Introduction to Environmental Health Public Health Tracking
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Transcript of Introduction to Environmental Health Public Health Tracking
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Introduction to EnvironmentalPublic Health Tracking
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Objectives
Increase knowledge of the NationalEnvironmental Public Health TrackingNetwork
Develop skills in using the TrackingNetwork to mine data and identify trendsto address public health problems
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Preview
About National Environmental PublicHealth Tracking Network
Using the Tracking Network Tracking in Action: Success Stories
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NATIONAL ENVIRONMENTAL PUBLIC
HEALTH TRACKING NETWORK
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What is the National EnvironmentalPublic Health Tracking Network?
CDC's Tracking Network: Working Toward aHealthier Planet for Healthier People
http://www.youtube.com/watch?v=J42CLZH1NlE
http://www.youtube.com/watch?v=J42CLZH1NlEhttp://www.youtube.com/watch?v=J42CLZH1NlE -
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What is the Tracking Network?
A system of integrated health, exposure, andhazard information and data from a variety ofnational, state, and city sources
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Building the Tracking Network
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Why is the Tracking NetworkImportant?Before Tracking With Tracking
Simple questions could take months to
answer
Can respond quickly-often within hours-to
locate hazard sources or answer concerns
Environmental and health fields were
often separated
These two worlds are brought together to
the benefit of all
Focused mainly on acute events such as
hazardous chemical releases or point-
source pollution
Ability to trace amounts and geographic
spread of pollutants over time, allowing
monitoring of long-term trends and place
those acute events in context
Environmental health surveillance wasmore difficult than infectious disease
surveillance
The same "disease detective" skills can beapplied to finding environmental causes of
illnesses and then take preventive measures
to protect the public's health
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Why is the Tracking Network Important?
The Tracking Network canhelp: Determine areas with at-
risk populations Leverage resources anddevelop partnerships
Evaluation of control and
prevention measures Facilitate policydevelopment
http://ephtracking.cdc.gov/showBiomonitoringLanding.action -
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TRACKING NETWORK DATA
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Tracking Network Data Sources
Grantees Health departments in 23 states and 1 city(NYC)
Partners CDC programs
Federal agencies
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Data on the Tracking Network
Visit: http://ephtracking.cdc.gov/docs/EPHTDataSources.pdf
EnvironmentalHazard
Health
PopulationExposures and
Characteristics
http://ephtracking.cdc.gov/docs/EPHTDataSources.pdfhttp://ephtracking.cdc.gov/docs/EPHTDataSources.pdf -
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ENVIRONMENTAL HAZARD DATA
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Environmental Hazard Data
Air quality
Water quality
Climate change Community design
Homes
http://ephtracking.cdc.gov/showWaterLanding.actionhttp://ephtracking.cdc.gov/showCommunityDesign.actionhttp://ephtracking.cdc.gov/showClimateChangeLanding.action -
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Environmental Hazard Data: Air
Visit: http://ephtracking.cdc.gov/showAirLanding.action
http://ephtracking.cdc.gov/showAirLanding.actionhttp://ephtracking.cdc.gov/showAirLanding.action -
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ACTIVITYEnvironmental Hazard Data: Air
Air qualityMonitored data
Modeled data
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Environmental Hazard Data: Water
Water quality
Community water
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ACTIVITYEnvironmental Hazard Data: Water
How is community drinking watertracked?
What contaminants are being monitored?
What are the data sources?
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Environmental Hazard Data:Climate Change
Extreme heat Weather and health data can be used toidentify patterns in extreme heat and theirassociated health effects.
These indicators use data from the past toidentify extreme temperatures, deaths thatmight be related to heat, and conditions thatmake people vulnerable to heat.
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Environmental Hazard Data:Community Design
Types of transportation to work
Air quality (ozone and PM2.5)
Childhood lead poisoning Motor vehicle-related fatalities
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Environmental Hazard Data: Homes
Homes Childhood lead poisoning
Age of housing
Carbon monoxidepoisoning
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Environmental Hazard Data Limitations
Coverage
Spatial characteristics Temporal characteristics
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HEALTH DATA
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Health Data
Asthma
Birth defects
Cancer Carbon monoxide poisoning
http://ephtracking.cdc.gov/showCancerMain.action -
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Health Data
Childhood lead poisoning
Developmental disabilities
Heart attacks Reproductive and birth outcomes
http://ephtracking.cdc.gov/showHeartAttack.actionhttp://ephtracking.cdc.gov/showDevelopmentalDisabilitiesLanding.actionhttp://ephtracking.cdc.gov/showHeartAttack.actionhttp://ephtracking.cdc.gov/showRbMain.action -
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POPULATION DATA
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Population Data: Characteristics
Data that can provide context aboutrelationships between exposures andhealth effects Information about age, sex, race, and behavioror lifestyle may help us understand why aperson has a particular health problem
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Population Data:Biomonitoring/Population Exposures
Measures human exposure to environmentalchemicals, national estimates only
Visit: http://ephtracking.cdc.gov/showBiomonitoringTracking.action
Eleven Chemicals:
ArsenicBenzene
Cadmium
Chloroform
Cotinine
Lead
MercuryNaphthalene
Pyrene
Toluene
Uranium
http://ephtracking.cdc.gov/showBiomonitoringTracking.actionhttp://ephtracking.cdc.gov/showBiomonitoringTracking.action -
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USING THE TRACKING NETWORK
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Using the Tracking Network
Queries
Maps, charts, and tables
Share, and export
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Indicators and Measures
i.e. Heart Attacks
i.e. Hospitalizationsfor Heart Attacks
i.e. Number ofHeart Attacks
Content AreaIndicator
Measure
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Indicators and MeasuresContent Area Indicator Measure
Heart Attacks Hospitalizations for Heart Attacks Number of Heart Attacks
Asthma Asthma Prevalence among Children Percent of Children Ever Diagnosed
with Asthma
Asthma Hospitalizations for Asthma Crude Rate of Hospitalizations for
Asthma per 10,000 population
Cancer Incidence of Bladder Cancer Annual Number of Cases of Bladder
Cancer
Population
Characteristics
Demographic Measures Number of People
Climate Change Heat-Related Mortality Number of Deaths due to Heat
Stroke/Exhaustion by state, by
month, by yearHomes Blood Lead Testing and Age Housing Number of Homes Built Before
1950 (2000 census)
Visit: http://ephtracking.cdc.gov/showIndicatorsData.action
http://ephtracking.cdc.gov/showIndicatorsData.actionhttp://ephtracking.cdc.gov/showIndicatorsData.actionhttp://ephtracking.cdc.gov/showIndicatorsData.action -
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Air Quality Data Query
Visit: http://ephtracking.cdc.gov/showAirIndicators.action
http://ephtracking.cdc.gov/showAirIndicators.actionhttp://ephtracking.cdc.gov/showAirIndicators.actionhttp://ephtracking.cdc.gov/showAirIndicators.action -
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Air Quality Data Query
Year Number of Days Above Ozone
Air Quality Standard, San
Bernardino County
2003 125 counts
2004 118 counts
2005 110 counts
2006 116 counts
About the Indicator: Ozone - Days Above
Regulatory StandardThe number of days in which the daily
maximum 8-hour average ozone concentrationexceeds a standard provides an indication of
short-term spikes in ozone concentrations. This
may give you an idea of how many days per
year you may be exposed to unhealthy levels of
ozone.
Podcast: Asthma Rates and Air Quality
http://www2c.cdc.gov/podcasts/player.asp?f=5883117http://www2c.cdc.gov/podcasts/player.asp?f=5883117 -
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Health Data Query
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Health Data Query
Year Number of Days Above Ozone Air
Quality Standard, San Bernardino
County
Number of Heart
Attack Cases, CA
2003 125 counts 63,064
2004 118 counts 59,514
2005 110 counts 57,157
2006 116 counts 54,729
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Health Data Query
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Year Number of Days
Above Ozone Air
Quality Standard,
San Bernardino
County
(VERY HIGH)
Number of Heart
Attack Cases, CA
(HIGH nationally)
Number of Heart
Attack Cases, San
Bernardino
2003 125 counts 63,064 3,418
2004 118 counts 59,514 3,189
2005 110 counts 57,157 3,1692006 116 counts 54,729 2,886
Health Data Query
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ACTIVITY: Query
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Using the Tracking Network
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Map
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Chart
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Table
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Metadata
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Additional Features
Resources
Grantee tracking networks Secure portal Contextual information
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Why Use the Tracking Network?
Quantify the magnitude of a public health problem Detect unusual trends in health, exposures, and hazards
Identify populations at risk of environmentally relateddiseases or of exposure to hazards
Generate hypotheses about the relationship between healthand the environment
Direct and evaluate control and prevention measures andindividual actions
Facilitate policy development
Guide public health actions Educate the public so they can take action to protect their
health and the health of their families
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TRACKING IN ACTION: SUCCESS STORIES
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Success Story Saving Lives
Identifying the increases in preterm birth rates in Fresno County, CaliforniaWhat is the problem? Research shows preterm birth is associated with the mother's exposure to traffic pollutants
and lead. A routine review of data on the California Environmental Health Tracking Networkrevealed a pattern in the risk of preterm birth in Fresno County, one of the major populationcenters in the state's Central Valley area.What did Tracking do?
California's Tracking Program informed the Fresno Department ofPublic Health of the trends. The local health department askedthe Tracking Network for more data about: Preterm birth trends reported by race and ethnicity Maternal Infant Health (MIH) indicators, including very preterm birth
(less than 32 weeks gestation) Rates by census tractsImproved public health
Fresno County used the information to identify locations for targeting activities that arerelated to childhood lead poisoning, air quality, and asthma. Fresno County officials reportedthat the data and assistance from the tracking network were very helpful to the localchildhood lead poisoning prevention program.
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Success Story Protecting People
Answering community concerns about cancer in MarylandWhat is the problem? Community concerns about cancer and potential links to environmental hazards occur relatively
frequently in Maryland. Before the Maryland Tracking Program began in 2002, most concerns aboutcancer and the environment were addressed only by the Maryland Cancer Registry and possibly localhealth departments. Maryland had no systematic way to respond to frequently asked questions fromindividuals, groups, and communities about cancer and the environment.
What did Tracking do? The Tracking Program, working with the Maryland Cancer Registry, geocoded all residential addressesin the Registry. Now the Maryland Cancer Registry can accurately show cancer data in maps andcarry out geospatial analyses of cancer information. Also, for the first time, there is an establishedprocess for evaluation of cancer concerns in Maryland. The new process involves a coordinatedresponse that includes the Maryland Cancer Registry, the Center for Environmental HealthCoordination, the Maryland Department of the Environment (MDE), and local health departments andis now available on the Tracking Program's Web site.Improved public health
The Tracking Program has worked with the Maryland Cancer Registry on two major cancerinvestigations, one in Poolesville and another in Frederick. The first looked at concerns about cancerand drinking water; the second involved concerns about cancer in a community. In both cases, theMaryland Tracking Program provided maps showing the geographic distribution of cancer and geo-statistical analyses of the cancer cases. The results of these two investigations were presented atcommunity meetings. To date, there is no evidence of cancer clusters, but experts were able toanswer questions from community residents.
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Success Story Protecting People
Lowering exposure to arsenic fromprivate well water in UtahWhat is the problem? Some Millard County residents use private wells for cooking and drinking
water. The Health Hazard Assessment team of the Utah Department ofHealth confirmed that in the Delta Conservation Districts, many of theprivate wells had arsenic concentrations high enough to be an urgent
public health hazard.What did Tracking do? The Health Hazard Assessment team used drinking water data from the
Utah Tracking Network to assess health effects in residents of MillardCounty caused by drinking arsenic-contaminated water from private wells.Improved public health
Due to the high levels of arsenic found in this study, the Health HazardAssessment team recommended that well water in this area not be used fordrinking or cooking. They also suggested that residents of the areapurchase and install water systems to reduce arsenic exposure in thecommunity. Arsenic levels in water will be monitored until amounts are atlevels that are not harmful to human health.
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Success StoryProtecting PeopleHeat Wave PreparednessWhat is the problem? During the California 2006 heat wave, there were 140 confirmed deaths and an additional 515 suspected
deaths due to extreme heat. An estimated $133 million in health-related costs was attributed to the heatwave, along with an estimated $500 million in agriculture-related costs from the loss of livestock. Heatwaves have and will continue to impact all regions of California, including urban, rural, inland, and coastalareas. In California, heat waves are expected to become longer and more frequent over time.
What did Tracking do? The California Tracking Program worked with the Bay Area National Weather Service (NWS) regional office toconduct a study to determine if heat alerts accurately predicted times when people suffered the most heat
illness. NWS monitors temperature and issues heat alerts. The heat alerts serve as triggers for cities andcounties to take preventative action, such as opening cooling centers where the public can gather for life-saving relief from the heat. The California Tracking Program showed that heat-related emergency room visitspeaked immediately following heat alerts for the San Jose area and subsided when the heat alerts werediscontinued. Due to budget cuts, the City of San Jose wanted scientific evidence from NWS to show therewas a need for cooling centers during heat waves. Without this proof, decision-makers would not approvethe opening of cooling centers as part of the city's heat alert response plan for the upcoming summer.
Improved public health NWS presented the California Tracking Program study findings to City of San Jose decision-makers. Based
on this evidence, the city decided to allow cooling centers to open as part of the city's heat alert response.The California Tracking Program is partnering with NWS to conduct similar studies for other regions inCalifornia, including Los Angeles. This information will help cities to make decisions about heat wavepreparedness policies and help NWS refine its heat alert system for each region.
S S S i M
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Success Story Saving MoneyThrough Prevention
Informing health care providers about asthma in NYCWhat is the problem? Each Fall NYC sees a large increase in hospital stays and in emergency
department visits for asthma, especially among children. Illness ratesin the fall can be three times higher than rates during the summer.Possible reasons include infections among children returning to school,seasonal pollen, and cooler weather.What did Tracking do?
The NYC Tracking Program analyzed childhood asthma data. It usedthe results to write messages for health care providers. Themessagessent through the city's Health Alert Networkurgedproviders to update patients' asthma management plans in time forschool year start.Improved public health
In the last few years, the seasonal fall mailing to health care providersand other asthma prevention activities have coincided with a decreasein rates of NYC hospital stays among children. Because of theprogram's success, advisories to health care providers have become astandard practice at the beginning of each school year in NYC.
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Success Story Educating Communities
Louisiana - Deepwater Horizon (British Petroleum) Oil SpillWhat is the problem? On April 20, 2010, a drill rig explosion caused about 4.9 million barrels of oil to spill into the
Gulf of Mexico. The explosion killed 11 platform workers and injured 17. Marine and wildlifehabitats were severely affected, and the fishing and tourism industries of U.S. coastal stateswere devastated.
What did Tracking do? The Louisiana Tracking Program has been developing an oil spill response plan in
collaboration with CDC/ATSDR*, CDC/NIOSH+, and agencies from other affected Gulf Coaststates. Survey- and map-based tracking systems were developed to capture and track healthcomplaints and environmental monitoring results. In addition, the Louisiana Tracking Programworked with the Occupational Safety and Health Administration (OSHA) to make sure thatoutreach materials were available in several languages and available to people with limitedInternet access.
Improved public health The Louisiana Tracking Program worked with the state health department to notify OSHA
about workplace exposures and health complaints from emergency response workers.Interventions were held to educate response workers, residents, and health care providers ontopics such as personal protective equipment, seafood safety, chemicals of concern, potentialroutes of exposure, and associated health effects.
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More Success Stories
Tracking in Action: Interactive Map
http://www.cdc.gov/nceh/tracking/flashmap.html -
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Group Activity
Scenario You are a student intern working for the Wisconsin Department of
Health Services Program and Planning Office. The departments HeartDisease and Stroke Prevention Program wants to increase the publicsawareness about womens risks for heart disease and stroke.
Your task You are asked to develop educational materials that highlight key
points that women need to know about risks for heart disease andheart attacks. The fact sheet will be distributed to three counties inWisconsin for which heart attack hospitalization rates are higher thanthe state rate. Use data and information from the National andWisconsin Tracking Networks
(http://www.dhs.wisconsin.gov/epht/index.htm) to identify the threecounties in Wisconsin where educational efforts will be targeted. Youreducational materials may include a poster, a fact sheet, or any otheritems you think would best convey your message.
http://www.dhs.wisconsin.gov/epht/index.htmhttp://www.dhs.wisconsin.gov/epht/index.htmhttp://www.dhs.wisconsin.gov/epht/index.htm -
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Homework: Scenarios
Chose and complete one scenario
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Homework: Queries
Conduct three queries on the TrackingNetwork, choosing a contentarea/indicator/measure of your choice,
and turn in the following for each: Health: Output data in a chart
Environment: Output data in a table
Population characteristics: Output data in amap
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For additional details on CDCsNational Tracking Network, visit
www.cdc.gov/eph tracking
The findings and conclusions in this presentation have not been
formally disseminated by the CDC and should not be construed to
represent any agency determination or policy.
Thank You!
http://www.cdc.gov/ephtrackinghttp://www.cdc.gov/ephtracking