Core Competencies for Public Health in Canada

Core competency statements describe the essential knowledge, skills and attitudes necessary for the practice of public health.

They are the basic building blocks of public health education and professional development programs; they encourage evidence-based, collaborative, ethical and standardized public health service; they support the recruitment, development and retention of the public health workforce; and they are a first step in articulating common standards, terminology and approaches.

Core competencies help Canadian public health organizations get the right people in the right place at the right time.

Developed in consultation with more than 3000 practitioners across the country, Core Competencies for Public Health in Canada: Release 1.0 organizes 36 competency statements into the following seven categories:

1. Public health sciences
2. Assessment and analysis
3. Policy and program planning, implementation and evaluation
4. Partnerships, collaboration, advocacy
5. Diversity
6. Communication
7. Leadership

These core competencies, with their companion glossary, transcend the boundaries of specific disciplines and provide a baseline for all public health professionals.

1. 0 Public health sciences

This category includes key knowledge and critical thinking skills related to the public health sciences: behavioural and social sciences, biostatistics, epidemiology, environmental public health, demography, workplace health, and the prevention of chronic diseases, infectious diseases, psychosocial problems and injuries. Competency in this category requires the ability to apply knowledge in practice.

A public health practitioner is able to:

1.1 Demonstrate knowledge of the following concepts: the health status of populations, inequities in health, the determinants of health and illness, strategies for health promotion, disease and injury prevention and health protection, as well as the factors that influence the delivery and use of health services.

• Front line provider: Discuss the need for a prenatal nutrition program in an Aboriginal community as well as contributing factors such as income, education, culture and traditional foods.

1.2 Demonstrate knowledge about the history, structure and interaction of public health and health care services at local, provincial/territorial, national, and international levels.

• Front line provider: Recall public health events such as the implementation of universal immunization programs in order to explain to parents the importance of this measure for maintaining public health.

1.3 Apply the public health sciences to practice.

• Front line provider: Apply the epidemiology triangle (host, environment and agent) to the issue of West Nile virus.
• Consultant/specialist: Integrate Geographic Information System (GIS) software for mapping cases of West Nile Virus to account for seasonal trends.

1.4 Use evidence and research to inform health policies and programs.

• Front line provider: Discuss how evidence from a recent research study can be utilized in practice.
• Consultant/specialist: Summarize key findings from a contact tracing report to support policy changes in communicable disease services.

1.5 Demonstrate the ability to pursue lifelong learning opportunities in the field of public health.

2.0 Assessment and analysis

This category describes the Core Competencies needed to collect, assess, analyze and apply information (including data, facts, concepts and theories). These competencies are required to make evidence-based decisions, prepare budgets and reports, conduct investigations and make recommendations for policy and program development.

A public health practitioner is able to:

2.1 Recognize that a health concern or issue exists.

• Front line provider: Describe a situation in a school community recognizing that the lack of healthy food choices in the school cafeteria is an issue.

2.2 Identify relevant and appropriate sources of information, including community assets and resources.

• Front line provider: Identify key informants such as student leaders and service providers.

2.3 Collect, store, retrieve and use accurate and appropriate information on public health issues.

• Front line provider: Use data collection tools (e.g., IPHIS) to document practice.
• Consultant/specialist: Design a data collection tool on Fetal Alcohol Spectrum Disorder (FASD) and obtain relevant provincial/territorial statistics on the prevalence of FASD.

2.4 Analyze information to determine appropriate implications, uses, gaps and limitations.

• Front line provider: Identify the limitations of information resulting from a telephone survey in a diverse community.

2.5 Determine the meaning of information, considering the current ethical, political, scientific, socio-cultural and economic contexts.

• Front line provider: Identify how smoking affects men and women differently and how reasons for smoking differ between genders, and among socioeconomic groups and different cultures.

2.6 Recommend specific actions based on the analysis of information.

• Consultant/specialist: Make recommendations for health policies regulating artificial tanning salons due to the increasing incidence of skin cancers.

3.0 Policy and program planning, implementation and evaluation

This category describes the Core Competencies needed to effectively choose options, and to plan, implement and evaluate policies and/or programs in public health. This includes the management of incidents such as outbreaks and emergencies.

A public health practitioner is able to:

3.1 Describe selected policy and program options to address a specific public health issue.

• Front line provider: Identify potential school intervention programs and activities to address increasing rates of sexually transmitted infections among youth.

3.2 Describe the implications of each option, especially as they apply to the determinants of health and recommend or decide on a course of action.

• Front line provider: Explore the social and economic implications of a folic acid education program directed at adolescents and decide whether or not to proceed.

3.3 Develop a plan to implement a course of action taking into account relevant evidence, legislation, emergency planning procedures, regulations and policies.

• Consultant/specialist: Prioritize the components of a restaurant inspection logic model including appropriate rationale and develop the implementation plan for each component.

3.4 Implement a policy or program and/or take appropriate action to address a specific public health issue.

• Consultant/specialist: Act according to the organization's emergency response plan in the event of an outbreak or emergency.

3.5 Demonstrate the ability to implement effective practice guidelines.

• Front line provider: Use universal infection control measures appropriately.

3.6 Evaluate an action, policy or program.

• Front line provider: Develop and implement an evaluation plan for a smoke-free workplace program in collaboration with stakeholders.

3.7 Demonstrate an ability to set and follow priorities, and to maximize outcomes based on available resources.

• Front line provider: Set priorities for action on safer crack use in a local harm reduction program based on existing resources.

3.8 Demonstrate the ability to fulfill functional roles in response to a public health emergency.

• Front line provider: Be familiar with the organization's emergency management manual.
• Manager/supervisor: Arrange a debriefing session after a public health incident to identify lessons learned and assess the need for recovery intervention for team members involved.

4.0 Partnerships, collaboration and advocacy

This category captures the competencies required to influence and work with others to improve the health and well-being of the public through the pursuit of a common goal. Partnership and collaboration optimizes performance through shared resources and responsibilities. Advocacy–speaking, writing or acting in favour of a particular cause, policy or group of people–often aims to reduce inequities in health status or access to health services.

A public health practitioner is able to:

4.1 Identify and collaborate with partners in addressing public health issues.

• Front line provider: Explain the roles of the provincial government, local recreation department, school boards, boards of health and the Boys and Girls Club in addressing childhood obesity to a parent group.

4.2 Use skills such as team building, negotiation, conflict management and group facilitation to build partnerships.

• Front line provider: Assist the school in developing a school health team.
• Consultant/specialist: Facilitate the development of the terms of reference for a partnership between school boards and public health.

4.3 Mediate between differing interests in the pursuit of health and well-being, and facilitate the allocation of resources.

• Front line provider: Interview key community members to determine the range of opinions on the implementation of a local tobacco by-law.
• Consultant/specialist: Synthesize input from individuals and organizations in order to prepare a report on the readiness of a community to offer a needle exchange clinic.

4.4 Advocate for healthy public policies and services that promote and protect the health and well-being of individuals and communities.

• Consultant/specialist: Using information from the Canadian Community Health Survey and feedback from principals, make a presentation to the Board of Health to advocate for a provincial school nutrition policy.

5.0 Diversity and inclusiveness

This category identifies the socio-cultural competencies required to interact effectively with diverse individuals, groups and communities. It is the embodiment of attitudes and practices that result in inclusive behaviours, practices, programs and policies.

A public health practitioner is able to:

5.1 Recognize how the determinants of health (biological, social, cultural, economic and physical) influence the health and well-being of specific population groups.

• Consultant/specialist: Develop a funding proposal in collaboration with key stakeholders for a community kitchen project in a disadvantaged area with a culturally diverse population.

5.2 Address population diversity when planning, implementing, adapting and evaluating public health programs and policies.

• Front line provider: Provide access to vaccines for people of all cultural groups and populations (e.g., drive-through vaccine clinics for disabled population groups).

5.3 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.

• Front line provider: Collaborate with members of an Afghanistan community to develop a tuberculosis screening program in their neighbourhood.
• Manager/supervisor: Negotiate with primary care team to provide cancer screening clinics staffed with female practitioners for Muslim women.

6.0 Communication

Communication involves an interchange of ideas, opinions and information. This category addresses numerous dimensions of communication including internal and external exchanges; written, verbal, non-verbal and listening skills; computer literacy; providing appropriate information to different audiences; working with the media and social marketing techniques.

A public health practitioner is able to...

6.1 Communicate effectively with individuals, families, groups, communities and colleagues.

• Front line provider: Revise oral presentations to meet the needs of various audiences.

6.2 Interpret information for professional, non-professional and community audiences.

• Front line provider: Develop immunization schedule fact sheets for people with low literacy levels.
• Consultant/specialist: Discuss population health information about health status and demographics with front line providers.

6.3 Mobilize individuals and communities by using appropriate media, community resources and social marketing techniques.

• Front line provider: Use multiple strategies to effectively communicate health messages appropriate to audiences (e.g., community newspapers, local television, radio, billboards, face-to-face events).
• Manager/supervisor: Use community networks to receive and provide information about issues affecting the health of citizens.

6.4 Use current technology to communicate effectively.

• Consultant/specialist: Forward workplace health information from a health promotion listserv to staff members on a workplace health committee.

7.0 Leadership

This category focuses on leadership competencies that build capacity, improve performance and enhance the quality of the working environment. They also enable organizations and communities to create, communicate and apply shared visions, missions and values.

A public health practitioner is able to:

7.1 Describe the mission and priorities of the public health organization where one works, and apply them in practice.

• Front line provider: Illustrate how a program logic model incorporates the organization's mission into program specific goals and outcomes.
• Manager/supervisor: Apply the priorities of the organization to the work plan of an interdisciplinary team.

7.2 Contribute to developing key values and a shared vision in planning and implementing public health programs and policies in the community.

• Front line provider: Involve parents, teachers and students in developing a vision and health goals for the school community.

7.3 Utilize public health ethics to manage self, others, information and resources.

• Consultant/specialist: Develop a research protocol that protects the privacy of participants from a local women's shelter.
• Manager/supervisor: Facilitate a lunch and learn session for the interdisciplinary team with a local ethicist to discuss vaccine security.

7.4 Contribute to team and organizational learning in order to advance public health goals.

• Front line provider: Participate on a staff committee whose purpose is to facilitate the incorporation of best practice guidelines into policies and practice.
• Consultant/specialist: Participate in a mentoring program with other employees.

7.5 Contribute to maintaining organizational performance standards.

• Front line provider: Assist in the collection of data for inclusion in the organization's annual performance report.
• Manager/supervisor: Develop a plan to form an accreditation team to review and use the Public Health Standards of the Canadian Council on Health Services Accreditation.

7.6 Demonstrate an ability to build community capacity by sharing knowledge, tools, expertise and experience.

• Front line provider: Facilitate discussion with a community group that is developing an active living program, to identify factors that could impact on program delivery such as resources, space and previous community experience.
• Manager/Supervisor: Sponsor and participate in a continuing education session for an interdisciplinary team on working effectively with community groups to achieve public health goals.