FAQ’s About Workforce Competencies

Q: What does genetics have to do with public health?

A: The goal of public health is to prevent disease. To accomplish this goal, public health has focused on moderating environmental factors such as behaviors and exposures. Genetic factors play a significant role in the development of adult-onset diseases such as cancer, diabetes, and heart disease. In fact, virtually all human diseases result from the interaction of genetic variation with environmental factors. By identifying people who are susceptible to a particular disease because of their genetic make-up and determining and manipulating associated environmental factors, public health can target intervention strategies to people who will benefit most, prevent the development of disease, and improve health.

Q: What are workforce competencies?

A: Competencies are skills, knowledge, and attitudes necessary for the effective practice of public health. Competencies are crosscutting because they are for all workers in public health and are also specific to certain disciplines within public health. Competencies are a guide for public health workforce development including curriculum and the content of public health education and training programs.

See: Core Competencies for Public Health Professionals – A Project of the Council on Linkages Between Academia and Public Health Practice

Q: Who is considered the public health workforce?

A: The public health workforce includes over 500,000 people working in local, state, and federal public health programs and the volunteers involved in public health and local, state, and national boards of health.

Q: Who developed the genomic competencies?

A: The competencies were developed by a team of leaders in public health currently working in local, state, and federal public health programs as administrators, clinicians, environmentalists, epidemiologists, health educators, and laboratory directors. They supported the development of genomic competencies and personally saw the
need for additional training in genomics in their daily work in public health programs.

See: Team Leaders, Members, and Staff

Q: Who will use genomic competencies?

A: Competencies are intended for public health workers who do not have a primary focus in genetics and do not currently have a degree in a genetics related field. Competencies are for those individuals where genetics currently plays a small or non-existent role in their day-to-day professional life, but will play an increasing role in the future.

Q: How are competencies organized?

A: Competencies are organized by increasing levels of responsibility. Someone working in a public health program without a leadership role would be expected to accomplish the first short list of 3 competencies. Individuals with a professional role in public health would be expected to accomplish the short list of 3, the list for all public health professionals, and the list for their area of concentration.

Q: What does genomics mean?

A: The term genomics is a new and just beginning to appear in popular and scientific literature. A standard definition, although evolving, is not yet available. For the purpose of these competencies, team leaders felt it important to define our use of genomics.

We used the term genomics to refer to the new information emanating from the Human Genome Project. This information supports the idea that common diseases are the result of the interactions between two or more genes and the interactions between genes and environments. Genomics is an interdisciplinary term —bringing biology together with the environment, with epidemiology, with mathematics, etc.

Genomics is also associated with the notion that certain genes predispose people to such common diseases as colon cancer, breast cancer, diabetes and arteriosclerosis while still other genes play a role in prevention. These common diseases apparently manifest when predisposing genes are present, protective genes are absent, and environmental triggers exist. Common conditions potentially prevented by genetic mutations include HIV, cancer, and diabetes. Genes also play a role in differences in susceptibility to environmental exposures such as asthma.

In this document, the term genomics often replaces the term genetics to encourage readers to expand their concept of genetics to include this interplay of genes and the environment. Our use of the term genomics does not imply that single gene disorders and traditional medical genetic services are less important or that public health providers need not be concerned about assessment, access, and quality issues in this arena.

Q: What is genomic medicine?

A: Genomic medicine is the use of genotypic analysis (DNA testing) to enhance the quality of medical care, including presymptomatic identification of susceptibility to disease, preventive intervention, selection of pharmocotherapy, and individual design of medical care based on genotype. The Metabolic & Molecular Bases of Inherited Disease, 8th
edition, page 4.

Q: Why Genomic workforce competencies?

A: Genomic competencies are not meant to replace general public health competencies or those written for academia or for other disciplines. Some disciplines, such as Genetic Counselors, have already created a general set of competencies specific to their profession. Genomic competencies were designed to enhance these competencies and as an aid to groups who are developing or updating their own set of competencies.

Q: With so many pressing public health issues, why is it important to develop genomic competencies now?

A: Rapid advances in human genetics are beginning to change the clinical diagnosis and treatment of chronic diseases such as cancer and diabetes, etc. Increasingly, public health workers will be asked to incorporate genetic information into public health practice. An understanding of genetics as it pertains to each public health discipline will be essential to develop programs that benefit the public.

Q: Aren’t competencies mainly for health care providers and health professionals?

A: Competencies are for everyone in public health. Historically, clinicians have been the first to use genetic information in practice, but public health workers will be increasingly called upon as to use genetic information in population-based prevention programs. People in public health who are responsible for policy decisions about healthcare services and disease prevention efforts need competencies. Public health programs tracking the incidence of disease and the effectiveness of prevention efforts need to include genetic factors in their evaluation. Competencies are also for volunteers, clerical personal, health educators, and others at all levels of skill and education.

Q: When will the competencies be finished?

A: The genomic competencies are a starting point for public health programs to use as they begin to incorporate genetic discoveries into public health. The genomic competencies are not intended as a standard or required list.

The competencies will evolve as new discoveries naturally expand the scope of genetics in public health and the needs of public health change.

Q: What is next?

A: Hopefully public health programs and academic programs will evaluate their current competencies and begin to incorporate the genomic competencies.