This study was performed to determine the expected competencies of environmental health graduates in a way to be able to manage environmental and Social Determinants of Health. The results showed eight competency areas and 29 competencies. The competency areas were expert knowledge, reasoning and planning, advocacy, system-based practice, professionalism, instructional expertise, social and personal skills, and research expertise which are necessary for training environmental health experts.
Among determined priorities in competency areas, were advocacy, personal and social skills, and system-based practice. These results cohere with the findings of some previous researches. Marandi and Vahidi showed that these competencies were necessary for having organizations’ and institutions’ support and participation to control Social Determinants of Health [16, 17]. Alami, sited from final report of SDH commission of World Health Organization (2008), had pointed to participation of organizations who were effective on SDH, in health sector activities . In their study with the title “a review on 3-year performance of health and food safety councils”, Damary and colleagues have mentioned that improving health indices in national and provincial level needed inter-sectional cooperation and people’s participation. Also, according to their investigation, informing stake holders and people of the society as well as using advocacy technique for developing inter-sectional cooperation was important. Moreover, they have mentioned that empowering faculty members for improving their attitude and skills towards SDH approaches were important activities . Likewise, in DeVoe and colleagues’ study about primary health vision for integrating SDH, they have pointed to cooperation between different organizations, standardizing the data collection and presentation, and participation in health activities of society as important tasks . In fact, the responsibility of providing society’s health is much more than what Ministry of Health can provide by itself and needs inter-sectional coordination and cooperation and using all their capacities.
Wartman and colleagues, in their study about the role of university health centers in addressing social responsibilities, have paid attention to issues such as creating inter-disciplinary relations, making interaction between professions and disciplines, and developing multidisciplinary groups  which matches the results of the present study. In another study in Swaziland University regarding developing graduate studies, they have determined the needs of stake holders and organizations regarding environmental health, and the results have emphasized on practical skills, research capabilities, project management, entrepreneurship skills, advanced lab analysis skills, and computer skills, which mainly corresponds to the results of the present study . Most of these studies also show, in addition to advocacy and system-based practice, there is a need to personal, social and research capabilities in order to promote society’s health and manage SDH.
The present study also emphasized on reasoning and planning as needed capabilities. The result of Grimm and colleagues’ study in Nebraska University in 2012 showed that cultural capabilities and communication skills were two important competencies needed in public health. Their results, also revealed that the most emphasized educational needs were financial planning, managerial skills, and analytical/assessment skills . These results are almost the same as the results of the present study especially in the fields of communication skills, reasoning, and planning. In another study by Hamdi and colleagues about Job analysis of environmental health staff, some tasks such as health education, assessment of health services provided in health networks, being familiar with environmental health regulations, and computer software have been mentioned as educational needs . These educational needs are mostly in areas of education, reasoning and planning, professionalism, and system-based practice which correspond to present study.
The review of other studies showed that each study had pointed to some of the competencies needed to manage Social Determinants of Health. While the present study tried to determine most of the needed competencies for managing SDH, in the context of Iran. Although, we tried to encompass a comprehensive view toward responding the research question using literature review, one of the limitations of this study was not using the views of more faculty members and experts other universities of Iran. But the strength of this study was suing the views of faculty members and experts in the field of Social Determinants of Health as well as environmental health staff which gave us a vast range of all stakeholders’ views.