large. For this reason, the committee recommends that leadership training, support, and development be a high priority for governmental public health agencies and other organizations in the public health system and for schools of public health that supply the public health infrastructure with its professionals and leaders.
Credentialing is a mechanism that is used to certify specific levels of professional preparation. There are many different forms of credentials, including academic degrees, professional certifications, and licenses. For example, medical credentials include medical degrees to certify successful completion of course work, professional testing (e.g., through medical board exams) to provide evidence of qualification to practice medicine, and medical licensing to establish compliance with state standards for medical practice. An individual credentialed as a Certified Health Education Specialist (CHES) has successfully completed a course of study and passed a competency-based test.
Although some public health workers are credentialed as physicians, nurses, health educators, or environmental health practitioners, few are credentialed within those professions specifically for public health practice. Most physicians working in public health lack board certification in preventive medicine or public health; most nurses working in public health lack credentials in community public health nursing; and most individuals working as health educators lack the CHES credential. Furthermore, no single credentialing or certification process has been established to test the various competencies required for the interdisciplinary field of public health; thus, the majority of the public health workforce (80 percent) lacks credentials (HRSA, 2000).
Given the importance of establishing and maintaining a competent public health workforce, CDC and other public health agencies and organizations, including NACCHO, the Association of State and Territorial Health Officials (ASTHO), the Association of Schools of Public Health, and the American Public Health Association (APHA), are examining the feasibility of creating a credentialing system for public health workers based on competencies linked to the essential public health services framework. CDC (2001d) has recommended the use of credentialing. Such a process would complement efforts to establish national public health performance standards for state and local public health systems based on the essential public health services framework and the related objectives of Healthy People 2010 (Objective 23–11) (DHHS, 2000). Although this national effort focuses on experienced public health leaders, support is growing for the concept of credentialing at a basic level all public health workers and at an