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CEHTP Goals (2006-2011)
1. Develop a state
EPHT Network information technology infrastructure that is consistent
with national standards and architecture.
2. Improve the availability
and utility of existing data or facilitate the creation of new data
to ensure the accessibility of core and other EPHT measures.
3. Inform policies,
practices, and other actions to prevent or reduce illnesses, injury
and death related to environmental risk factors.
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In August of 2006, we transitioned from a planning and pilot phase to an
implementation phase of Environmental Public Health Tracking. We are excited
to be working with our local, state, and national partners to build on
the foundations that were established over the past four years. Our five-year
plan for the implementation of California's EPHT Network builds on our commitment
to scientific rigor, technological innovation, and participatory approaches
to realize our program goals.
GOAL 1: Develop an information technology
infrastructure.
During implementation, CEHTP will develop an EPHT Network infrastructure
through a service-oriented strategy that: (1) satisfies the standards and
specifications for the national EPHT Network and the Public Health Information
Network; (2) enhances data systems' functionality and content; and (3) supports
the needs of end-users of EPHT-generated information. We will continue to
facilitate the secure and well-informed enhancement, linkage, exchange,
analysis, reporting, visualization, and dissemination of environmental health
data and information. The following services will be developed for CEHTP
and will be made available to stakeholders via a web portal.
 Metadata
(data about data) services: enables the efficient use of environmental health
data by (1) providing a central access point for EPHT stakeholders to search
and discover relevant data (2) assisting stakeholders to understand the
characteristics, availability, intended uses, and limitations of data.
Data
exchange services: enables timely access and utilization of EPHT data by
providing stakeholders the ability to electronically transfer data in a
secure and standard manner.
Spatial
enhancement services: enables stakeholders to enhance their data through
automated processes such as geocoding.
Spatiotemporal
integration services: enables the linkage and analysis of health indicators
and geographically-related exposures to environmental hazards.
Record-level
integration/linkage services: enables dynamic integration of confidential
datasets, facilitates trend and associations analysis, and generates de-identified
public-use information.
Visualization
and dissemination services: enables creation of dynamic, custom materials
in the forms of maps, charts, graphs, tables, and reports.
GOAL 2: Improve the availability and utility
of data.
CEHTP's priority for this goal is to track nationally-consistent environmental
health indicators. We have also selected several supplemental indicators
identified as priorities in California. We will phase in the initial set
of indicators listed below during the next five years. Additional indicators
will also be identified by the Centers for Disease Control and Prevention.
HAZARD INDICATORS:
Particulate
Matter and Ozone.
Water
Contaminants.
HEALTH INDICATORS:
Hospitalizations
for Asthma and Myocardial Infarction (heart attacks).
Vital
Statistics: preterm birth, low birthweight, and Sudden Infant Death Syndrome
(SIDS).
Short-Latency
Cancers.
Neurodevelopmental
Disorders: autism and idiopathic mental retardation.
Birth
Defects.
Lead
Screening and Child Blood Lead.
In addition to the required activities above, we will explore - via the
following supplemental activities - ways to maximize the utility of EPHT
data to inform public health practice.
Biomonitoring:
validation of pesticide and drinking water monitoring (see spotlight).
Tracking
community vulnerability and disproportionate exposure (see spotlight).
Climate
change impacts on public health: Assessing the health effects of ozone under
changing climatic conditions.
Evaluation
of methods for disease mapping and cluster surveillance: Improving the ability
to predict geographically-related exposures.
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SPOTLIGHT
Biomonitoring:
Biomonitoring is a key component of EPHT, as it provides measures
of contaminants in biological media that correspond to human exposures
and their effects. CEHTP has been exploring the utility of the California
Pesticide Use Reporting (PUR) system for tracking pesticide exposures.
We will determine how well PUR data predict actual pesticide exposures
to local residents. We will select 4-5 pesticides for assessment
in a single community to validate the utility of PUR data and evaluate
a dispersion model for estimating pesticide exposures. In addition,
we will be validating the use of drinking water concentrations as
a marker of exposure to common drinking water contaminants.
Community Vulnerability:
A prominent issue in EPHT discussions in California has been
the disproportionate burden of environmental hazards and related
diseases borne by some communities, as well as the social factors
that may operate to leave such communities particularly vulnerable
to environmental pollution. Building on a collaboration between
U.S. EPA Region 9, UC Santa Cruz, and CEHTP to examine indicators
of community demographics, civic engagement, and measures of segregation,
we will incorporate additional measures reflecting housing conditions,
social stressors, and availability of health services. We will conduct
a comprehensive assessment of the feasibility, quality, and availability
of these data for Environmental Public Health Tracking.
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GOAL 3: Inform policies, practices, and other actions.
Key components that will determine the utility and
effectiveness of EPHT include: (1) stakeholder contribution to and support
of EPHT activities, and (2) appropriate communication and dissemination
of the information. During the implementation phase, we will develop and
implement:
An
outreach plan to inform and explain the functions and activities of EPHT
to various stakeholders, address key questions and concerns, and provide
examples of program efforts and lessons learned.
An
information communication and dissemination plan to interpret, present,
and disseminate EPHT-generated information in an accessible, comprehensible,
and relevant manner.
Information can be a powerful asset. However, stakeholders
need the skills, resources, relationships, and tools to integrate data,
take action, and become stronger partners in the delivery of essential public
health services. To that end, we will also conduct activities aimed at increasing:
Stakeholder
knowledge, skills, and abilities in the underlying concepts and methods
of EPHT.
Stakeholder
capacity and resources to effectively apply EPHT information (i.e. translate
information to policies and actions).
Advisory Bodies for Implementation:
For the implementation phase of EPHT, we have
convened advisory by building on our existing base
of support. The Tracking Implementation Advisory Group (TIAG) is
composed of partners from a range of governmental, non-governmental, and
academic organizations at the state, local, and national levels. The
TIAG will provide guidance and recommendations
for the implementation of a state EPHT Network and ensure its
interoperability and compatibility with national standards and
architecture.
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