 FRAMING HEALTH MATTERS 

Development of a Core Competency Model for the

Master of Public Health Degree
| Judith G. Calhoun, PhD, MBA, Kalpana Ramiah, MSc, MPH, CHES, Elizabeth McGean Weist, MA, MPH, and Stephen M. Shortell, PhD, MPH

of competencies in the evaluation of the in-

Core competencies have been used to redefine curricula across the major health
structional, research, and service efforts in the
professions in recent decades. In 2006, the Association of Schools of Public Health
graduate schools accredited by the CEPH is
identified core competencies for the master of public health degree in graduate
schools and programs of public health. We provide an overview of the model de- evidenced in the differences in the accredita-
velopment process and a listing of 12 core domains and 119 competencies that tion standards as amended in 2002 and
can serve as a resource for faculty and students for enhancing the quality and ac- again in 2005. The January 2002 Accredita-
countability of graduate public health education and training. The primary vision tion Standards for Graduate Schools of Public
for the initiative is the graduation of professionals who are more fully prepared Health17 includes only a single reference to the
for the many challenges and opportunities in public health in the forthcoming concept of competencies (page 10), which was
decade. (Am J Public Health. 2008;98:1598–1607. doi:10.2105/AJPH.2007.117978) used in relation to defining learning objec-
tives. No references were made to the terms
The need for change in educational practices the organization of certifying boards, the competency or competency-based education. By
across the health professions has been widely American Board of Medical Specialties, en- contrast, in the most current CEPH standards,
addressed in the literature, as well as in all 4 dorsed 6 general competencies as the foun- the June 2005 Accreditation Criteria for
of the seminal Institute of Medicine reports dation for all graduate medical education. Schools of Public Health,18 there are more than
published during the past 9 years.1–4 As a These include (1) patient education, (2) med- 30 references to competencies across 6 differ-
result, a resounding call for reform in health ical knowledge, (3) practice-based learning ent pages (pages 3 and 16–20) with an en-
professions education, training, and profes- and improvement, (4) interpersonal and tirely new section (Section 2.6 on pages
sional development programs has been made communication skills, (5) professionalism, 15–16) specifically addressing “Required
in relation to curricular content, outcomes, and (6) systems-based practice. Currently, Competencies.” The 2005 section also out-
and process review.5–9 these competencies are being phased into edu- lines the interpretation of competencies, their
On the basis of outcomes from related re- cational programs across both medical schools relation with instructional objectives, and re-
search,10,11 educators generally agree that and specialty board licensure processes.4 quired documentation for the review process
competency- or outcomes-based education Other competency model deployment ini- associated with the required competencies.
can improve individual performance, enhance tiatives have been undertaken by the Ameri- Of note in the 2005 “Required Competen-
communication and coordination across can Association of Colleges of Nursing and cies” section (page 15), competencies are de-
courses and programs, and provide an impe- their Commission on College Nursing Educa- fined as “what a successful learner should
tus for faculty development, curricular re- tion, the American Organization of Nurse Ex- know and be able to do upon completion of a
form, and leadership in educational innova- ecutives, the American Association of Dental particular program or course of study.” As well,
tion.4 In addition, explicitly specified, action- Schools Commission on Dental Accreditation, the newer standards specifically differentiate
oriented behavioral competencies can signifi- the Council on Linkages between Academia between “competencies” and “learning objec-
cantly enhance learning and assessment out- and Public Health Practice, the National Cen- tives,” stating that the “relationship between
comes.12 Consequently, several initiatives ter for Healthcare Leadership, and the Com- competencies and learning objectives (the in-
have been launched to identify and specify mission on Accreditation of Health Manage- cremental learning experiences at the course
competencies for graduates of educational ment Education, the last of which accredits and experiential levels that lead to the develop-
programs in the health professions, including programs in health policy and management ment of the competencies) should be explicit.”
medicine, nursing, pharmacy, dentistry, and associated with many schools of public health
health management.13 across the United States and Canada. A more RESPONDING TO THE NEED FOR
Competency-based education has also complete listing of recent competency model COMPETENCY-BASED
begun to redefine accreditation and certifica- development initiatives is outlined in works by PROFESSIONAL EDUCATION
tion oversight activities across the health pro- Calhoun et al.13 and Garman and Johnson.16
fessions.14,15 In 1997, the American Council The accreditation of graduate schools of The Association of Schools of Public
on Pharmaceutical Education adopted accred- public health and of certain graduate public Health (ASPH) initiated its Core Competency
itation standards focused on 18 professional health programs is overseen by the Council Model Development Project for the master of
competencies. In 1999, the Accreditation on Education for Public Health (CEPH). A public health (MPH) degree in 2004 with
Council for Graduate Medical Education and similar trend toward a new focus on the use support from the US Centers for Disease

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Control and Prevention. The ASPH repre- supplement to the online version of this article seeking the MPH degree. Although histori-
sents the 40 accredited schools of public at [Link] were charged with coming cally the MPH curriculum had served to aug-
health in North America, with a combined to consensus on the top 8 to 10 competencies ment students’ medical or health science de-
faculty of more than 7500 and an annual required by any MPH student upon gradua- grees, in reality, most students currently enter
enrollment of nearly 21 000 students. tion, regardless of area of specialization or in- into masters-level degree programs without
To equip graduates for analysis and consid- tended career direction. For example, the set grounding in the biological bases of health
eration of solutions to public health problems of competencies that emerged from the biosta- and illness. The public health biology work-
at the community, institutional, and societal tistics workgroup reflected the knowledge, group was therefore established to similarly
levels, the MPH curriculum in graduate schools skills, and other attributes that any MPH grad- identify competencies for more fully inform-
and programs of public health has traditionally uate must possess independent of specializa- ing both faculty and students of the relevant
been organized around 5 core disciplines: bio- tion in any of the other core areas or specialty biological processes influencing 21st-century
statistics, epidemiology, environmental health tracks, such as global health, maternal and population-based health.
science, health policy and management, and child health, and public health nutrition. Each workgroup member was nominated
social and behavioral sciences. Public health Although the workgroups varied in the by a dean or public health partner (the
graduates typically concentrate in one of the methods they used to draft an initial list of American Public Health Association, the As-
core discipline areas; however, study can also universal competencies for their specific do- sociation of State and Territorial Health Offi-
be focused on particular population groups or main, all of the workgroups used nominal cials, or the National Association of County
subject areas, such as aging studies, global group technique, a modified Delphi process, and City Health Officials). Workgroup chairs,
health, maternal and child health, mental to refine their draft competency lists. Three or co-chairs, were selected and then asked to
health, or public health nutrition. modified Delphi surveys were subsequently identify, from the nominees, a group of 10
We provide an overview of the develop- undertaken by each core workgroup to delin- content specialists or practitioners to serve
ment process for the ASPH Core Competency eate and refine their competencies. After each as members of the core workgroup. Addi-
Model for the MPH degree. Also presented survey, core members convened to discuss tional nominees were invited to serve on
are the final model; its core competency do- the results of the survey in order to distill and discipline-specific resource task groups pro-
mains, including domain definitions; and each refine the next list of competencies. For each viding supplementary review and input on
of the domain-specific competencies as guide- of the 3 survey rounds, individual workgroup drafts. Also, other interested individuals,
lines for improving the quality and accounta- respondents had the opportunity to provide such as ASPH council members and faculty
bility of public health education and training. input by using a “general comments” section. members from programs in public health
For the purpose of the modeling project, we Throughout the modeling activities, the who expressed interest in becoming involved
defined the MPH core competencies as a workgroups maintained open communication in the process, were added to the resource
unique set of applied knowledge, skills, and among members and with the public health groups. A total of 135 members participated
other attributes, grounded in theory and evi- community by publishing progress results in Phase 1. Ultimately, the workgroups were
dence, for the broad practice of public health. (conference call minutes and draft compe- composed of faculty and selected leaders
tency lists) on the ASPH Web site. In addi- from both practitioner organizations and
MODEL DEVELOPMENT PROCESS tion, the ASPH “Friday Letter” was used to public health programs.
disseminate all workgroup outcomes and The individual workgroups determined
The project was completed over a 2-year each of the draft competency sets as they their own methods and resources for their
period from 2004 to 2006 under the guid- were identified during the survey activities. initial competency selection and development
ance and direction of the ASPH Education A special ASPH e-mail box was also used to activities. The specific numbers of competen-
Committee in 2 separate phases: Phase 1, track input from members and from the cies reviewed during each of the 3 Delphi
Discipline-Specific Competency Identification public health community. surveys during Phase 1, as well as the re-
and Specification, and Phase 2, Crosscutting Phase 1: Discipline-Specific Competencies. In viewer response rate from the respective
Competency Identification and Specification. the fall of 2004, the ASPH Education Com- workgroup, are listed in Table 1. The average
Parallel processes were conducted across mittee established the first 6 workgroups, 5 in response rate was 91% during Phase 1.
both phases, with individual expert panels or each of the 5 core public health areas (biosta- After each of the 10 workgroups had sepa-
workgroups being appointed to identify and tistics, environmental health sciences, epide- rately distilled a core set of MPH competen-
specify the competencies for each competency miology, health policy and management, and cies in their respective discipline, a Core
domain (outlined in the process flow diagram social and behavioral sciences) and 1 group Competency Council was established that
in the appendix that is available as a supple- devoted to public health biology. Public comprised the chairs of each of the work-
ment to the online version of this article at health biology was included in Phase-1 plan- groups and 2 practitioners, who were also
[Link] The chairs for the work- ning, model development, and review in rec- drawn from the workgroups. This collective
group, representing 14 different universities ognition of existing gaps between the histori- council was charged with integrating the
(as listed in the appendix that is available as a cal and current backgrounds of students disparate sets from the 10 independent

September 2008, Vol 98, No. 9 | American Journal of Public Health Weist et al. | Peer Reviewed | Framing Health Matters | 1599
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TABLE 1—Summary of Discipline-Specific and Crosscutting Delphi Processes

Delphi 1 Delphi 2 Delphi 3 Final List

Response Response Response No. of No. of
No. of Rate, No. of Rate, No. of Rate, Discipline-Specific Crosscutting
Competency Domains Competencies % Competencies % Competencies % Competencies Competencies

Social and Behavioral Sciences 41 81 21 89 11 72 10 10

Biostatistics 30 81 14 94 9 100 10 0
Environmental Health 17 100 14 100 9 100 8 0
Epidemiology 24 100 15 92 11 81 10 2
Health and Policy Management 46 90 50 92 13 100 10 2
Public Health Biology 55 81 16 81 10 100 10 1
Total ... ... ... ... ... ... 58 15
Communication and Informatics 76 92 18 90 11 77 ... 10
Diversity and Culture 65 82 21 65 10 100 ... 10
Leadership 60 91 31 86 12 66 ... 9
Professionalism 41 100 25 77 14 80 ... 11
Program Planning 52 100 28 66 13 75 ... 10
Systems Thinking 58 100 32 76 14 100 ... 11
Total ... ... ... ... ... ... ... 61
Total of Phase 1 and 2 ... ... ... ... ... ... ... 119

workgroups into an overarching model re- tiatives such as those guided by the Institute presented to the ASPH deans at their re-
flecting the full range of knowledge, skills, of Medicine and the Council on Linkages. treat on July 21 for final revisions and ap-
and other attributes required for current and This draft set was subsequently reviewed by proval. Version 1.3, which was limited to
future public health practice, including both the council once again via a modified Del- the discipline-specific competencies in the
discipline-specific domains and essential inter- phi process and was then presented to the 5 basic public health science areas, was fi-
disciplinary, crosscutting competency domains Education Committee in May of 2005 as nalized on November 23 and was approved
for graduate public health education and model version 1.0. On the basis of com- by the ASPH Education Committee on No-
training. Using expert panel identification and ments from the meeting participants and vember 29. Version 1.3, with 48 competen-
consensus-building processes, the council ini- the Education Committee, the 9 crosscutting cies in 5 discipline-specific domains, was
tially identified the following 9 interdiscipli- domains were ultimately revised and consol- then approved by the ASPH board of direc-
nary domains: (1) communication, (2) data idated into the following 6 domains for sub- tors on December 12, 2005.
analysis and information management, (3) di- sequent Phase-2 specification and refine- Phase 2: Crosscutting Competencies. Phase 2
versity and cultural proficiency, (4) ecological ment: (1) communication, (2) diversity and of the ASPH Core Competency Model Devel-
determinants of health, (5) leadership, cultural proficiency, (3) leadership, (4) pro- opment Project was launched in the Fall of
(6) management and policy, (7) professional- fessionalism and ethics, (5) program planning 2005 with the formation of 6 new work-
ism, (8) program planning and assessment, and assessment, and (6) systems thinking. groups to further identify and refine compe-
and (9) systems thinking. Three of the 9 interdisciplinary domains, tencies for the remaining 6 crosscutting do-
In line with the 8 to 10 competencies data analysis and information management, mains. All ASPH member schools, the
identified for the discipline-specific domains, ecological determinants of health, and Association of Prevention Teaching and Re-
members of the council also drafted an initial management and policy, were re-integrated search, and practitioner organizations (the
set of concepts and illustrative competencies into the preexisting discipline-specific American Public Health Association, the As-
and subcompetencies for the first set of competency areas for additional review and sociation of State and Territorial Health Offi-
crosscutting competencies, as well as defini- vetting during Phase 1 of model development. cials, and the National Association of County
tions for each of the domains. This first round Subsequent iterations of the proposed and City Health Officials) were invited to
of interdisciplinary domain concept forma- model version 1.1 (completed on June 17, nominate representatives to the crosscutting
tion was supplemented with competencies 2005) and version 1.2 (finalized on July 15 domain workgroups. Also, on the basis of
identified by the Phase-1 workgroups, with after review and input by the associate input from the deans of schools of public
suggestions that had been previously sub- deans of schools of public health at their health and the ASPH Education Committee,
mitted to the council, and by the literature, annual meeting) were both disseminated the public health biology workgroup was revi-
including prior competency specification ini- widely for comments. Version 1.2 was also talized with new nominations from member

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schools and both academic and practice part-

ners. This group was charged with identifying
additional illustrative public health biology
subcompetencies that would provide more
guidance to faculty and students in this area.
A total of 197 members participated in the
7 workgroups formed in Phase 2.
As with the discipline-specific competency
modeling process, each workgroup came to
consensus on the top 8 to 10 competencies
in the 6 crosscutting domains required by any
MPH student, again regardless of area of spe-
cialization or intended career trajectory upon
graduation. Each of the 6 crosscutting do-
mains were prepopulated with 5 to 8 compe-
tencies on the basis of suggestions from the
preliminary work of the 6 discipline-specific
workgroups and the first Core Competency
Council, as well as from a review of the re-
lated literature. During Phase 2, the work-
groups also finalized the following domain
constructs, as well as the definition of each:
(1) communication and informatics, (2) diver-
sity and culture, (3) leadership, (4) profession-
alism, (5) program planning, (6) public health
biology, and (7) systems thinking.
As the Phase-2 processes evolved, the
communication workgroup members decided FIGURE 1–Association of Schools of Public Health Core Competency Model for the MPH
to include informatics in their domain title Degree
and definition because a considerable num-
ber of informatics competencies for all MPH
graduates emerged during their discussions The ASPH Education Committee reviewed petencies are included in the final 2.3 version
and survey activities. Consequently, a small the Phase-2 version 2.0 of the model in April of the model.
subgroup on informatics worked under the 2006, which was also presented to ASPH
direction of the communication workgroup. members and partners in May 2006. Version DISCUSSION AND SUMMARY
The specific numbers of competencies re- 2.1 was subsequently presented to the associ-
viewed during each of the 3 rounds of Phase- ate deans at their summer retreat in June; In total, more than 400 individuals directly
2 modified-Delphi surveys, as well as the re- and version 2.2 was reviewed and approved contributed to or provided input to the devel-
viewer response rate from the respective by the ASPH deans at their retreat in July. opment of the final ASPH Core Competency
workgroup, are listed in Table 1. The average The ASPH board accepted version 2.2 with Model, version 2.3, that was released in Au-
response rate for the surveys was 85% in minor revisions, which were reflected in the gust 2006. The model development process
Phase 2. Similar to Phase 1, members con- final ASPH Core Competency Model for the was a comprehensive, grassroots, expert panel
vened in a second Core Competency Council MPH degree, version 2.3, released in August effort with ongoing field-wide dissemination
meeting for Phase 2 in March 2006. This 2006. The full ASPH MPH Core Competency and calls for input by interested parties, in-
meeting included chairs of the 6 crosscutting Model is graphically depicted in Figure 1. The cluding faculty, public health partners, practi-
areas, a public health biology chair, a practice definitions and competencies for each of the tioners, and students. The limitations and
partner, a representative from the Association 12 domains comprising the ASPH Core Com- constraints associated with expert panel and
of Prevention Teaching and Research, and a petency Model are further outlined in Box 1. Delphi survey technique are well recognized
Phase-1 chair. The group discussed the ration- The definitions were developed to provide the by the ASPH Education Committee. How-
ale for each of the interdisciplinary domains context by which the workgroups’ competency ever, given the diversity of the field and the
and finalized the complete competency model. modeling activities took place, versus describ- many career paths and work settings for grad-
During this meeting, public health biology was ing the entire field of a particular discipline’s uates with the MPH, the initiative provides
designated as a crosscutting domain. scholarship and practice. A total of 119 com- the first national consensus-building model

September 2008, Vol 98, No. 9 | American Journal of Public Health Weist et al. | Peer Reviewed | Framing Health Matters | 1601
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Association of Schools of Public Health Core Competencies for the Master of Publich Health Degree, by Competency Domain
BIOSTATISTICS ENVIRONMENTAL HEALTH SCIENCES EPIDEMIOLOGY
The development and application of The study of environmental factors, including The study of patterns of disease and injury
statistical reasoning and methods biological, physical, and chemical factors in human populations and the applica-
in addressing, analyzing, and that affect the health of a community. tion of this study to the control of health
solving problems in public health–, • Describe the direct and indirect human, problems.
health care–, and biomedical-, ecological, and safety effects of major • Identify key sources of data for epidemio-
clinical-, and population-based environmental and occupational agents. logic purposes.
research. • Describe genetic, physiologic, and psychosocial • Identify the principle and limitations of
• Describe the roles biostatistics factors that affect susceptibility to adverse public health screening programs.
serves in the discipline of public health outcomes following exposure to • Describe a public health problem in terms
health. environmental hazards. of magnitude, person, time, and place.
• Describe basic concepts of • Describe federal and state regulatory • Explain the importance of epidemiology for
probability, random variation, and programs, guidelines, and authorities that informing scientific, ethical, economic,
commonly used statistical control environmental health issues. and political discussion of health issues.
probability distributions. • Specify current environmental risk assessment • Comprehend basic ethical and legal
• Describe preferred methodologic methods. principles pertaining to the collection,
alternatives to commonly used • Specify approaches for assessing, preventing, maintenance, use, and dissemination of
statistical methods when and controlling environmental hazards that epidemiologic data.
assumptions are not met. pose risks to human health and safety. • Apply the basic terminology and definitions
• Distinguish among the different • Explain the general mechanisms of toxicity in of epidemiology.
measurement scales and the eliciting a toxic response to various • Calculate basic epidemiology measures.
implications for selection of environmental exposures. • Communicate epidemiologic information to
statistical methods to be used on • Discuss various risk management and risk lay and professional audiences.
the basis of these distinctions. communication approaches in relation to • Draw appropriate inferences from
• Apply descriptive techniques issues of environmental justice and equity. epidemiologic data.
commonly used to summarize • Develop a testable model of environmental • Evaluate the strengths and limitations of
public health data. insult. epidemiologic reports.
• Apply common statistical methods
for inference.
• Apply descriptive and inferential
methodologies according to the
type of study design for answering
a particular research question.
• 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.
• Interpret results of statistical
analyses found in public health
studies.
• Develop written and oral
presentations on the basis of
statistical analyses for both public
health professionals and educated
lay audiences.

Continued

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Continued

HEALTH POLICY AND MANAGEMENT SOCIAL AND BEHAVIORAL SCIENCES COMMUNICATION AND INFORMATICS
A multidisciplinary field of inquiry The study of behavioral, social, and cultural The ability to collect, manage, and organize
and practice concerned with the factors related to individual and population data to produce information and
delivery, quality, and costs of health and health disparities over the life meaning that is exchanged by use of
health care for individuals and course. Research and practice in this area signs and symbols; to gather, process,
populations. This definition contributes to the development, and present information to different
assumes both a managerial and a administration, and evaluation of programs audiences in-person, through
policy concern with the structure, and policies in public health and health information technologies, or through
process, and outcomes of health services to promote and sustain healthy media channels; and to strategically
services including the costs, environments and healthy lives for design the information and knowledge
financing, organization, outcomes, individuals and populations. exchange process to achieve specific
and accessibility of care. • Identify basic theories, concepts, and models objectives.
• Identify the main components and from a range of social and behavioral • Describe how the public health information
issues of the organization, financing, disciplines that are used in public health infrastructure is used to collect,
and delivery of health services and research and practice. process, maintain, and disseminate
public health systems in the • Identify the causes of social and behavioral data.
United States. factors that affect health of individuals • Describe how societal, organizational, and
• Describe the legal and ethical bases and populations. individual factors influence and are
for public health and health services. • Identify individual, organizational, and influenced by public health
• Explain methods of ensuring community concerns, assets, resources, communications.
community health safety and and deficits for social and behavioral • Discuss the influences of social,
preparedness. science interventions. organizational, and individual factors on
• Discuss the policy process for • Identify critical stakeholders for the planning, the use of information technology by
improving the health status of implementation, and evaluation of public end users.
populations. health programs, policies, and interventions. • Apply theory- and strategy-based
• Apply the principles of program • Describe steps and procedures for the planning, communication principles across
planning, development, budgeting, implementation, and evaluation of public different settings and audiences.
management, and evaluation in health programs, policies, and interventions. • Apply legal and ethical principles to the use
organizational and community • Describe the role of social and community of information technology and resources
initiatives. factors in both the onset and solution of in public health settings.
• Apply principles of strategic planning public health problems. • Collaborate with communication and
and marketing to public health. • Describe the merits of social and behavioral informatics specialists in the process of
• Apply quality and performance science interventions and policies. design, implementation, and evaluation
improvement concepts to address • Apply evidence-based approaches in the of public health programs.
organizational performance issues. development and evaluation of social and • Demonstrate effective written and oral
• Apply “systems thinking” for behavioral science interventions. skills for communicating with different
resolving organizational problems. • Apply ethical principles to public health audiences in the context of professional
• Communicate health policy and program planning, implementation, and public health activities.
management issues using evaluation. • Use information technology to access,
appropriate channels and • Specify multiple targets and levels of evaluate, and interpret public health data.
technologies. intervention for social and behavioral • Use informatics methods and resources as
• Demonstrate leadership skills for science programs or policies. strategic tools to promote public health.
building partnerships. • Use informatics and communication
methods to advocate for community
public health programs and policies.

Continued

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Continued

DIVERSITY AND CULTURE LEADERSHIP PUBLIC HEALTH BIOLOGY a

The ability to interact with diverse The ability to create and communicate a The ability to incorporate public health
individuals and communities to shared vision for a changing future, biology—the biological and molecular
produce or impact an intended champion solutions to organizational and context of public health—into public
public health outcome. community challenges, and energize health practice.
• Describe the roles of, history, power, commitment to goals. • Specify the role of the immune system in
privilege, and structural inequality • Describe the attributes of leadership in public population health.
in producing health disparities. health. • Describe how behavior alters human biology.
• Explain how professional ethics and • Describe alternative strategies for collaboration • Identify the ethical, social, and legal issues
practices relate to equity and and partnership among organizations implied by public health biology.
accountability in diverse community focused on public health goals. • Explain the biological and molecular basis
settings. • Articulate an achievable mission, set of core of public health.
• Explain why cultural competence values, and vision. • Explain the role of biology in the ecologic
alone cannot address health • Engage in dialogue and learning from others model of population-based health.
disparity. to advance public health goals. • Explain how genetics and genomics affect
• Discuss the importance and • Demonstrate team building, negotiation, and disease processes and public health
characteristics of a sustainable conflict management skills. policy and practice.
diverse public health workforce. • Demonstrate transparency, integrity, and • Articulate how biological, chemical, and
• Use the basic concepts and skills honesty in all actions. physical agents affect human health.
involved in culturally appropriate • Use collaborative methods for achieving • Apply biological principles to development
community engagement and organizational and community health goals. and implementation of disease
empowerment with diverse • Apply social justice and human rights principles prevention, control, or management
communities. when addressing community needs. programs.
• Apply the principles of community- • Develop strategies to motivate others for • Apply evidence-based biological and
based participatory research to collaborative problem solving, molecular concepts to inform public
improve health in diverse decisionmaking, and evaluation. health laws, policies, and regulations.
populations. • Integrate general biological and molecular
• Differentiate among availability, concepts into public health.
acceptability, and accessibility of
health care across diverse
populations.
• Differentiate between linguistic
competence, cultural competency,
and health literacy in public health
practice.
• Cite examples of situations in which
consideration of culture-specific
needs resulted in a more effective
modification or adaptation of a
health intervention.
• Develop public health programs and
strategies responsive to the diverse
cultural values and traditions of the
communities being served.

Continued

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Continued

PROFESSIONALISM PROGRAM PLANNING SYSTEMS THINKING

The ability to demonstrate ethical The ability to plan for the design, development, The ability to recognize system-level
choices, values and professional implementation, and evaluation of properties that result from dynamic
practices implicit in public health strategies to improve individual and interactions among human and social
decisions; consider the effect of community health. systems and how they affect the
choices on community stewardship, • Describe how social, behavioral, environmental, relations among individuals, groups,
equity, social justice, and and biological factors contribute to specific organizations, communities, and
accountability; and commit to individual and community health outcomes. environments.
personal and institutional • Describe the tasks necessary to ensure that • Identify characteristics of a system.
development. program implementation occurs as intended. • Identify unintended consequences
• Discuss sentinel events in the • Explain how the findings of a program produced by changes made to a public
history and development of the evaluation can be used. health system.
public health profession and their • Explain the contribution of logic models in • Provide examples of feedback loops and
relevance for practice in the field. program development, implementation, “stocks and flows” within a public
• Apply basic principles of ethical and evaluation. health system.
analysis (e.g., the Public Health • Differentiate among goals, measurable • Explain how systems (e.g., individuals, social
Code of Ethics, human rights objectives, related activities, and expected networks, organizations, and communities)
framework, other moral theories) outcomes for a public health program. may be viewed as systems within systems
to issues of public health practice • Differentiate the purposes of formative, in the analysis of public health problems.
and policy. process, and outcome evaluation. • Explain how systems models can be tested
• Apply evidence-based principles and • Differentiate between qualitative and and validated.
the scientific knowledge base to quantitative evaluation methods in relation • Explain how the contexts of gender, race,
critical evaluation and decision- to their strengths, limitations, and poverty, history, migration, and culture
making in public health. appropriate uses, with emphases on are important in the design of
• Apply the core functions of reliability and validity. interventions within public health
assessment, policy development, • Prepare a program budget with justification. systems.
and assurance in the analysis of • In collaboration with others, prioritize individual, • Illustrate how changes in public health
public health problems and their organizational, and community concerns systems (including input, processes,
solutions. and resources for public health programs. and output) can be measured.
• Promote high standards of personal • Analyze interrelations among systems that
and organizational integrity, influence the quality of life of people in
compassion, honesty, and respect their communities.
for all people. • Analyze the effects of political, social, and
• Analyze determinants of health and economic policies on public health
disease using an ecological systems at the local, state, national,
framework. and international levels.
• Analyze the potential impacts of
legal and regulatory environments
on the conduct of ethical public
health research and practice.
• Distinguish between population and
individual ethical considerations in
relation to the benefits, costs, and
burdens of public health programs.
• 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.

Continued

September 2008, Vol 98, No. 9 | American Journal of Public Health Weist et al. | Peer Reviewed | Framing Health Matters | 1605
  FRAMING HEALTH MATTERS 

Continued

• Appreciate the importance of working • Assess evaluation reports in relation to their • Analyze the impact of global trends and
collaboratively with diverse quality, utility, and impact on public health. interdependencies on public health–
communities and constituencies related problems and systems.
(e.g., researchers, practitioners, • Assess strengths and weaknesses of
agencies, and organizations). applying the systems approach to public
• Value commitment to lifelong learning health problems.
and professional service including • More information about Systems Thinking
active participation in professional is available at [Link]
organizations. [Link]?page=898.
a
Public health biology illustrative sub-competencies are available at [Link]

for continued review, development, and re- and relevancy of the competency set, and tion of professionals more fully prepared for
finement. In addition, the model represents ongoing changes and progress in the field of the many challenges and opportunities in
an integration of the core competencies for public health. Competency sets generally public health in the forthcoming decade.
both the core disciplines and the integrative, have a lifespan of 3 to 5 years, and it will
crosscutting competencies in the field of aca- soon be time to revisit the set and initiate
demic public health practice. new activities for further refinement and About the Authors
The ASPH has disseminated the competen- updating in line with new thinking and future At the time of the study, Judith G. Calhoun was with the De-
partment of Health Management and Policy, University of
cies to a wide audience beyond its member challenges to the field. The model will not Michigan, Ann Arbor. Kalpana Ramiah and Elizabeth
schools. In particular, we anticipate that the remain static. McGean Weist were with the Association of Schools of Public
competencies will be useful to graduate pub- The competencies are intended to serve Health, Washington, DC. Stephen M. Shortell was with the
School of Public Health, University of California, Berkeley.
lic health programs, employers, practice and as a resource and guide for those interested Requests for reprints should be sent to Elizabeth Weist,
agency partners, CEPH, and the National in improving the quality and accountability MA, MPH, Association of Schools of Public Health
Board of Public Health Examiners. Through of public health education and training. (ASPH), 1101 15th St, NW, Suite 910, Washington, DC
20005 (e-mail: eweist@[Link]).
this process, the ASPH sought to provide They were developed with respect for the This article was accepted December 27, 2007.
direction and specification regarding essential uniqueness and diversity of the schools of
educational outcomes for the MPH core cur- public health. Therefore, the model may be Contributors
riculum and to provide leadership in defining of assistance to schools of public health in J. G. Calhoun conducted the research and provided the
contemporary and future education in public identifying specific subcompetencies and methodologic direction for the study, consulted with
and advised the Association of Schools of Public Health
health graduate education. The model also specialty competencies that apply to individ- (ASPH) on all aspects of the study and was the main
serves as a basis for launching individual ini- ual schools and unique program missions. developer of the article. K. Ramiah provided research,
tiatives associated with the many career path- The competencies are not meant to pre- communications, and logistical support and coordinated
all aspects of the project. E. McGean Weist managed
ways and professional employment positions scribe the methods or processes for achieve- the project and oversaw the submission of all study
that make up the field of public health. ment; implementation of the competencies deliverables. S. M. Shortell helped to provide overall
A comprehensive overview of the ASPH may vary as a function of each school’s direction for the study and reviewed the article.

MPH core competency modeling process, the mission and goals.

complete listing of all the competencies con- As well, the ASPH Core Competency Model Acknowledgments
This project was supported by the Centers for Disease
sidered by the workgroups during the model was not designed to serve as a framework for Control and Prevention (grant U36/CCU300430-23/24).
development process, and a list of resources certain required core courses or for one-to-one Special recognition and appreciation is extended to
that were used in support of the development development of a core curriculum, but instead the chairpersons of each of the competency domain
workgroups, as listed in the appendix that is available
of the Core Competency Model are available is aimed at providing a baseline overview of as a supplement to the online version of this article at
on the Internet.19–21 the knowledge, skills, and other attributes ex- [Link] for their ongoing leadership and contri-
The Core Competency Model, version 2.3, pected of emerging public health profession- butions throughout the ASPH Master of Public Health
degree competency model development initiative. In
is considered the ASPH’s best effort to date als. The competencies are anticipated to serve addition, appreciation is extended to all of the individu-
in defining the core competencies for the as a useful guide for faculty to include, as ap- als who served on each of the workgroups and pro-
MPH degree. However, competency model propriate, relevant content in their existing vided advice and counsel for final model completion.
A complete listing of all workgroup members can be
development is an iterative process, and the courses and as an aid to MPH students seek- found on the ASPH Web site at [Link]
model will have to be regularly updated on ing opportunities to comprehensively update userfiles/[Link].
the basis of faculty deployment of the compe- their understanding and skill sets. The pri- Note. The contents of this article are solely the re-
sponsibility of the authors and do not necessarily repre-
tencies, continued dialogue regarding the use mary vision for the ASPH competency sent the official views of the Centers for Disease Con-
of the competencies, input on the currency model development initiative is the gradua- trol and Prevention.

1606 | Framing Health Matters | Peer Reviewed | Weist et al. American Journal of Public Health | September 2008, Vol 98, No. 9
  FRAMING HEALTH MATTERS 

Human Participant Protection curriculum content in schools of public health: a base-

All participants were national academic and practi- line assessment. Am J Public Health. 2004;94:10,
tioner leaders serving as voluntary members of work- 1671–1674.
groups and task forces for the purpose of providing
16. Garman AN, Johnson MP. Leadership competen-
advice and counsel, as well as their opinions for the
cies: an introduction. J Healthc Manag. 2006;51:1,
study. They were fully informed of all of the methods
13–17.
both verbally and in writing. For each Delphi opinion
survey round, they had the option to participate or not. 17. Accreditation Standards for Graduate Schools of
Data were collected anonymously and were reported Public Health. Washington, DC: Council on Education
on a cohort basis only. No protocol approval was for Public Health; 2002.
needed for this study. 18. Accreditation Criteria for Schools of Public Health.
Washington, DC: Council on Education for Public
Health; 2005. Available at: [Link] Ac-
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