PH 416 Conferencing Exercise

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As a member of the governing council for your state public health association, you are coordinating the development of a position statement for a proposal to credential public health professionals that is being considered by the agency that licenses health professionals in your state. There are 4 positions to be considered in this debate:

Position A: public health should adopt a minimum credential to distinguish public health professionals; this credential should be a bachelor's level degree in public health sciences.
Position B: public health should adopt a minimum credential to distinguish public health professionals; this credential should be a master's degree in the public health sciences.
Position C: public health should adopt a minimum credential to distinguish public health professionals; this credential should be a doctoral level degree in the public health sciences.
Position D: public health should adopt a minimum credential to distinguish public health professionals, but this should not be based on any academic degree.

Below, you will find a series of communications from the other members of association's governing council. Your task is to review the inputs of your colleagues and develop a position statement, with appropriate arguments and evidence, supporting one of these four positions (you don't necessarily have to agree with the position you select). You will electronically post this position via the Submit Assignments link using PH 416 Conferencing Exercise as the title.

Position A argues that public health should adopt a minimum credential to distinguish public health professionals; this credential should be a bachelor's level degree in public health sciences.

I agree that public health should adopt credentials for Bachelor Degree professionals but the degrees should vary. As an organization we need business, medical, environmental, teachers, and computer personnel. Each of these and more should qualify for the credentials. Also, I strongly believe that work experience without a degree should carry weight in receiving the certificate. Not everybody in public health may have a degree but they are very competent and perform well within their positions. I think the certification may bring more status to our field.
Even though I believe a bachelor's degree in public health sciences would at least give some indication of competency, I have a strong belief that experience is an important issue and in some cases would supersede the degree. I have known people who have had no academic degree, but have excelled in public health because of their experience, enthusiasm, and on the job training. Perhaps continuing education credits in public health or public health seminars should be part of the educational requirements after you are on the job.
I agree that individuals working in public health should have a minimum of a BS degree. Individuals completing a BS degree have has exposure to a variety of disciplines such as sociology, psychology, elementary statistics, etc. In addition one should be required to be certified in public health. This gives a grounded education in areas like core functions, community assessment, health promotion, program evaluation and public health administration. Unfortunately many local health jurisdictions and states with rural health offices might find it hard to staff and afford with individuals with the above credentials.
The Association of State and Territorial Health Officials identify National Public Health Performance Standards listing eight core competencies with skill levels for front line staff, senior level staff, and supervisory and management staff. These core competencies distinguish public health professionals from other disciplines. My initial response was that public health should adopt a minimum credential at the master's level. However, after reviewing the core competencies at the various skill levels it seems apparent that a minimum of bachelor's degree may be established. I believe that public health programs could promote advanced degrees in public health service by streamlining from the bachelor's level to the doctoral level, thereby preparing future faculty and credentialing public health professionals at a higher degree level. I did further research on this by emailing the Competencies Project. A message from Dianna Conrad indicated that, "the jury is still out on credentialing. The ASPH/APHA credentialing effort is still in the planning phases." Maybe our Public Health 101 class can impact this effort!
This class has demonstrated that there are many levels of public health professionals from technicians to Executive Directors. They come from various backgrounds with different levels of experience in public health. I feel a minimum credential of Bachelor degree to enter the field is not unreasonable. But I don't fully agree the degree should be in public health because I feel we might eliminate many professional with other degrees who could contribute experience and knowledge to public health. I recommend course work, like this class, leading to a certification in public health to get everyone the necessary basics. Then work on continuing education to keep pace with the inevitable changes in public health.
I agree with debate proposition A. I feel that a public health professional should have a B.S.Degree. This is a very important issue. Knowledge is power. The person should also have compassion.
The credentialing of public health professionals is a fairly new concept that is being addressed now. One of the Healthy People 2010 objectives is to challenge public health agencies to assure a competent public health workforce. It is important that people in the public health field are all competent in their area of specialty in order to raise the level of service and quality of their services to the public. The HRSA reported that only 20% of the nation's estimated 400,000 to 500,000 public health professionals have the education and training needed to do their jobs most effectively. One way to respond to the Healthy People 2010 objective is that public health professionals should have a minimum of a bachelor's level degree in the public health sciences. A bachelor's degree from an accredited school in the health sciences will bring in competent and qualified people to entry-level health professional positions. They will be able to bring their knowledge for grant writing (objectives, evaluation, etc.), behavioral interventions, and theoretical knowledge and computer skills to name a few. By adapting the idea that public health professionals have at least a bachelor's level degree in the public health sciences will put these professionals all on the same playing field. Public health professionals with at least a minimum of a bachelor's level degree will have the training and understanding of the missions of public health and at least some knowledge in emergency response preparedness. It is important for public health agencies and professionals alike to see the importance for initial education and training needed in order to raise the level of quality given to the public. This higher level of quality will in turn be reflected upon the society and will continue to increase the performance of the public health professional.

Position B argues that public health should adopt a minimum credential to distinguish public health professionals; this credential should be a master's level degree in public health sciences.

I think that Public Health is misunderstood by the general public because it does not have a common definition. Any professional, such as a doctor, lawyer or psychologist, must meet a set of core competencies before he/she is licensed to practice. In order for a Public Health professional to obtain recognition as a professional, he/she must demonstrate competency. A minimum of a Master's Degree would provide this credentialing. Public health could then be recognized and defined as an organized profession, which must be respected as any other professional
I believe that public health should adopt a minimum credential to recognize and distinguish the public health professional, and that this should be a master's level degree in public health sciences. The title "professional" by its very nature, presupposes a commitment to, and a standardized competency in a particular field or discipline. It also carries some sort of certification by which each individual's level of attainment is ascertained. Public health builds on basic knowledge gathered from almost every field of human endeavor. This basic knowledge, is of necessity, gathered during a bachelor's degree. However, the master's in public health builds on those basics and equips the individual to meet the demands of this field. Public health by virtue of its purpose, compels each person, community and the global society, to follow its principles. With increasing public awareness, and the ever expanding scope of public health, a variety of programs will surely emerge, to help recognize and distinguish the public health professional.
To date, there is no minimum degree requirement for public health professionals. Consequently, only 20 percent of the nation’s more than 400,000 public health professionals have the education and training needed to do their jobs effectively.(1) Master’s programs offer classes that foster a basic understanding of the public health field. Take for instance UIC’s program. Classes are offered in epidemiology, biostatistics, community health sciences, health policy and administration, and environmental and occupational health sciences. This program exposes students to multiple public health disciplines and provides them with a wide breadth of knowledge. Agencies, including the Institute of Medicine, agree that public health professionals require a certain level of training and have delineated universal and professional competencies that describe the basic skills necessary for practice. Master’s programs aim to address these competencies during instruction. Since many of the professors at schools of public health are public health professionals themselves, they realize the importance of preparing students for their future field. The shift towards more trained professionals has implications for the job sector. In the future, employers may look to only hire individuals with at least a master’s degree to ensure properly trained employees. Public health professionals significantly reduce the number of preventable deaths, a number totaling almost one million.(1) Therefore, it would only benefit employers to selectively hire those with this level of preparation. Public health professionals impact and improve millions of lives. It is expected that they be competent and well equipped for practice. A master’s level education provides the education and training to achieve this and should be the minimum credential that distinguishes all public health professionals. References: (1) http://bhpr.hrsa.gov/publichealth/index.htm. Taken 11/5/2001.
I believe that it is not entirely necessary that someone receive a degree higher than a bachelor's to be proficient in the Public Health field. However, I do believe that a master's degree in the field would ensure that the professional that is to be accredited is competent, more experienced, and knowledgeable in the context of Public Health. Pursing a master's in Public Health actually means that someone has mastered the concepts within Public Health and understand how PH works within the community. With this understanding, the professional will be able to effectively apply his/her knowledge and capabilities to the Public Health field as well as the community.
I believe that a MPH degree should be required for a public health official. However, there are many who do not have a MPH but they work in the field of Public Health. So you can be trained in a special area such as nursing and still be competent when it comes to working in the field of public health. However, there are many nurses that are specifically trained as public health nurses. When I say that a MPH should be required for a public health official I'm mainly talking about those who are like me that have a allied health background but need s further educational training in the fields of public health such as policy making, epidemiology, and bio statistics. These type of courses that are critical in public health are areas that majority Bachelor degree programs do not cover.

Position C argues that public health should adopt a minimum credential to distinguish public health professionals; this credential should be a doctoral level degree in public health sciences.

I am basing my argument on the agency that I work for - each department is headed by a person with at least a master's degree and the supervisors within the department must have at least a bachelor's degree - it would stand to reason that the person in charge of the entire department should have at least a master's degree.

Position D argues that public health should adopt a minimum credential to distinguish public health professionals; but that this credential should not be based on any academic degree.

I think that there should be a minimal competency-based credential to distinguish public health professionals in order to more publicly recognize the profession, help ensure that we all share a common base of knowledge and skills to fulfill PH functions, create the infrastructure for career development, and help ensure that we keep up to date on current knowledge and practice. Instead of relying on an academic degree, credentialing could be accomplished through a certain combination of means: an academic degree, demonstrated competency in the field, an exam, a system of continuing education, and/or successful completion of a series of short courses. This flexible approach would recognize the value of experience and, if developed with the input from all interested PH professionals, it will promote profession-wide support and ownership.
I agree with the proposition that public health should adopt some form of credential to recognize and distinguish public health professionals but that this credential should not be based on any academic degree. While a person's level of educational attainment is a good barometer of how well they will do in a chosen field; it is no substitute for actual experience in that field. Regardless of the nature of the degree or level of educational attainment, most adults of average intelligence can become quite competent in any field they choose. This definitely holds true for the field of Public Health where a person should be judged on their performance and the expertise they exhibit in the conduct of their responsibilities.
I believe that there should be a minimum level of credentials for public health professionals because doing so would help raise the value of the public health profession. The minimum criteria can be related to experience or course completions (like this one). However, keep in mind that there are basic skills that the public health worker needs. Some people may possess these skills without a degree. The public health profession needs persons from all backgrounds and experiences to successfully deal with public health hazards. You can no longer isolate people or infections. For instance, in fighting AIDS, you need everyone to act as a public health educator/worker. You need doctors, nurses, religious leaders, coworkers, peers, parents, etc. to combat this devastating disease. To that end, continuing education opportunities should be made available for new public health workers. This is the case for me.
It is true that credentialing must take place in order to assure the public of the competency of the work force and the quality of available public health services. Credentialing has many benefits including monitoring of continuing education and work force training. It is important to note that the public health work force is made up by a myriad of diverse professions and disciplines. When considering the appropriate level of knowledge for credentialing, it is imperative that public health remember those who have received training in other fields. Similarly, it would be detrimental to exclude a public health professional who has earned a bachelors or graduate degree. Instead of focusing on a particular degree level or discipline it would be far more beneficial to incorporate professionals with varying credentials. A public health professional could be defined as one who meets established criteria. These criteria would address educational level, work experience and the core competencies of public health (including analytical, communication, policy development and program planning, cultural, basic public health sciences, and financial planning and management skills.) In order to preserve the diverse public health workforce, it would be beneficial to create an exhaustive list of acceptable credentials that identify public health professionals. This list could be developed and managed by an organization such as the American Public Health Association (APHA) or the National Commission for Health Education Credentialing (NCHEC). Examples of possible approved credentials on this list include: Master of Public Health (MPH), Certified Health Education Specialist (CHES), and Certified Public Health Administrator (CPHA). In addition to these specific public health disciplines, public health professionals could also include teachers, doctors, nurses, dentists, epidemiologists, lawyers, and statisticians.
Although my first tendency was to say that Public Health Professionalism should be based on some level of academic degree, after more reflection and studying the people around me who work in public health, I have to agree with proposition D: minimum credential. I can't help returning to Dr. Turnock's statement that 'the unique feature of public health is not a common preparation through education and training.' It seems to me that the common link between the public health professionals is a philosophical one. From practical day to day experience, it is easy to pick out the individual nurse, social worker, or nutritionist who intuitively understands the mission of public health. They use the core functions daily, although they may not be able to name them. On the other hand, there should still be some requirements to distinguish the public health professional. This could take place in a variety of ways from attending a Leadership Institute to taking a course on the internet. This would allow a variety of disciplines to have a common foundation and understanding.
I feel that Public Health should initiate some type of a credential to distinguish someone as a public health professional. While education and academic achievements are important, I feel that experience is also important. A suggestion is that a minimum of 5 years experience in the medical or scientific field would qualify you as a public health professional. An Associates degree with 1 year experience is also an option. To maintain the status of a public health professional, on-going education should be a requirement.
I believe credentialing would be good for Public Health - but not necessarily a particular academic degree due to the wide variety of disciplines involved in Public Health. Credentialing could increase the visibility of our profession, provide a means of self-regulation, provide for standardization of a basic body of knowledge and core competencies, and perhaps assist in the development of a more tangible and thus communicable definition of public health to increase collaboration amongst our profession and to increase support from our public. Credentialing could include a minimum number of years of experience in a public health related position, a bachelor's degree in a public health related field, and evidence of competency in several defined areas related to assessment, assurance and policy development. Something like the new certification process for Public Health Administrators in Illinois!
I concur with Proposition D: public health should adopt a minimum credential to distinguish public health professionals, but this should not be based on any academic degree. It should be based on a spectrum of criteria: academic degree might be part of it, life experience, job experience, continuing education, and any number of other experience and educational endeavors that would add to a individuals development of the Universal Competencies that a public health professional should possess. This combination of a number of various criteria would be more difficult to demonstrate and logistically might be more troublesome for the applicant and reviewers but I believe it would reflect the true nature of a competent public health professional more than any one thing would.

PH 416 Conferencing Exercises last revised March 17, 2004 (epowell)