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Background


The Need

The environment plays an important role in human development and health. Researchers have linked exposures to some environmental hazards with specific diseases. One example is the link between exposure to asbestos and lung cancer. Another example is the link between exposure to lead and decreased mental function in children. However, other links remain unproven, such as the suspected link between exposure to disinfectant byproducts (for example, chlorine from showerheads) and bladder cancer.

In 1988, in its report "The Future of Public Health," the Institute of Medicine noted that the removal of environmental health authority from public health agencies has led to fragmented responsibility, lack of coordination, and inadequate attention to the health dimensions of environmental problems.

In January 2001, the Pew Environmental Health Commission issued the report "America's Environmental Health Gap: Why the Country Needs a Nationwide Health Tracking Network." [PDF 30 Kb] The report, which stated that the existing environmental health system is neither adequate nor well organized, recommended the creation of a "Nationwide Health Tracking Network for disease and exposures."

At that time, no systems existed at the state or national level to track many of the exposures and health effects that may be related to environmental hazards. In addition, in most cases, existing environmental hazard, exposure, and disease tracking systems were not linked together. Because existing systems were not linked, it was difficult to study and monitor relationships among hazards, exposures, and health effects. The Tracking Network is CDC's answer to these issues.

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Development

Environmental public health tracking is the ongoing collection, integration, analysis, and interpretation of data about the following factors:

  • environmental hazards
  • exposure to environmental hazards
  • health effects potentially related to exposure to environmental hazards.

The goal of environmental public health tracking is to protect communities by providing information to federal, state, and local agencies. These agencies, in turn, will use this information to plan, apply, and evaluate public health actions to prevent and control environmentally related diseases.

In fiscal year 2002, Congress provided CDC with initial funding to:

  • begin developing a nationwide environmental public health tracking network
  • develop capacity in environmental health within state and local health departments.

 
CDC's goal was to develop a tracking system that integrates data about environmental hazards and exposures with data about diseases that are possibly linked to the environment. This system allows federal, state, and local agencies, and others to:

  • monitor and distribute information about environmental hazards and disease trends
  • advance research on possible linkages between environmental hazards and disease
  • develop, implement, and evaluate regulatory and public health actions to prevent or control environment-related diseases.

Planning for an environmental public health tracking network is an important priority for CDC because of the opportunity it provides to address some of the most challenging problems facing local, state, and national public health leaders. From the outset, this activity has involved substantial collaboration between CDC and public health and environmental partners (e.g., see the memorandum of understanding between CDC and the Environmental Protection Agency).

CDC assembled four workgroups to develop recommendations for the environmental public health tracking program. The workgroups included representatives from 30 organizations, including the following:

  • Federal agencies
  • State and local public health and environment agencies
  • Non-governmental organizations
  • Academic institutions.

The workgroups addressed the following topics:

  • Organization and management
  • Data technology and tracking methodology
  • Tracking system inventory and needs assessment
  • Policy, and public health action.
     

See Report[PDF 199 Kb] of the Tracking Network Workgroups for further details.

From 2002 to 2006, Congress provided funding to CDC for pilot projects. CDC began working with state and local health departments, federal partners, professional partners, and community groups to lay the foundation for a system to track environmental hazards and the health problems they may cause.

In 2006, Congress began funding the implementation of the National Tracking Network. With this money, CDC funded health departments in 16 states and 1 city to build local tracking networks that contribute to the National Network. In addition, CDC funded 4 academic partners and continued to work with several federal partners. In 2009 and 2010, Congress increased funding for the Tracking Network and CDC was able to fund an additional 7 states, and now funds 5 academic partners.

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Tracking Network Vision Document

This document provides a vision for the Environmental Public Health Tracking Network. The document is designed to: 1) describe, at a conceptual level, the function and purpose of the Tracking Network, 2) provide a profile of the stakeholders and users of the Network, and 3) outline the major features of the Tracking Network.


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Tracking's National Network Implementation Plan

The National Network Implementation Plan (NNIP) [PDF 1.3 Mb] outlines the path that the Tracking Program is taking to develop and implement the Tracking Network. The plan supports achieving success in both immediate and long-term time frames while providing direction and guidance to the many stakeholders who contribute to the Tracking Network's ongoing development as well as the overall program's implementation. The NNIP gives insight into the topics and approaches that lead to improved network performance, sustainability, quality, and focus. The NNIP outlines CDC's strategy for developing and implementing the Tracking Network by clarifying functions and components and describing approaches to developing the components. Specifically, the NNIP

  • describes the background, context, needs, and goals of the Tracking Network;
  • outlines the principal functions and components of the Tracking Network;
  • discusses the steps needed to implement the components; and
  • identifies the entities responsible for taking the implementation steps.

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CDC's Strategy for the National Tracking Program (Fiscal Years 2005-2010)

Defines the vision, mission, and five goals that set the direction of the Tracking Program ...more[PDF, 1 Mb]

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Tracking Network Vision Document (2004)

This document provides a vision for the Environmental Public Health Tracking Network. The document is designed to 1) describe, at a conceptual level, the function and purpose of the Tracking Network, 2) provide a profile of the stakeholders and users of the Network, and 3) outline the major features of the Tracking Network ...more[PDF, 213 Kb]


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