteristics

Following -- in no particular order -- are some of the traits and characteristics of an effective environmental health practitioner!

  • positive attitude
  • versatility and flexibility
  • practical perspective and common sense
  • strong principles and ethics
  • practitioner integrity
  • strong work ethic
  • tenacity
  • willing to learn
  • focused on fair solutions
  • collaborative
  • embraces change
  • involved with community
  • remains calm in conflict
  • understands other points of view
  • able to observe
  • focuses on team accomplishments
  • appropriate appearance and body language
  • assumes leadership
  • big picture perspective
  • respects diversity
  • knows when to ask for help