Developing Integrated Multistate Environmental Public Health Surveillance

Abstract

Environmental exposures cause substantial morbidity and mortality in the United States. A major goal of Centers for Disease Control and Prevention Environmental Public Health Tracking program is the development of a national network of health and environmental data with analytic tools for rapid evaluation of specific national or regional environmental health concerns. A six-state collaborative project in the northeast United States was established to assess the feasibility of such a system, assessing the possible association between ambient air quality and adverse birth outcomes. For this regional surveillance project, issues were discussed surrounding the design of a mutually acceptable protocol, obtaining human subjects’ protection approvals, obtaining and organizing both the exposure and outcome data, analyzing the data both locally and regionally, and planning subsequent interventions to address identified public health concerns.

A Decade of Environmental Public Health Tracking (2002-2012)

“…7,32,41,50-52 Thirty percent of the articles in this group were related to best practices and offered guidance related to disease surveillance techniques for the Tracking Network. 15,30,45,54 Twenty percent of the publications described the accomplishments and challenges of developing the National Tracking Network. 12,38,47 …”

“…∥ Sixty-seven percent of the articles reviewed in this category related to collaborative efforts among local, state, and/or federal government agencies, 9,12,24,37,40,44 11% among Tracking grantees, 54 and 11% among community leaders. 18 One article (11%) described linking environmental data from an environmental agency with health data from health agencies to form a sustainable partnership.…”

“…Laflamme and Vanderslice 9 examined partnerships between state and federal agencies and suggested the use of environmental health–related modules as part of state BRFSS (Behavioral Risk Factor Surveillance Systems). Wartenberg et al 54 proposed an integrated regional, multistate collaboration between health departments using adverse birth health outcomes and outdoor air quality as a proposed model. Once developed, a collaborative environmental health surveillance would allow states to share standard data among themselves and analyze data for regional interpretations.…”

Engaging academia to advance the science and practice of environmental public health tracking

“…In collaboration with the U.S. Environmental Protection Agency (EPA), we have developed a hierarchical Bayesian model to predict daily PM 2.5 concentrations on a small scale (Vaidyanathan et al, 2013). Further we have hosted several workshops with EPA, academia, and state and local partners to identify and collaborate on common methodological challenges (Matte et al, 2009; Ozkaynak et al, 2009) and have evaluated the use of different data sources and methods for tracking health outcomes, exposures, and hazards (Beale et al, 2010; Rabito et al, 2007; Talbot et al, 2009; Wartenberg et al, 2008; Wilhelm et al, 2008; Young et al, 2008). …”

Advances and Current Themes in Occupational Health and Environmental Public Health Surveillance

“…After closure of the plant, PM 10 was not significantly associated with cardiorespiratory or cardiovascular disease hospitalizations. Moreover, other academic centers of excellence in EPHT have joined with CDC tracking states to consider specific regional environmental health concerns such as the relationship between air quality and adverse birth outcomes (129).…”