EPHT Planning Activities New Mexico Department of Health Office of Epidemiology Santa Fe, New Mexico

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EPHT Planning ActivitiesNew Mexico Department
of Health Office of EpidemiologySanta Fe, New
Mexico

• 2003 CSTE Conference
• June 23-25, 2003
• Presenter Barbara Malczewska-Toth, Ph.D., DABT

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Program Announcement 02179 Requirements

• Collaborative project
• Local, tribal, state, federal, and academic
  agencies and organizations
• Letters affirming collaboration and support
• Formal partnership between the state health and
  environmental agencies for development of the
  EPHT System
• Formal collaborative agreement
• Liaisons in both agencies identified

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What is to be covered?

• Environmental Public Health Indicators
• Prioritization of EPH Indicators
• Inventory of EPH data systems

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Environmental Public Health Indicators

• New Mexico History
• Health Milestones Project (1996)
• New Mexico Turning Point Initiative (1998-1999)
• Environmental Health Report Card (2000)
• Environmental Health Indicators for the United
  States-Mexico Border Area (2001)
• Environmental Health Capacity Building (CA
  between CDC and NMDOH) (2001)

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Environmental Public Health Indicators

• Definitions
• http//www.cste.org/pdffiles/Environmentalpubliche
  althindicators.pdf
• Environmental public health indicators provide
  information about a populations health status
  with respect to environmental factors.
• Hazard Indicator A condition or activity that
  identifies the potential for exposure to a
  contaminant or hazardous condition.
• Exposure Indicator A biological marker in tissue
  or fluid that identifies the presence of a
  substance or combination of substances that may
  potentially harm the individual.
• Health Effect Indicator A disease or condition
  that identifies the occurrence of an adverse
  effect from exposure to a known or suspected
  environmental hazard.
• Intervention Indicator A program or official
  policy that minimizes or prevents an
  environmental hazard, exposure, or health effect.

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Environmental Public Health Indicators

• Role of Indicators for the EPHT
• Establish priorities for tracking environmental
  exposures and related diseases in New Mexico
  communities
• Guide development of EPHT system in New Mexico
• Identify environmental conditions and health
  outcomes of greatest relevance
• Identify best available data
• Develop most informative measures
• Identify limitations, data needs, future
  directions
• Drive data collection, although data collection
  also can drive the selection and use of indicators

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Environmental Public Health Indicators

• Role of Indicators for the EPHT
• (concluded)
• Monitor current status or trends of environmental
  and health conditions in New Mexico in order to
  prevent adverse health effects related to
  environmental conditions
• Provide a basis for building environmental health
  capacity within state and local environmental,
  health, and related agencies

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Environmental Public Health Indicators

• Process for Developing the EPHIs
• CSTE/CDC Environmental Public Health Indicators
  (2002)
• http//www.cdc.gov/nceh/indicators/default.htm
• EPHI framework
• Topics
• Core EPHIs
• Other EPHIs and other indicator projects
• Measures

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Environmental Public Health Indicators
Framework
Human Exposure
Environmental Hazard
Health Effect
Intervention
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EXAMPLETopic Ambient (Outdoor) Air Quality

• Rationale and Role Air quality affects peoples
  health. Certain air pollutants can cause or
  exacerbate certain diseases.
• This indicator may be used to
• Monitor trends in air pollution
• Map levels of air pollution to identify hotspots
  or areas in need of special action
• Estimate how many people are exposed to excess
  levels of air pollution
• Monitor levels of compliance with air quality
  standards
• Assess the effects of air quality policies
• Help investigate associations between air
  pollution and health effects.

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EXAMPLETopic Ambient (Outdoor) Air
Quality(continued)
Linkage with Other Indicators This indicator
represents one in a suite of indicators that
together describe the effects of air pollution on
health Indoor Air Quality Ambient Water
Quality Fish Safety
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EXAMPLEEnvironmental Hazard
Indicator Measure Data Sources
Criteria Pollutants in Ambient Air Concentrations of Ozone, PM10, PM2.5, Sulfur Dioxide, Nitrogen Dioxide, Carbon Monoxide, Lead NMED-AQB database CABQ-EHD, NAQET (EPA) AIRS (EPA)
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EXAMPLEHealth Effect
Indicator Measure Data Sources
Asthma Mortality Rate of asthma-related deaths Vital Statistics
Asthma Morbidity Rates of hospitalization for acute asthma events (per 100,000 population by age groups annually) Health Policy Commission-Hospital Inpatient Discharge Data
Asthma Morbidity Rates of ED/ER visits for acute asthma events (per 100,000 population by age groups annually) Emergency department or emergency room visits reporting
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EXAMPLEIntervention
Indicator Measure Data Sources
Programs that address motor vehicle emissions Proportion of population residing in jurisdictions with vehicle emissions regulations Census data NMED-AQB CABQ-EHD NM Highway Transportation Dept.
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Prioritizing EPHIs

• Develop preliminary list of priority indicators
  through collaboration of EH professionals and
  other citizens
• EPH program priorities
• Stakeholder priorities
• Survey EPH programs, professionals, and
  scientists to identify data sources for
  indicators
• Select these indicators for which data are
  available and can be linked on an ongoing basis
• Select these indicators for which interventions
  are available to remove the hazard or prevent the
  exposure
• Identify limitations, data needs, future
  directions/activities

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Inventory of EPH Data Systems

• Purpose
• Identify, describe, and evaluate available
  ongoing environmental hazard, human exposure, and
  health outcome data systems in New Mexico, and
• Integrate/link environmental exposure and health
  effect data and monitor EPH conditions

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Inventory of EPH Data Systems

• History
• Initial inventories of EH data systems developed
  through compilation of results from previous
  surveys (prior to the start of the project)
• Health data system elements
• Name of dataset/data system
• Owner/location
• Description/purpose/content
• Major indicator/variables
• Geographic area

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Inventory of EPH Data Systems

• History
• (concluded)
• Environmental data system elements
• Database name business purpose
• Technology
• Major inputs
• Major outputs
• Users

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Inventory of EPH Data Systems

• Updated initial inventory of EPH data systems
  through
• Internet searches
• Telephone interviews with data owners
• Current inventory includes more than 100 datasets
  and data systems
• Disseminated among members of the EPHT Planning
  Consortium

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Inventory of EPH Data Systems

• Phased survey of EPH datasets and data systems
• Three phases/levels
• Each phase includes evaluation component

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Inventory of EPH Data Systems

• Phase I
• Initial survey to identify and describe the
  variables, geographic and temporal coverage of
  each dataset and other basic information

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Inventory of EPH Data Systems

• Phase II
• Focus on data quality, timeliness, and
  completeness issues
• Phase III
• Focus on technology considerations

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Inventory of EPH Data Systems

• Prioritized datasets and data systems for the
  initial survey
• Criteria
• Information on one or more indicator category
• Health outcome data or information that can be
  related to one or more indicator category
• Developed a draft questionnaire, including
  glossary of EH terms to conduct initial survey of
  EH datasets and data systems identified in the
  prioritized inventory

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Inventory of EPH Data Systems

• Next step Conduct initial survey

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Challenges Opportunities

• Establishing the EPHT Planning Consortium and
  workgroups and maintaining interest of all
  stakeholders
• Developing data sharing agreements
• Developing data linkage methods
• Assuring consistency with other systems such as
  NEDSS that are not fully defined yet
• Other

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Acknowledgements

• CSTE/CDC Indicator Projects
• http//www.cste.org
• This presentation is supported by Cooperative
  Agreement
• U50/CCU522441-01 from CDC. Its contents are
  solely the responsibility of the authors and do
  not necessarily represent the official views of
  the CDC.