What is Environmental Public Health Tracking?
Public health tracking, also called public health surveillance, is a way to monitor the health of communities over time. This is commonly done for infectious diseases, such as flu or West Nile virus.
Environmental public health tracking looks at environmental hazards, possible exposure to those hazards, and health effects (like chronic illnesses, hospitalizations and deaths) associated with those hazards. This is important since environmental exposures are responsible for approximately 5% of early deaths in the United States. Collecting this information over time makes it possible to see trends and patterns. Environmental public health tracking investigates possible associations between environmental exposure and resulting health effects. This helps us better understand how the environment affects human health. Understanding how health and the environment are connected is an essential step in our efforts to protect the health of our communities.
Researchers have linked specific diseases with exposures to some environmental hazards, such as asbestos and lung cancer. However, other links remain unproven, such as the suspected link between exposure to disinfection by-products and bladder cancer. Previously no system existed at the state or national level to track many of the exposures and health effects that may be related to environmental hazards.
The Environmental Public Health Tracking Network (Tracking Network) is one way to fill these gaps. The mission of tracking is to provide information that can be used to plan, apply, and evaluate actions to prevent and control environmentally related diseases. Understanding how these and other environmental factors are linked to chronic disease is essential to disease prevention and to protecting the health of our communities.
Environmental public health tracking looks at environmental hazards, possible exposure to those hazards, and health effects (like chronic illnesses, hospitalizations and deaths) associated with those hazards. This is important since environmental exposures are responsible for approximately 5% of early deaths in the United States. Collecting this information over time makes it possible to see trends and patterns. Environmental public health tracking investigates possible associations between environmental exposure and resulting health effects. This helps us better understand how the environment affects human health. Understanding how health and the environment are connected is an essential step in our efforts to protect the health of our communities.
In 1988, in its report "The Future of Public Health," the Institute of Medicine noted that the removal of environmental health authority from public health agencies has led to fragmented responsibility, lack of coordination, and inadequate attention to the health dimensions of environmental problems.
In 2000, the Pew Environmental Health Commission issued the report "America's Environmental Health Gap: Why the Country Needs a Nationwide Health Tracking Network" (PDF). The Commission detailed an "environmental health gap," a lack of basic information needed to document links between environmental hazards and chronic disease. At that time, no systems existed at the state or national level to track many of the exposures and health effects that may be related to environmental hazards. In addition, in most cases, existing environmental hazard, exposure, and disease tracking systems were not linked together. Because existing systems were not linked, it was difficult to study and monitor relationships among hazards, exposures, and health effects.
The report found that "while overt poisoning from environmental toxins has long been recognized, the environmental links to a broad array of chronic diseases of uncertain cause are unknown." To close this gap, the Pew report called for integrating tracking systems for environmental hazards, bodily exposures, and diseases; linking data to allow swift analysis; and using the results to prevent disease and save lives."
Because the existing environmental health system was neither adequate nor well organized, it recommended the creation of a nationwide health tracking network for disease and exposures. The National Environmental Public Health Tracking Network is the CDC's answer to these issues.
In 2000, the Pew Environmental Health Commission issued the report "America's Environmental Health Gap: Why the Country Needs a Nationwide Health Tracking Network" (PDF). The Commission detailed an "environmental health gap," a lack of basic information needed to document links between environmental hazards and chronic disease. At that time, no systems existed at the state or national level to track many of the exposures and health effects that may be related to environmental hazards. In addition, in most cases, existing environmental hazard, exposure, and disease tracking systems were not linked together. Because existing systems were not linked, it was difficult to study and monitor relationships among hazards, exposures, and health effects.
"When the Pew Commission report came out, everyone- the press, the public, Congress- couldn't believe that a Tracking Program didn't already exist."
-Shelly Hearne, DrPH
Founding Executive Director, Trust for America's Health
Founding Executive Director, Trust for America's Health
The report found that "while overt poisoning from environmental toxins has long been recognized, the environmental links to a broad array of chronic diseases of uncertain cause are unknown." To close this gap, the Pew report called for integrating tracking systems for environmental hazards, bodily exposures, and diseases; linking data to allow swift analysis; and using the results to prevent disease and save lives."
Because the existing environmental health system was neither adequate nor well organized, it recommended the creation of a nationwide health tracking network for disease and exposures. The National Environmental Public Health Tracking Network is the CDC's answer to these issues.
In 2002, the CDC established the National Environmental Public Health Tracking Network (National Tracking Network). The CDC was awarded funding which they used to establish Tracking Networks in state and local health departments and schools of public health. Through these partnerships, (state, local and universities) the CDC wanted to build environmental public health capacity, increase collaboration between environmental and health agencies, identify and evaluate environmental and health data systems, build partnerships with non-governmental organizations and communities, and develop model systems linking environmental and health data. To view all current National Tracking Network participants, see the map below.
The National Tracking Network is a system of integrated health, exposure, and hazard information and data from a variety of national, state, and city resources. On the National Tracking Network's website, you can view maps, tables, and charts with data about:
Click here to visit the State and Local Tracking Programs.
The National Tracking Network is a system of integrated health, exposure, and hazard information and data from a variety of national, state, and city resources. On the National Tracking Network's website, you can view maps, tables, and charts with data about:
- chemicals and other substances found in the environment
- some chronic diseases and conditions
- the area where you live
Click here to visit the State and Local Tracking Programs.
The Utah Environmental Public Health Tracking Network (Utah Tracking Network) is a part of the National Tracking Network. The Utah Tracking Network helps you understand the link between the environment and health by integrating existing health and environmental data in a standardized format. Our goal is to provide the necessary information, tools, and resources to prevent and control environmentally related health effects.
The Utah Tracking Network improves and expands the environmental public health surveillance capacity for the State of Utah. This is accomplished through better data linkage, display, and analysis. It also supports Utah's goal of evidence-based public health information and action. The accurate and timely tracking of data makes it easier to investigate disease impacts and trends; recognize disease patterns; and identify high-risk populations and geographic areas.
This website provides the data, information, and tools necessary to help you understand more about how the environment impacts human health. Please visit the Contents and Usage page to learn more about how to use this website.
If you have any questions, please Contact Us.
The Utah Tracking Network improves and expands the environmental public health surveillance capacity for the State of Utah. This is accomplished through better data linkage, display, and analysis. It also supports Utah's goal of evidence-based public health information and action. The accurate and timely tracking of data makes it easier to investigate disease impacts and trends; recognize disease patterns; and identify high-risk populations and geographic areas.
This website provides the data, information, and tools necessary to help you understand more about how the environment impacts human health. Please visit the Contents and Usage page to learn more about how to use this website.
If you have any questions, please Contact Us.
Mission
Without question, environmental contaminants affect people's health. Environmental hazards are among parents' top health concerns for their children, according to the American Academy of Pediatrics. Americans are concerned about hazards and health impacts related to environmental exposures. Citizens and policy makers want access to current, relevant, and accurate information about environmental exposures and health outcomes to facilitate individual, community, state, and national decision-making about adopting strategies to reduce the burden of disease attributable to the environment.Researchers have linked specific diseases with exposures to some environmental hazards, such as asbestos and lung cancer. However, other links remain unproven, such as the suspected link between exposure to disinfection by-products and bladder cancer. Previously no system existed at the state or national level to track many of the exposures and health effects that may be related to environmental hazards.
The Environmental Public Health Tracking Network (Tracking Network) is one way to fill these gaps. The mission of tracking is to provide information that can be used to plan, apply, and evaluate actions to prevent and control environmentally related diseases. Understanding how these and other environmental factors are linked to chronic disease is essential to disease prevention and to protecting the health of our communities.
Goals
- Build sustainable National and State Tracking Networks
- Build Tracking workforce and infrastructure
- Provide data to inform health policy, practices, and other actions
- Advance environmental public health science and research
- Foster collaboration among health and environmental groups
The Utah Tracking Network helps protect Utahns' health by strengthening the capacity and infrastructure to understand and respond to environmental public health concerns. Here are some of the ways the Utah Tracking Network accomplishes this.
An important function of the Utah Tracking Network is to support investigations of environmental public health concerns. Ensuring that the State of Utah has the necessary capacity to understand, investigate, and respond to these types of concerns is vital to protecting the health of Utahns.
What was the problem/situation?
During the past 10 years, the Utah Environmental Epidemiology Program had received numerous requests from concerned citizens about brain cancer incidence. Based on these public concerns, a statistical study was conducted to evaluate 8 possible brain cancer clusters in the state.
How was the Utah Tracking Network involved?
The Utah Tracking Network provided data preparation services, analytical tools, and other data that was necessary to conduct the study. Because these aspects of the study were already in place, the amount of time needed to conduct the study was decreased, allowing quicker response to public concern.
What action was taken to resolve the problem?
The study did not validate any of the cancer cluster areas. Furthermore, while the number of brain cancer cases in Utah is increasing, it is due to increases in the population. The study did not reveal any significant environment risk other than exposure to ionizing radiation to the head. After the study, there was media attention (newspaper, TV station) that allowed the results to reach a wide range of the public and provide public health messaging about lowering the risk of cancer.
For more information, please visit the Cancer Topic Page.
During the past 10 years, the Utah Environmental Epidemiology Program had received numerous requests from concerned citizens about brain cancer incidence. Based on these public concerns, a statistical study was conducted to evaluate 8 possible brain cancer clusters in the state.
How was the Utah Tracking Network involved?
The Utah Tracking Network provided data preparation services, analytical tools, and other data that was necessary to conduct the study. Because these aspects of the study were already in place, the amount of time needed to conduct the study was decreased, allowing quicker response to public concern.
What action was taken to resolve the problem?
The study did not validate any of the cancer cluster areas. Furthermore, while the number of brain cancer cases in Utah is increasing, it is due to increases in the population. The study did not reveal any significant environment risk other than exposure to ionizing radiation to the head. After the study, there was media attention (newspaper, TV station) that allowed the results to reach a wide range of the public and provide public health messaging about lowering the risk of cancer.
For more information, please visit the Cancer Topic Page.
What was the problem/situation?
A medical incinerator in North Salt Lake, Davis County, Utah caused great concern after the public became aware of a series of emissions violations. This prompted a series of health outcomes investigations because residential neighborhoods were situated within 300 feet of the incinerator. A cancer review was the first health outcome assessed.
How was the Utah Tracking Network involved?
Utah Tracking Network also provided data preparation and geocoding services, as well as analytical tools used in the investigation. This helped decrease the amount of time necessary to conduct the cancer investigation.
Why is this important?
The cancer investigation of the vicinity found a higher risk for six types of cancer. However, there is no known environmental link to any of these six cancers. After the investigation, the Utah Department of Health invited media outlets in order to inform the public about the results.
For more information on this issue, please visit the South Davis County - Dioxins Concerns in North Salt Lake web page.
A medical incinerator in North Salt Lake, Davis County, Utah caused great concern after the public became aware of a series of emissions violations. This prompted a series of health outcomes investigations because residential neighborhoods were situated within 300 feet of the incinerator. A cancer review was the first health outcome assessed.
How was the Utah Tracking Network involved?
Utah Tracking Network also provided data preparation and geocoding services, as well as analytical tools used in the investigation. This helped decrease the amount of time necessary to conduct the cancer investigation.
Why is this important?
The cancer investigation of the vicinity found a higher risk for six types of cancer. However, there is no known environmental link to any of these six cancers. After the investigation, the Utah Department of Health invited media outlets in order to inform the public about the results.
For more information on this issue, please visit the South Davis County - Dioxins Concerns in North Salt Lake web page.
What was the problem/situation?
A concerned midwife in Vernal, Utah began to see an increase in the number of stillbirths among the patients that she attended. With these anecdotal observations, she began to raise public concern about reproductive health issues in the Uinta Basin region. As this issue gained more statewide and national attention, people began to raise concerns about the presumed effects that environmental exposures are having on the increase of stillbirths. Public attention began to focus on how the Uinta Basin Region's booming oil and gas drilling industry could be contributing to this increase. This issue generated local, state, and national news coverage. At the request of the Tri-County Local Health Department (LHD), an investigation was conducted to find out if there was a higher risk of adverse birth outcomes in this region.
How was the Utah Tracking Network involved?
The investigation examined five types of adverse birth outcomes: low birth weight, small-for-gestational-age, premature birth, stillbirth, and infant death. The Utah Tracking Network collaborated with the Tri-County LHD and Utah-APPLETREE program (ATSDR's Partnership to Promote Localized Efforts to Reduce Environmental Exposures) to help carry out the investigation. This included helping design the study, geocoding the birth outcomes and population data used in the study, and providing the tools necessary to analyze the data. All of this decreased the amount of time necessary to complete the study and respond to public concern.
What action was taken to resolve the problem?
The investigation found that there is no increased risk for any adverse birth outcome in the Uinta Basin when compared to the rest of the state. However, the investigation did reveal that the risk of stillbirths and small-for-gestational-age have been increasing within the Uinta Basin region. This validated the midwife's original concern that stillbirths were increasing. Due to the results of the investigation, a number of recommendations were made, including empowering public health policy, evaluating the feasibility of conducting a robust investigation that examines the causes of the adverse birth outcomes, and the utility of additional follow up studies. After the study was released to the public, the Utah Tracking Network Risk Communication Plan was used to develop and disseminate key messages about the results and recommendations. This was especially important due to the large amount of media coverage and speculation surrounding this issue. Utah Tracking Network attended public meetings in Vernal and Roosevelt to discuss the results with the Board of Health and local citizens. The Tri-County LHD is using the investigation results to evaluate and strengthen its prenatal health programs. The results are also being used to determine what steps to take for future investigations.
For more information on this issue, please visit the Tri-County Adverse Birth Outcomes Statistical Review web page.
A concerned midwife in Vernal, Utah began to see an increase in the number of stillbirths among the patients that she attended. With these anecdotal observations, she began to raise public concern about reproductive health issues in the Uinta Basin region. As this issue gained more statewide and national attention, people began to raise concerns about the presumed effects that environmental exposures are having on the increase of stillbirths. Public attention began to focus on how the Uinta Basin Region's booming oil and gas drilling industry could be contributing to this increase. This issue generated local, state, and national news coverage. At the request of the Tri-County Local Health Department (LHD), an investigation was conducted to find out if there was a higher risk of adverse birth outcomes in this region.
How was the Utah Tracking Network involved?
The investigation examined five types of adverse birth outcomes: low birth weight, small-for-gestational-age, premature birth, stillbirth, and infant death. The Utah Tracking Network collaborated with the Tri-County LHD and Utah-APPLETREE program (ATSDR's Partnership to Promote Localized Efforts to Reduce Environmental Exposures) to help carry out the investigation. This included helping design the study, geocoding the birth outcomes and population data used in the study, and providing the tools necessary to analyze the data. All of this decreased the amount of time necessary to complete the study and respond to public concern.
What action was taken to resolve the problem?
The investigation found that there is no increased risk for any adverse birth outcome in the Uinta Basin when compared to the rest of the state. However, the investigation did reveal that the risk of stillbirths and small-for-gestational-age have been increasing within the Uinta Basin region. This validated the midwife's original concern that stillbirths were increasing. Due to the results of the investigation, a number of recommendations were made, including empowering public health policy, evaluating the feasibility of conducting a robust investigation that examines the causes of the adverse birth outcomes, and the utility of additional follow up studies. After the study was released to the public, the Utah Tracking Network Risk Communication Plan was used to develop and disseminate key messages about the results and recommendations. This was especially important due to the large amount of media coverage and speculation surrounding this issue. Utah Tracking Network attended public meetings in Vernal and Roosevelt to discuss the results with the Board of Health and local citizens. The Tri-County LHD is using the investigation results to evaluate and strengthen its prenatal health programs. The results are also being used to determine what steps to take for future investigations.
For more information on this issue, please visit the Tri-County Adverse Birth Outcomes Statistical Review web page.
The Utah Tracking Network fosters collaboration between government agencies to solve environmental public health problems.
What was the problem/situation?
The Utah Tracking Network frequently collaborates with the Utah Radon Program to educate the public about the dangers of radon gas. The Utah Radon Program offers free radon test kits to parents of newborns by distributing coupons for free test kits in hospitals. However, the Utah Radon Program has had difficulty providing these materials to parents of newborn children in rural areas, especially in cases of in-home births. Furthermore, radon testing in rural areas in Utah is very low compared to more populated areas. The Utah Radon Program collaborated with the Utah Tracking Network to help solve this problem.
How was the Utah Tracking Network involved?
The Utah Tracking Network analyzed radon testing data to select five rural areas where radon education would be most beneficial. This was based on radon testing data trends over many years. After the areas were chosen, the Utah Tracking Network collaborated with one of its partners, the Office of Vital Records and Statistics, to speak with hospitals and midwives in these areas about providing radon materials to parents of newborn children.
Why is this important?
The Office of Vital Records and Statistics regularly provides education and reporting materials to hospital and midwives in rural areas. Since in-home births are more common in rural areas, providing these materials to midwives was very important. Normally, mothers who choose to do in-home births would not receive radon education materials because they do not visit a hospital for the birth of their child. However, the midwives bring this type of materials to the mothers' homes when they assist with the birth. Both the hospitals and midwives responded enthusiastically to providing radon education materials. This collaboration resulted in a new way to reach out to communities and individuals to warn about the dangers of radon.
What was the problem/situation?
The Utah Tracking Network frequently collaborates with the Utah Radon Program to educate the public about the dangers of radon gas. The Utah Radon Program offers free radon test kits to parents of newborns by distributing coupons for free test kits in hospitals. However, the Utah Radon Program has had difficulty providing these materials to parents of newborn children in rural areas, especially in cases of in-home births. Furthermore, radon testing in rural areas in Utah is very low compared to more populated areas. The Utah Radon Program collaborated with the Utah Tracking Network to help solve this problem.
How was the Utah Tracking Network involved?
The Utah Tracking Network analyzed radon testing data to select five rural areas where radon education would be most beneficial. This was based on radon testing data trends over many years. After the areas were chosen, the Utah Tracking Network collaborated with one of its partners, the Office of Vital Records and Statistics, to speak with hospitals and midwives in these areas about providing radon materials to parents of newborn children.
Why is this important?
The Office of Vital Records and Statistics regularly provides education and reporting materials to hospital and midwives in rural areas. Since in-home births are more common in rural areas, providing these materials to midwives was very important. Normally, mothers who choose to do in-home births would not receive radon education materials because they do not visit a hospital for the birth of their child. However, the midwives bring this type of materials to the mothers' homes when they assist with the birth. Both the hospitals and midwives responded enthusiastically to providing radon education materials. This collaboration resulted in a new way to reach out to communities and individuals to warn about the dangers of radon.
The Utah Tracking Network provides information to strengthen Utah's public health policy.
What was the problem/situation?
The Utah Tracking Network wanted to investigate a different method of screening children for heavy metals in the bloodstream. The Utah Public Health Laboratory had previously developed a methodology that suggested that newborn blood spots could be used as a more effective means to do this. If effective, this methodology would improve the quality of Utah's current heavy metal screening program, not only by making it more efficient, but sampling a wider range of the population as well.
How was the Utah Tracking Network involved?
The Utah Tracking Network organized three multi-year, statewide pilot studies to evaluate this new methodology. In addition, the Utah Tracking Network provided the data and analysis tools that were necessary to conduct the investigation. Each study sought to evaluate the new methodology for a different heavy metal: cadmium, lead, and mercury.
Why is this important?
The pilot studies found that the proposed methodology would not be feasible to implement, which indicates that the current biomonitoring surveillance methods are still proving to be the most efficient and informative. The studies' results were useful because they contribute to informed public health practice in Utah. Since Utah's heavy metal screening strategies have not changed in a long time, it was important to make sure that there are currently no better options. Based on the results of the pilot studies, the Utah Tracking Network recommended that no changes be made for screening children for heavy metals.
What was the problem/situation?
The Utah Tracking Network wanted to investigate a different method of screening children for heavy metals in the bloodstream. The Utah Public Health Laboratory had previously developed a methodology that suggested that newborn blood spots could be used as a more effective means to do this. If effective, this methodology would improve the quality of Utah's current heavy metal screening program, not only by making it more efficient, but sampling a wider range of the population as well.
How was the Utah Tracking Network involved?
The Utah Tracking Network organized three multi-year, statewide pilot studies to evaluate this new methodology. In addition, the Utah Tracking Network provided the data and analysis tools that were necessary to conduct the investigation. Each study sought to evaluate the new methodology for a different heavy metal: cadmium, lead, and mercury.
Why is this important?
The pilot studies found that the proposed methodology would not be feasible to implement, which indicates that the current biomonitoring surveillance methods are still proving to be the most efficient and informative. The studies' results were useful because they contribute to informed public health practice in Utah. Since Utah's heavy metal screening strategies have not changed in a long time, it was important to make sure that there are currently no better options. Based on the results of the pilot studies, the Utah Tracking Network recommended that no changes be made for screening children for heavy metals.
The Utah Tracking Network pursues ways to improve data reporting. Improving data reporting helps Utah government programs better understand and respond to Utahns' needs and concerns. One such way the Utah Tracking Network has accomplished this is by creating tool to increase the utility of Utah Poison Control Center data.
What was the problem/situation?
The Utah Poison Control Center actively collects poison data on a daily basis when people call for help. However, the data was only being stored and left unused for any additional purpose. The Utah Poison Control Center reached out to the Utah Tracking Network to explore ways to make the data more available to public health professionals. It was determined that poison control data contained information that could be useful for a number of other purposes, such as improving hazardous substance release reporting. Furthermore, the Utah Poison Control Center frequently receives calls about cases of foodborne illness. This information could be very useful to investigate foodborne illness; however, information from these calls was not reported to health department officials. In these instances, a wealth of information that would be useful to protecting Utahns was going completely unused.
How was the Utah Tracking Network involved?
The Utah Tracking Network collaborated with a Utah Department of Health information technologist specialist to create a data tools to access and query poison control center data. This involved linking the query with the poison control data warehouse, recoding variables, removing identifiable data, and creating an application to export the data. After the tool was finished, the Utah Tracking Network was able to create custom data query modules for both hazardous substance release and foodborne illness investigation requirements.
Why is this important?
Due to this new tool, Utah public health professionals have access to a wider range of information that increases the quality of hazardous substance release reporting. On average, the query provides 35 entirely new hazardous substance release reports per month, reports which otherwise would not have been found without the tool. Furthermore, it also provides additional demographic information about the people affected by a hazardous substance release. This type of additional information can be added to reports that already exist. All of these new reports and additional information would not have been captured if not for the new tool.
On the other hand, the new tool provides much more data and information that can be used in foodborne illness investigations. This includes information about patient demographics, symptoms, exposure time frame, suspected location of exposure, and suspected contaminated food. Without the tool that the Utah Tracking Network created, this information would be unavailable. All of this improves Utah's ability to investigate and stop foodborne illness outbreaks.
What was the problem/situation?
The Utah Poison Control Center actively collects poison data on a daily basis when people call for help. However, the data was only being stored and left unused for any additional purpose. The Utah Poison Control Center reached out to the Utah Tracking Network to explore ways to make the data more available to public health professionals. It was determined that poison control data contained information that could be useful for a number of other purposes, such as improving hazardous substance release reporting. Furthermore, the Utah Poison Control Center frequently receives calls about cases of foodborne illness. This information could be very useful to investigate foodborne illness; however, information from these calls was not reported to health department officials. In these instances, a wealth of information that would be useful to protecting Utahns was going completely unused.
How was the Utah Tracking Network involved?
The Utah Tracking Network collaborated with a Utah Department of Health information technologist specialist to create a data tools to access and query poison control center data. This involved linking the query with the poison control data warehouse, recoding variables, removing identifiable data, and creating an application to export the data. After the tool was finished, the Utah Tracking Network was able to create custom data query modules for both hazardous substance release and foodborne illness investigation requirements.
Why is this important?
Due to this new tool, Utah public health professionals have access to a wider range of information that increases the quality of hazardous substance release reporting. On average, the query provides 35 entirely new hazardous substance release reports per month, reports which otherwise would not have been found without the tool. Furthermore, it also provides additional demographic information about the people affected by a hazardous substance release. This type of additional information can be added to reports that already exist. All of these new reports and additional information would not have been captured if not for the new tool.
On the other hand, the new tool provides much more data and information that can be used in foodborne illness investigations. This includes information about patient demographics, symptoms, exposure time frame, suspected location of exposure, and suspected contaminated food. Without the tool that the Utah Tracking Network created, this information would be unavailable. All of this improves Utah's ability to investigate and stop foodborne illness outbreaks.
