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Environmental Public Health Tracking: From Data to Action

Yip, Fuyuen Y. PhD, MPH

Journal of Public Health Management & Practice: September/October 2017 - Volume 23 - Issue - p S1–S3
doi: 10.1097/PHH.0000000000000632
Editorial

Environmental Health Tracking Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia.

Correspondence: Fuyuen Y. Yip, PhD, MPH, Environmental Health Tracking Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F-60, Atlanta, GA 30341 (fyip@cdc.gov).

The content of this article is solely the responsibility of the author and does not necessarily represent the official views of the Centers for Disease Control and Prevention.

The author declares no competing financial interests.

Public health surveillance is the ongoing, systematic collection, analysis, and interpretation of health data for the planning, implementation, and evaluation of public health practice and is an important component in assessing the function of public health.1 In 2000, a Pew Environmental Health Commission's report highlighted the lack of surveillance data and information to monitor the burden of environmentally related disease and the need to improve our understanding of the links between environmental hazards and chronic diseases.2 In response, the National Environmental Public Health Tracking Program (Tracking Program) at the Centers for Disease Control and Prevention (CDC) was developed in 2002. Since its inception, the Tracking Program has worked closely with a community of funded state and local health departments to build capacity and infrastructure to develop the National Environmental Public Health Tracking Network (Tracking Network), an integrated network of environmental health surveillance data at the local, state, and national levels. Application of these data is key to support evidence-based decision making and public health actions within state and local programs to help promote healthy and informed communities. Now in its 15th year, the Tracking Program continues to enhance the infrastructure of the Tracking Network to support more consistent use of its data and program resources to help inform public health actions, with the ultimate goal of reducing the burden of environmentally related health conditions.

This special issue of the Journal of Public Health Management & Practice offers a unique examination of the breadth of work by CDC and its partners in the Tracking Program, with a focus on how the Tracking Network and program resources have been utilized to support environmental public health practice and inform specific public health actions. Wilson and Charleston3 first provide an overview of the Tracking Program's history and development and how support from the Tracking Program can improve environmental public health practice at the state and local levels. Eatman and Strosnider4 then discuss the process that is taken to monitor public health actions, which serves as a performance measurement for the Tracking Program. They provide 3 case studies to highlight the diversity of actions taken by tracking partners. More than 400 public health actions have been finalized by the Tracking Program since 2005, thereby illustrating the opportunities for our partners to use the data and resources to help address the environmental public health needs at the state and local levels. Zhou et al5 then provide an initial examination of standardized approaches for estimating the monetary value of different health outcomes, for both generating additional information to support environmental health decision making and evaluating the costs and benefits of public health actions informed by the Tracking Program and its partners. Lucas-Pipkorn and Tuomi6 provide the last article at the national level and describe efforts by the Tracking Program to address gaps in the Tracking Network by developing new partnerships between the Tracking Program, state health departments, and tribal communities.

Our state and local partners then provide in-depth examination of specific public health actions that represent several key themes: (1) use of program resources to establish partnerships and expand capacity to address stakeholder needs, (2) use of tracking data to inform decision making, and (3) use of tracking data by the Tracking Program to improve disease detection.

Three articles showcase the use of program resources to establish partnerships and expand capacity to address stakeholder needs. Camponeschi et al7 summarize an innovative use of program resources in Wisconsin to establish partnerships and expand capacity in their effort to extend the utility of the Tracking Program to the community level. Through the awarding of minigrants that encouraged the use of Wisconsin tracking data and resources at the local level, the state tracking program helped build relationships and increased awareness of tracking data and resources with their local health partners. Chaudhuri et al8 discuss the creation of a biomonitoring consortium by Arizona, Colorado, New Mexico, and Utah to engage and leverage resources from existing grantee tracking networks and public health emergency preparedness programs, to identify common environmental health concerns, and to develop a regional framework and laboratory capacity. In California, the state tracking program leverages partnerships to develop several strategies to make complex data on pesticide use more accessible to a broader audience by developing a linkage service and a mapping tool.9

There are 3 articles that highlight the use of tracking data to help engage policy makers or inform decision making. McKelvey et al10 provide examples on how restaurant food safety and air pollution control data from the New York City Tracking Program played a role in enacting legislative proposals and adopting regulations. Johnson et al11 also summarize how the Minnesota Tracking Program collaborated with the Minnesota Pollution Control Agency to inform air pollution-related policies in the Twin Cities by demonstrating quantifiable health impacts from air quality improvements. Florida's environmental public health tracking program also describes how it utilized its data to conduct an analysis, using the Health Impact Assessment Framework, to not only improve understanding on adverse health outcomes that may be related to an extreme flood event but also be better prepared for future events.12

Under the last theme, there are 4 articles that describe work conducted by respective tracking programs to improve surveillance for disease detection. Stamm et al13 examined acute myocardial infarction (AMI) rates in census tracts along the state border to help improve the adequacy and case ascertainment in utilizing administrative hospital data to track AMI. The South Carolina Tracking Program describes the integration of adult blood lead level (BLL) data into its Tracking Network and the program's ability to use the BLL to identify opportunities to mitigate exposure in occupational settings.14 Creswell et al15 provide a summary of their response to a large-scale carbon monoxide poisoning in Wisconsin that, in turn, prompted the development of a real-time alert system for CO poisonings using poison center data as well as improved outreach efforts. Finally, the Colorado Tracking Program developed and implemented more complex methodologies for routine analysis of childhood BLL data to identify potential areas of concern at a fine spatial resolution to help provide more targeted intervention.16

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Conclusion

In 2015, Qualters et al17 assessed the utility of the Tracking Program and Tracking Network in environmental public health practice and identified nearly 200 public health actions that primarily focused on activities including capacity building, infrastructure enhancement, and data linkage. As we begin our 15th year, and with a new 5-year strategic plan in place, we are excited to explore more innovative uses of the tracking data to help address new public health actions. We are working closely with our key stakeholders to develop a science-to-action agenda that will serve as a framework to ensure that our translation of science into health action is not only timely and relevant but also follows a clearly defined purpose. From the articles in this issue, it is very clear that the Tracking Program has shown significant progress in establishing unique and diverse partnerships, developing innovative ways to use its data and resources, and identifying approaches in making its data more accessible, all with the goal to improve public health at the local, state, and national levels.

We would like to thank the editors of the Journal of Public Health Management & Practice, especially Drs Lloyd Novick and Justin Moore, for their guidance and assistance with the submission and publication of these articles. We would also like to thank Dr Greg Kearney for his assistance during the publication process.

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References

1. Thacker SB, Berkelman RI. Public health surveillance in the United States. Epidemiol Rev. 1988;10:164–190.
2. Pew Environmental Health Commission. America's Environmental Health Gap: Why the Country Needs a Nationwide Health Tracking Network: Technical Report. Baltimore, MD: Johns Hopkins University School of Public Health; 2000.
3. Wilson H, Charleston A. Environmental Public Health Tracking Program advances and successes: highlights from the first 15 years. J Public Health Manag Pract. 2017;23(5 Supp):S4–S8.
4. Eatman S, Strosnider H. Public health actions update.J Public Health Manag Pract. 2017;23(5 Supp):S9–S17.
5. Zhou Y, Nurmagambetov T, McCord M, Hsu W. Economic valuation of selected illnesses in environmental public health tracking. J Public Health Manag Pract. 2017;23(5 Supp):S18–S27.
6. Lucas-Pipkorn S, Tuomi A. Addressing data inequities in American Indian communities through an environmental public health tracking pilot project. J Public Health Manag Pract. 2017;23(5 Supp):S28–S31.
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14. Davis H, Lynes C, Corley H. South Carolina Environmental Public Health Tracking Program's role in monitoring and reducing occupational exposure to lead: public health actions in collaboration with the South Carolina Occupational Safety and Health Administration. J Public Health Manag Pract. 2017;23(5 Supp):S53–S59.
15. Creswell PD, Vogt CM, Wozniak RJ, et al Improving outreach and surveillance efforts following a large-scale carbon monoxide poisoning in Wisconsin. J Public Health Manag Pract. 2017;23(5 Supp):S67–S71.
16. Berg K. Spatial surveillance of childhood lead exposure in a targeted screening state: an application of generalized additive models in Denver, Colorado. J Public Health Manag Pract. 2017;23(5 Supp):S79–S92.
17. Qualters J, Strosnider HM, Bell R. Data to action: using environmental public health tracking to inform decision making. J Public Health Manag Pract. 2015;21(2):S12–S22.
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