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Report of the Tracking Network Workgroups Download as PDF [199 Kb]


The environment unquestionably plays an important role in human development and health. Although some links between environmental exposures and diseases--such as asbestos and lung cancer--are well documented, others--such as environmental exposures and childhood cancers--remain unproven. Domestic environmental public health concerns need to be addressed first; however, ultimately global issues need to be addressed because many environmental public health threats do not respect national boundaries.

We need to be able to respond to all the environmental public health objectives presented in Healthy People 2010. The critical importance of achieving these objectives is reflected in the "Environmental Health" component of this document where it states, "Poor environmental quality is estimated to be directly responsible for approximately 25 percent of all preventable ill health in the world..." Source: Report of the CDC/ ATSDR Working Group on a Shared Vision for Environmental Public Health at CDC/ATSDR, December 2000.

Accessing, analyzing, and acting on health and health-related data are fundamental to the practice of public health. Yet, the public health system as it relates to environmental public health often does not have access to health data. In January 2001, The Pew Environmental Health Commission addressed the environmental public health capacity of the U. S. in its report, America's Environmental Health Gap: Why the Country Needs a Nationwide Health Tracking Network. The report described a lack of basic information with which to document possible links between environmental toxins and chronic and other diseases. The Pew report also indicated that the nation's preparedness against terrorism underscored the need for a strong tracking infrastructure to detect and respond to environmental threats and disease outbreaks caused by terrorist attacks. The Pew report presented a compelling way to address this gap: integrate tracking systems for chronic and other diseases, environmental exposures, and environmental hazards; link and analyze data from these systems; and implement disease prevention strategies.

"Few would dispute that we should keep track of the hazards of pollutants in the environment, human exposures, and the resulting health outcomes--and that this information should be easily accessible to public health professionals, policy makers, and the public. Yet even today we remain surprisingly in the dark about our nation's environmental health." Source: Pew Environmental Health Commission, America's Environmental Health Gap: Why the Country Needs a Nationwide Health Tracking Network.

From the Pew Report into Action

The Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR) work jointly on important environmental public health problems. In August 2001, following up on the Pew report, CDC and ATSDR developed a document entitled CDC and ATSDR's Proposed Plan for an Environmental Public Health Tracking Network. The plan described methods to 1) develop and implement an integrated tracking system, 2) strengthen the environmental public health workforce at the state and local levels, and 3) improve collaboration among agencies and organizations that have environmental public health and environmental protection responsibilities.

The CDC and ATSDR Tracking Vision

The CDC and ATSDR tracking vision is that human health will be improved by tracking and linking health data to environmental hazards and exposures and ensuring that communities have the capacity act on this information. Implicit in this vision are the following elements:

  • A nationwide environmental public health tracking network (EPHTN) that will lead to local public health actions
  • State and local public health and environmental protection agencies that have the human and financial resources necessary to develop comprehensive and sustainable environmental health programs grounded in good science
  • Federal environmental public health and environmental protection systems linked to each other and to states, communities, and citizens

When fully implemented, the tracking network is expected to enable public health and environmental protection agencies to rapidly detect emerging environmental public health threats, including disease clusters; to develop, implement, and evaluate the efficacy of control strategies; and to ensure an informed and participating public.

The Workgroup Process

To develop practical recommendations for implementing an EPHTN as envisioned in CDC and ATSDR's Proposed Plan for an Environmental Public Health Tracking Network, NCEH, the lead CDC organization for the tracking program, identified 75 senior scientists, managers, and policy specialists from 27 agencies and organizations to serve on workgroups to address tracking issues (Attachment A). Where appropriate, the workgroups were asked to suggest recommendations for CDC Requests for Proposals (RFP) for tracking projects and to develop recommendations for the tracking network as a whole. Workgroups provided input without regard to current and future budget projections of CDC and ATSDR and partners while recognizing that the pace by which recommendations can be addressed is influenced by dollar and staff resources.

NCEH sponsored four workgroup meetings: an orientation meeting for workgroup members in October 2001 and three, 2-day workgroup meetings in December 2001 and January and March 2002.

The workgroups addressed the following areas:

  • Workgroup 1: Organization and management (led by Mr. Michael J. Sage, Associate Director, Office of Policy, Planning, and Evaluation, NCEH) to define roles and promote collaboration between state and local public health and environmental protection agencies and among CDC and ATSDR, the Environmental Protection Agency (EPA), and other partners; and to identify state and local capacity needed to implement the tracking network
  • Workgroup 2: Data technology and tracking methodology (led by Ms. Donna Knutson, Executive Director, Council of State and Territorial Epidemiologists) to identify relevant national data standards; to establish system specifications; and to describe potential prototypes or models for automating, linking, and analyzing hazard, exposure, and health outcome data
  • Workgroup 3: Tracking system inventory and needs assessment (led by Ms. Leslie Tucker, Director of Environmental Health, American College of Preventive Medicine) to identify and describe existing tracking systems at the national, state, and local levels; to determine priorities for integrating existing tracking systems; and to identify and prioritize the development of new systems
  • Workgroup 4: Translation, policy, and public health action (led by Ms. Georgi Jones, Director, Office of Policy and External Affairs, ATSDR) to define state, local, and federal actions that can ensure rapid and effective responses to data and other information generated by the environmental public health tracking network (e.g., implementing disease prevention strategies and initiating prevention research)


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