Upcoming CEHTP Presentations

In February 2012, the California Environmental Health Tracking Program (CEHTP) launched a web-based tool to assist water systems in creating digital maps of the areas they serve.  Prior to this effort, many systems only had paper maps, and there was no central location where this information was available for the entire state.  So far, the CEHTP water tool has compiled information for water systems that collectively serve almost 90% of the total California population. 

Since the launch, data on the location of these water system service areas have been publicly available for use in research studies and other public health activities (see examples below). This is the first time that such a comprehensive map of water system boundaries for California has been developed.  Compiling these data into a single digital dataset facilitates coordination among water system managers, public officials, and community groups when considering emergency preparedness, research, or future interventions to protect public health.

New Information Fuels Public Health Research

In just one year, new data on water system boundaries has enabled or facilitated efforts by state and local agencies, as well as university and non-governmental researchers, to conduct a number of new studies related to water quality, water costs, and the ongoing surveillance of California's water resources.  The data have also been incorporated into existing research efforts that are used to inform community planning.  Below are a few of the exciting research activities in progress, and we expect many more to come.

Researching water costs

The costs associated with providing and transporting drinking water in a clean, secure, and reliable fashion can vary by location, and it is unclear how pricing is set.  The Pacific Institute and the Community Water Center used the CEHTP water system boundary dataset as a core component of their research on water costs in California.

The researchers combined water boundary data with data on income and water costs to evaluate variations in price by census tract. "Understanding how different water suppliers determine pricing will be valuable for both the providers and for the customers," said Dr. Juliet Christian-Smith of the Pacific Institute.  "We know a lot about how water prices are changing, but we don't always know why.  This study will inform efforts to develop strategies for agencies to stay fiscally solvent while providing fair prices."  To learn more about the study, go to http://www.pacinst.org/reports/water_rates/.

Evaluating nitrate pollution in agricultural communities

Nitrate-contaminated drinking water can lead to serious illness in infants, and exposure to nitrates has been associated with certain cancers and adverse reproductive outcomes, including various birth defects.  In 2008, Senate Bill SBX2 1 (Perata) required that the State Water Resources Control Board (SWRCB) submit to the legislature a report to "improve understanding of the causes of [nitrate] groundwater contamination, identify potential remediation solutions and funding sources to recover costs expended by the State ... to clean up or treat groundwater, and ensure the provision of safe drinking water."

In response to SBX2 1, the University of California at Davis (UCD), on behalf of the SWRCB, used the CEHTP water system boundary dataset, along with other information, to identify communities most exposed to nitrate contamination in drinking water and to propose potential remediation solutions.  The subsequent UCD report was used as the basis for the final SBX2 1 report provided by the SWRCB to the legislature in February 2013.  

Identifying regional solutions for drinking water contamination

Two regional partnerships- composed of cross-sector collaborations between local governments, engineering firms, and local non-profit organizations- have been established to identify solutions to drinking water contamination in disadvantaged communities.  These efforts are the Tulare Lake Basin Disadvantaged Community Water Study, administered by the County of Tulare, and the Kings Basin Disadvantaged Communities Pilot Study, administered by the Upper Kings Basin Integrated Regional Water Management Authority.  Both studies are funded by the California Department of Water Resources.

These studies are using stakeholder participation and a variety of planning and engineering tools to characterize water problems and develop long-term strategies for obtaining access to safe drinking water and reliable clean wastewater facilities.  As part of this effort to identify regional solutions, the CEHTP water system boundary dataset has been used to characterize water quality across the Tulare Lake Basin (which includes the Upper Kings Basin).

Identifying cumulative impacts at the neighborhood level

Researchers from Occidental College, the University of California at Berkeley, and the University of Southern California have been developing a Cumulative Impacts Screening Method.  Their research method provides a visual mapping tool and includes indicators of social, health, and environmental impacts to identify communities that may bear a disproportionate burden of pollution or disease.  The screening method has been used to assess and advance land use decision-making processes that promote environmental health.  As part of this effort, the research team has been incorporating the CEHTP water system boundary dataset into their tool to develop neighborhood metrics of drinking water quality.

Plans for the Future

Thanks to the ongoing, collaborative efforts by water systems and others to input their data into the CEHTP water tool, a statewide map of water system boundaries is now publicly available for planning, research, and other public health efforts.  This map is continually updated as water systems submit data or make edits when their system boundaries change.  CEHTP is working with the State's Division of Drinking Water and Environmental Management (DDWEM) to promote use of the tool by providing access to it via the Electronic Annual Reporting System, which water systems use annually to report data to DDWEM.  CEHTP is also making improvements to the tool, such as enhancing the ability to add areas to an existing map or to create a map using property boundaries, to make it easier for water systems to enter and update information.

In just one year, the data compiled and provided through the CEHTP water system boundary tool have been used in a range of research and evaluation activities.  We hope that others continue to utilize this resource to inform public health policy, research, and action. Understanding how CEHTP data are utilized provides us with the feedback needed to make our tools as useful as possible for public health professionals and others within government agencies, non-governmental organizations, academic institutions, and communities.

For More Information

For more information about the CEHTP Drinking Water Systems Geographic Reporting Tool, please see the newsletter article announcing its launch or visit www.cehtp.org/p/water_tool_home.

The water system boundary data are publicly accessible at www.cehtp.org/p/water_dataset. To access data related to drinking water quality, please visit: www.cehtp.org/p/drinking_water.

This tool is part of a collaborative effort led by CEHTP in partnership with DDWEM, the state agency that regulates water systems, and the UC Davis Information Center for the Environment.

New Data Available on National Tracking Portal

The Centers for Disease Control and Prevention (CDC) National Environmental Public Health Tracking Network has launched a new Health Behaviors module. 

When examining chronic diseases and their potential connection to the environment, it is important to consider other health risk factors that could play a role in their development.  Four behaviors that can impact chronic diseases are lack of physical activity, poor nutrition, tobacco use, and excessive alcohol consumption. The National Tracking Network currently provides health behavior data on the numbers and percentages of adults who smoke.  CDC plans to add data on other health behaviors to the Tracking Network soon. 

The Community Design module of the Tracking Network now also includes data on Access to Parks.  These data will provide a better picture of the access people have to places where they can participate in physical activity. 

Upcoming CEHTP Presentations

American Meteorological Society Annual Meeting

Extreme Weather, Climate, and Health: Putting Research into Practice

The California Breast Cancer Mapping Project (CBCMP), convened by staff from the California Environmental Health Tracking Program, used a participatory process to develop statewide maps of elevated breast cancer rates in a manner considered appropriate and useful by diverse breast cancer stakeholders.  

The CBCMP Advisory Group - which consisted of breast cancer and environmental health advocates, clinicians, and public health practitioners - led the development of a mapping protocol to identify geographic areas with the highest rates of breast cancer, while maintaining scientific rigor and protecting patient confidentiality.  The mapping protocol can detect geographic areas both within and across county boundaries.  The protocol includes analyses of demographic characteristics to better describe the women diagnosed with breast cancer and the populations living in areas with elevated rates.  This information can help breast cancer advocates and public health staff target service needs, explore resource opportunities and suggest avenues for future research.

The protocol and resulting statewide maps of elevated breast cancer rates are detailed in a new report entitled California Breast Cancer Mapping Project:  Identifying Areas of Concern in California.

The participatory stakeholder process is described in a separate publication (currently in press).   

Visit www.californiabreastcancermapping.org to learn more about the project and to download the report.

The CBCMP is a project of the Public Health Institute and was funded through a grant from the California Breast Cancer Research Program of the University of California.  

• Cancer- New cancers on the data query include mesothelioma, melanoma, liver and bile duct cancers, kidney cancers, and tobacco-related cancers.  Descriptions of these cancers are also provided.

• Climate Change- We have developed a new data query on hospitalizations and emergency department visits due to heat events.  Summary tables for heat related illness and deaths are also available.  

The National Environmental Health Association (NEHA), in partnership with the Centers for Disease Control and Prevention (CDC), has developed two online training courses: 

• Environmental Public Health Tracking 101- This course gives an overview of the major components of Environmental Public Health Tracking.

• Tracking in Action: Workforce Implementation- Tracking in Action provides real-life examples of grantee Tracking Programs and Networks and how they have partnered with local programs and organizations to identify and address environmental health concerns.

Both courses are available at no cost, and free continuing education credits from NEHA and CDC are available upon completion of each course.   

Visit http://www.neha.org/tracking.html for more information. 

• Registration is now open for the California Asthma Summit: Research to Practice, December 5-6, 2012 in San Francisco.  Visit California Breathing's website for registration details, agenda, and other information.

• The U.S. EPA's 2013 Environmental Justice Small Grant solicitation is now open and will close on January 7, 2013.  Visit EPA's Environmental Justice webpage for more information.  

Upcoming CEHTP Presentations

North American Association for Environmental Education

American Public Health Association Annual Meeting 

New National Guidelines

In May 2012, the Centers for Disease Control and Prevention (CDC) changed its guidelines for implementing interventions to reduce children's exposure to lead. Since 1991, the CDC has used the blood lead level (BLL) of 10 micrograms per deciliter (μg/dL) as the "level of concern" which triggers public health interventions.  Following a recommendation by the CDC's Advisory Committee on Childhood Lead Poisoning Prevention, the terminology "level of concern" has been eliminated, and instead CDC will rely on a "reference level" of 5 μg/dL.  The reference level is based on the BLL under which 97.5% of the population falls.  This recommendation was based on scientific evidence that BLLs below 10 μg/dL are associated with cognitive deficits, as well as cardiovascular, immunological, and endocrine effects.
 

Screening in California 

Dr. Valerie Charlton, Chief of California's Childhood Lead Poisoning Prevention Branch (CLPPB), points out that California was already concerned about lower blood lead levels and has been working to prevent lead exposure. By state regulation, families of all children are to receive proactive guidance on lead exposure from their health care providers, from the time that a child is 6 months old up until age 6 years. Since 2008, CLPPB has recommended that health care providers re-test children found to have BLLs greater than 4.5 μg/dL and carry out additional evaluations and follow-up. Forty-two local programs throughout California are supported by CLPPB to carry out direct services related to identifying and reducing lead exposure.  Dr. Charlton says:  
 

The American Journal of Public Health recently published "A Health Impact Assessment of California's Proposed Cap-and-Trade Regulations."  The health impact assessment (HIA) was led by the California Environmental Health Tracking Program and the California Department of Public Health.  The objective of the HIA was to identify potential unintended health effects of the regulations and to recommend program changes to improve health. 

HIA is a systematic process that uses scientific data, health expertise, and public input to identify potential health effects of a proposed policy or development.  As part of the HIA process, recommendations are made for minimizing health risks and capitalizing on opportunities to improve health.
 
For more information, view the project description here.

Upcoming CEHTP Presentations

Environmental Health Data Training in Coachella Valley

Western Regional Epidemiology Network (WREN) Conference

National Environmental Health Association (NEHA) Conference

CEHTP Collects and Disseminates Essential Information About Drinking Water Systems

 
Drinking water is an important resource and a key route of potential exposure to environmental contaminants.  Public water systems supply drinking water to most Californians, and all water systems must comply with State and Federal standards for safe drinking water.  However, not all contaminants are regulated, and water systems may vary in their ability to comply with these standards. Furthermore, drinking water supplies are always at risk of contamination during natural or man-made disasters.  Therefore, an essential component to protecting public health from drinking water contaminants is to know the exact locations being served by each water system.

• Which water system supplies a specific address?
• What populations are served by a particular water system?
• What is the drinking water quality for a specific community?
• If there is a natural or man-made disaster in a specific location, which water systems should be contacted?
• Which populations in the state are not supplied by public water systems?

Collaborative effort to map water systems

To enable these questions to be quickly and accurately answered, the California Environmental Health Tracking Program (CEHTP) developed a web-based tool to assist water systems in creating digital maps of the areas they serve.  The tool also compiles all of the individual maps onto a single statewide map. 

This tool is part of a collaborative effort led by CEHTP in partnership with the California Department of Public Health's Division of Drinking Water and Environmental Management (DDWEM), which is the state agency that regulates water systems, and the UC Davis Information Center for the Environment (ICE). 

The goal of this effort is to create an accurate and complete statewide map of water systems that is continually updated to capture changes to water system customer service areas as they occur over time. 

Customer service area for Apple Valley North, Golden State Water Company

These data and maps, which are subject to change as water systems continue to input and update their information, will help the water systems with their everyday planning and operating needs.  They will also be important for informing a variety of public health activities, including:

• Preparedness to ensure that the public has access to safe drinking water during emergencies
• Interventions to protect the public in the event of water system contamination
• Research to better understand the relationship between drinking water and public health

  Golden State Water Company

Low-income communities and communities of color often bear a disproportionate burden of environmental hazards and poor health outcomes. In this newsletter, we explore the striking environmental health disparities that exist in Imperial County, where data and collective community action provide a roadmap for other counties facing similar environmental health challenges.

Environmental health disparities occur when a community's health is influenced by the: (1) social environment, including limited income and education; (2) built environment, such as inadequate public transportation and substandard housing conditions; and 3) physical environment, including poor air quality and toxic waste. 

WHAT CAN YOU DO?

Check out our content on Birth Defects, Childhood Lead and Carbon Monoxide Poisoning

Childhood Lead Poisoning:

o       Find out who's most at risk for lead poisoning, and which counties have the highest rates of children with elevated blood lead levels among children screened

Birth Defects:

o       Learn about 12 birth defects and the five-year incidence rates in Central Valley Counties

Carbon Monoxide (CO) Poisoning:

o       Compare the rates of hospitalizations and emergency department visits due to CO poisoning across the state

These advisors have been instrumental in setting the direction of CEHTP, specifically by participating in an extensive strategic planning process where the Advisory Group and program staff collectively created a 5-year vision and strategic directions for Tracking in California. From that plan, the Advisory Group has continued to provide overall guidance and recommendations to CEHTP during our semiannual face-to-face meetings.

Since CEHTP exists to provide data, tools, and services for our stakeholders to use for environmental health action, having input and guidance from these stakeholders at each step as we develop our program is critical to ensure CEHTP stays useful and relevant.
 

CEHTP is currently working on a project, funded by the California Breast Cancer Research Program, to gather input from stakeholders to develop methods for mapping breast cancer to help locate vulnerable communities, understand demographic risk factors, target prevention/intervention efforts, and generate hypotheses about breast cancer.

The Breast Cancer Mapping Project engages a diverse statewide Advisory Group consisting of nearly 20 breast cancer advocacy and environmental justice organizations, researchers, and local public health departments. CEHTP provides key statistical expertise, geocoding services, and facilitation of the Advisory Group as this group develops recommendations for mapping breast cancer data at the community level.

"When a collaboration among state public health agencies and non-governmental organizations is

done well, it can provide a great opportunity to

leverage population-level data in a way that

addresses real-life concerns.  Such a collaboration

is exemplified by the Breast Cancer Mapping

Project, which has brought together an incredible

team to look at the complex societal and

environmental concerns that must be considered

in a project to map cases of breast cancer."

- Connie Engel, Program Coordinator,

  Breast Cancer Fund

The California Cancer Registry is a critical project partner, providing annual breast cancer data that will be mapped according to the methods agreed upon by the Advisory Group. This truly collaborative project incorporates key input from community and public health stakeholders to develop a mapping strategy that may ultimately be used by a statewide agency such as the California Cancer Registry. 

For more information about CEHTP, please visit our website at www.cehtp.org

To learn more about the features and uses of CEHTP's geocoding tools, register for our upcoming webinar scheduled on Tuesday, May 25^th from 10-11am (Pacific Time) by clicking on the link below:

Click here to register for geocoding webinar

• query systems that quickly generate maps, tables, and charts

• time trends by county

• tools and services to help search and view data, such as our agricultural pesticide mapping tool

• metadata (data about the data)

• background information and links to other resources by topic area

• maps at the sub-county level for some topic areas

• overviews of key environmental health and epidemiology concepts

• instructions and tutorials for the web tools and services

• standardized data across contributing states

• information by location

• data query for generating maps, tables, and charts