Tracking: Closing America's Environmental Public Health Gap
2004 At A Glance (Download as PDF Cdc-pdf
Environmental Public Health Tracking: Linking Hazards, Exposures and Health Effects
The environment plays an important role in human development and health. Researchers have related exposures to some environmental hazards with specific diseases; for example, exposure to asbestos and lung cancer. Other associations between environmental exposures and health effects are suspected, but need further research; for example, the association between exposure to disinfectant by-products and bladder cancer. Currently, few systems exist at the state or national level to track many of the exposures and health effects that may be related to environmental hazards. Tracking systems that do exist are usually not compatible with each other, and data linkage is extremely difficult.
Environmental public health tracking (EPHT) is the ongoing collection, integration, analysis, and interpretation of data about environmental hazards, exposure to environmental hazards, and human health effects potentially related to exposure to environmental hazards. It includes dissemination of information learned from these data.
The mission of EPHT is to improve the health of communities. Using information from an environmental public health tracking network, federal, state, and local agencies will be better prepared to develop and evaluate effective public health actions to prevent or control chronic and acute diseases that can be linked to hazards in the environment. Health care providers can provide better care and targeted preventive services. In addition, the public will have a better understanding of what is occurring in their communities and what actions they may take to protect or improve their health.
CDC’s Environmental Public Health Tracking Program
In fiscal year (FY) 2002, CDC established its National Environmental Public Health Tracking Program. The program’s goals are to (1) build a sustainable national EPHT network, (2) increase EPHT capacity, (3) disseminate credible information, (4) advance environmental public health science and research, and (5) bridge the gap between public health and the environment. Congress appropriated $17.5 million in FY 2002, $27.5 million in FY 2003, and $27.4 million in 2004 for the program. Since FY 2002, CDC has supported 20 state and local health departments and three schools of public health to (1) build environmental public health capacity, (2) increase collaboration between environmental and health agencies, (3) identify and evaluate environmental and health data systems, (4) build partnerships with non-government organizations and communities, and (5) develop model systems that link environmental and health data and that other states or localities can use. CDC is funding schools of public health to support state and local health departments and investigate possible links between health effects and the environment.
In FY 2003, CDC also began supporting nine states and New York City to conduct projects that will link environmental, exposure, and health effect data. CDC has awarded funding to professional national organizations to develop educational materials and tools to promote environmental public health tracking among state health officials and other critical partners. CDC also has established a memorandum of understanding with the National Aeronautics and Space Administration and, through the Department of Health and Human Services, with the Environmental Protection Agency to promote collaboration on environmental public health tracking-related initiatives. CDC’s internal workgroup that coordinates EPHT activities includes CDC expertise in environmental health, epidemiology, chronic disease prevention, birth defects and developmental disabilities, health statistics, integrated health information systems, injury prevention, and occupational safety and health.
Examples of Funded Program Activities
Part A Grantee
The Maine Department of Human Services (MDHS) (http://www.state.me.us/dhs/bohExternal
Part B Grantee
The Missouri Department of Health and Senior Services (MODHSS) (http://www.dhss.state.mo.us/EPHT/External
Data Linkage Demonstration Grantee
The New Jersey Department of Health and Senior Services (NJDHSS) (http://www.state.nj.us/health/eoh/External
Centers of Excellence Grantee
The University of California Berkeley’s (UCB) School of Public Health (http://sph.berkeley.edu/External
Examples of CDC’s External Partners
- Association of Public Health Laboratories
- Association of State and Territorial Health Officials
- Council of State and Territorial Epidemiologists
- Environmental Council of the States
- National Aeronautics and Space Administration
- National Association of County and City Health Officials
- National Environmental Health Association
- Physicians for Social Responsibility
- U.S. Environmental Protection Agency
Environmental Public Health Indicators Project
Several state and local health departments that have been funded as part of the National Environmental Public Health Tracking Program are evaluating the utility of environmental public health indicators (EPHIs). Health indicators are used to measure the health of a community, county, city, state, or the nation. Indicators may be used to assess baseline status and trends, track progress toward program goals and objectives, and build core surveillance capacity in state and local agencies. An EPHI framework was designed to be needs-based and to assist the states in meeting Healthy People 2010 objectives. The best indicators reliably predict the relationship between human health and the environment, are routinely collected, and have well-accepted definitions and data collection standards.
EPHIs provide information about a population’s health status with respect to environmental factors and may be particularly useful when measurable links are not clear. As such, they can be used to measure health or a factor associated with health in a specific population. For example, because the amount of lead in paint in older homes is difficult to measure, we use blood lead measurements in children to indicate both the lead paint hazard and the risk for childhood lead poisoning. For more information about EPHIs, visit http://www.cdc.gov/nceh/indicators/.
Future Directions
As additional funding becomes available, CDC plans to strengthen the program in the following ways:
- Fund additional state, local, territorial, and tribal health departments to increase their capacity building and demonstration projects
- Fund technical development activities required to support a nationwide network
- Expand training and education activities in collaboration with national and professional organizations
- Expand collaboration with national partners to coordinate technologic standards development efforts for the network