PowerPoint Presentation

Integration, Analysis, and Visualization of Health and Environmental Data in the National Tracking Network

Heather StrosniderActing Science Development Team LeadUS CDCs National Environmental Health Tracking Program

Frontiers in Spatial EpidemiologyLondon11/6/2012National Center for Environmental HealthAgency for Toxic Substances and Disease Registry

Pew Commission: Environmental Health Review, 2000Chronic conditions account for 4 out of every 5 deaths in the United StatesLittle information is routinely collected on non-infectious diseaseEnvironmental monitoring conducted regulatory purposesLittle human exposure dataAnswers needed about the role of the environment on health outcomesRecommended a Nationwide Health Tracking Network for diseases and exposuresEnvironmental health system was inadequate and fragmentedResponsibilities scattered among agenciesUnable to link environmental and health databasesKey Factors:Separation of health and environmental functions at national and state levelCategorical development of health and environmental data systemsLack of resources devoted to environmental public healthTracking Program GoalsGoal 1Build a Sustainable National Environmental Public Health Tracking NetworkGoal 2Advance Environmental Public Health Science and ResearchGoal 3Disseminate Information to Guide Policy, Practice, and Other Actions to Improve the Nations HealthGoal 4Enhance Environmental Public Health Tracking Workforce and InfrastructureGoal 5Foster Collaboration Among Health and Environmental ProgramsThe overarching goal of the Tracking Program is to improve and protect public health by allowing scientists, researchers, and public health professionals, and policy makers access to data that was previously not available in standardized formats. This allows them to monitor trends over time, to see where resources are needed for further research or public health interventions.

Instead of reading each goal, focus on one or two that you think are most relevant to your audience and explain some of what your program or the national program is doing to meet those goals. Detect and monitor trends Generate hypotheses Guide action Inform policymaking Provide information Track progressTracking Network:Integrated Data for Environmental Health

Descriptive and Exploratory analysisEvaluation of interventionsTracking ProgramNational NetworkPublic PortalsSecure PortalsStandardized DataData Utilization Engage PartnersBuild CapacityDATAINFORMATIONKNOWLEDGEACTION

National Public Portal15 datasets2.2 GB of data18.7 million rows of data257 measures

24 state and city public portals

Total Coverage165 million (55%)Asian9.6 million (70%)Black18.5 million (48%)Hispanic28 million (61%)Native American1.4 million (48%)Other2.8 million (57%)White132 million (55%)Total Coverage of US Population by Tracking Program

60% (156) measures cover more than Tracking states and cityContent and DataAsthmaBirth DefectsCancerCO PoisoningChildhood LeadDevelopmental DisabilitiesHeart AttacksReproductive Birth OutcomesBiomonitoringClimate ChangeCommunity DesignHomesOutdoor AirPopulation CharacteristicsWaterCriteria for PrioritizationBurden - Magnitude and severity Information system factorsResonates with partnersScientific plausibilityAbility to take actionDirection from Congress

CMST4 Tables

MiddlewareSQLSQLJAVASpringHibernateBlaze DSFlexAnychartESRI Flex MapPortalT3 TablesSQLBasic, high level overview of the system. Portal, both the query panel and the displays are less intelligent. They are spoon fed parameters, requirements, and data. The brains of the operation are in the middleware. All the intelligence is programmed here. We can easily update query panel and display as new technologies or functionalities are developed. The middleware grabs information from the CMS to populate the query panel. It uses the query parameters to identify the requested data. Then it grabs additional info from the CMS and the data from the T4 table and drops them into the format understood by the query panel and results.

Percent of children tested with confirmed elevated blood lead levels, by birth cohort

MEASURES4COUNTIES2736 (87%)YEARS8VARIABLEBLL category

Average annual number of Cleft Lip with or without Cleft Palate among live births MEASURES26DEFECTS12VARIABLEAge, Race, Ethnicity, Infant Sex

Number of states providing birth defect data

Estimated prevalence of ASDs per 1000 children 8 years old

Percent of children, 3-17, receiving early intervention, special education, or related services for developmental disabilityAutism Spectrum DisordersDevelopmental DelayEmotional DisturbanceHearing ImpairmentsIntellectual DisabilitySpecific Learning DisabilitiesSpeech or Language Impairments

Total Arsenic concentration in urine (g/g of creatinine)ANALYTES11VARIABLEAge, Race, Ethnicity, SexHIA

Estimated percent change in death rate from baseline associated with 20% reduction in air pollution

Integrated messaging with dataAdded new base layers to mapsImproved export by adding supporting infoNew Data Over the Next Year SUMMER 2012FALL 2012Childrens Environmental Health - launchedAccess to ParksBRFSS Smoking PrevalenceExtreme Heat Events

Drinking Water - Atrazine, DEHP, PCE, TCE, Radium, UraniumAir toxicsAsthma ED visits Heat ED visits, hospital, mortalityAnnual blood lead levels in children Pesticide exposures reported to poison control centersChemical Incidents from ATSDRs National Toxic Substance Incidents Program USGS Well Water

WINTER 2013SPRING 2013

Extreme Heat Days and EventsNumber of extreme heat eventsClimate ChangeDefinition(Required)PercentileFahrenheit

Heat MetricPercentileMax Daily TemperatureMax Daily Heat IndexThreshold: Absolute or Relative

2 or more daysMinimum Duration3 or more daysUnder Evaluation for the Public PortalAir toxics Ischemic heart disease mortality benefits associated w/ reducing PM2.5Mortality associated with extreme heat eventsAddtl cardio and resp hospitalizations, ED visits, & mortalityTemporal & spatial patterns in pollen Radon in homesPrivate well waterOccupational healthALS (from ATSDR registry)Vulnerability measuresPesticide residue in food New modeled air Intellectual disabilities from ADDM BLL 5 to