ADVANCEMENT OF THE PRACTICE
al., 2021). To summarize, a CoP was formed using exponential nondiscriminative snow- ball sampling of our existing contacts (Eti- kan et al., 2016; Goodman, 1961). This CoP was composed of EHPs and academics who assessed the activities, skills, and knowledge held by EHPs in the U.S., UK, and Austra- lia that allow EHPs to practice under their respective public health legislative and regu- latory guidelines. We used the following skills and knowledge bases for our comparison: • The U.S. skills and knowledge base were taken from accreditation guidelines from the National Environmental Health Sci- ence and Protection Accreditation Council (www.nehspac.org) and the NEHA Regis- tered Environmental Health Specialist/Reg- istered Sanitarian (REHS/RS) credential exam (www.neha.org/rehs-rs-exam). • The UK skills and knowledge base were taken from the Chartered Institute of Environmental Health (CIEH) Profes- sional Standards Framework v1.4 (www. cieh.org/professional-development/our- professional-standards). • The Australian skills and knowledge base were taken from the enHealth Environmen- tal Health Ocer Skills and Knowledge Matrix. These criteria are used by Environ- mental Health Australia to determine the content of university awards, which then allows graduates to practice as EHPs (www. eh.org.au/documents/item/868). These three sets of skills and knowledge bases were mapped for comparison (Supple- mental Tables 1–4, www.neha.org/jeh-sup plementals). Gaps in knowledge or skills that were identified were then considered in light of existing training oered by one or more of the countries to see if it would be possible for EHPs to obtain further study using existing short courses from one of the other countries. Where there are no readily identifiable formal educa- tional pathways to acquire the required addi- tional skills and knowledge, other pathways can be considered, including work experience and reflective practice reports (Figure 1). Results The results of the skills and knowledge mapping of UK/Australia and U.S./Australia clearly showed that most practice areas were duplicated by all three countries. Addition- ally, in all curricula for these three countries, we found a fundamental science foundation,
risk assessment skills, an understanding of policy and legislation implementation, and the capacity to communicate with both the public and other health professionals. Moreover, we found only minor gaps in the knowledge and skills of EHPs who were qualified to practice in the other countries (Supplemental Table 5). Next, we detail how these minor gaps could be addressed. The UK/Australia mapping showed that UK-trained EHPs hold all the skills and knowl- edge to practice in Australia. We identified one main area of dierence: EHPs in the UK are responsible for housing, for which there is no comparable responsibility for EHPs in Aus- tralia. This gap can be addressed through an existing short course oered by CIEH, Under- standing and Applying the HHSRS (Housing and Health Safety Rating System). The U.S./Australia mapping identified that GIS knowledge and knowledge of injury and violence prevention were lacking from Austra- lia’s EHP curriculum. To address this gap, we propose that existing science and risk assess- ment knowledge held by qualified EHPs from Australia likely provides a transferable under- standing of these areas. Alternatively, candi- dates could take the U.S. EHP exam (i.e., the NEHA REHS/RS credential exam). Discussion and Conclusion We have demonstrated that there are few dif- ferences in the skills and knowledge of prac- ticing EHPs across the U.S., UK, and Australia, which indicates that although jurisdictional pieces of legislation will need to be under- stood by EHPs who practice in another coun- try, the foundational knowledge and skills are consistent across these three countries. Our work shows that these three countries approach environmental health practice in a similar way. It is also clear that the accredita- tion requirements and the level of academic rigor that underpins these requirements are comparable, which is interesting because envi- ronmental health practice has shifted over the past 30 years. For example, in Australia, a sub- university award (i.e., lower than university but post-secondary level education) was the qualification required to practice as an EHP in the 1990s, but this requirement has shifted to a university-level degree, or even postgraduate award (Environmental Health Australia, n.d.). The ongoing comparability of the environ- mental health practice across these countries
indicates the ongoing academic advancement of the profession. This comparability also supports the idea that environmental health encompasses a diverse set of practice require- ments (enumerated in the Introduction) that are reflected internationally. We have provided strong evidence that recognition for the practice of environmental health exists across the U.S., UK, and Austra- lia and is possible because of the comparabil- ity of these countries’ practice requirements. We have identified some minor gaps in skills and knowledge and identified pathways for these gaps to be filled in a practicable way. The next step for these three countries is to engage with the relevant professional bodies (i.e., Environmental Health Australia, CIEH, and NEHA) to develop MOUs that would be publicly available. This step would demon- strate clearly to interested parties the route that needs to be taken to engage in EHP prac- tice across countries, which would require a commitment from the relevant professional bodies (Figure 1). It is well recognized that support from professional bodies is impera- tive for organizational change (DuFour, 2004; Greenwood et al., 2002). Limitations of our overview include that the scope is restricted to the opinions and work undertaken by our group. Further, there are dierences in practice, terminology, and legal tools used in dierent countries. Additionally, our mapping represents a point in time—the documents that were used will inevitably change as requirements in EHP practice change. The next step for our CoP is to initiate the mapping exercise with other countries, start- ing with European Union countries, specifi- cally Portugal and Estonia, as these countries are already represented in our CoP. We also invite any other academics or professional bod- ies who might be interested in engaging in this exercise to contact the corresponding author. This invitation is particularly for any parties in Asia, the Americas, or Africa, as we are inter- ested in how we might involve these continents to advance global recognition of environmental health practice across dierent countries. Corresponding Author: Kirstin Ross, Profes- sor, Environmental Health, College of Sci- ence and Engineering, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia. Email: kirstin.ross@flinders.edu.au
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