Chris DuClos EPHT Program

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Environmental Public Health Tracking and
Vital Statistics in Florida
Chris DuClosEPHT Program Meade Grigg State
Registrar Ken Jones Deputy State Registrar

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Background The Pew Report

• In September 2000, Pew Environmental Commission
  Report released to Congress.
• Outlined steady Increase of Chronic Diseases in
  the US
• Birth Defects - 1 Cause of Infant Mortality.
• Learning and Behavioral Disorders rising, over
  50 in the past 10 years.
• Asthma rate 75 increase (1980-1994)
• Reported increases in the incidence of cancers
• In addition, in a national survey, over 87 or
  persons polled, felt that environmental hazards
  in our environment were contributing to chronic
  illness in US.
• Despite evidence of increasing rates of disease
  and environmental links, a coordinated, a system
  to track many of the exposures to health effects
  that may be related to environmental hazards did
  not exist.

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The Response Health Tracking

• Congress appropriated funding for CDC National
  Environmental Public Health Tracking Program in
  2002
• For development and implementation of a
  nationwide environmental health tracking network
  and capacity development in environmental health
  at state and local health departments

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Health Tracking Surveillance

• Environmental Public Health Tracking (EPHT) is
  the ongoing, systematic collection, integration,
  analysis, and interpretation of data for
  evaluating
• environmental hazards,
• human exposure to environmental hazards,
• health effects potentially related to exposure.
• Results must be disseminated to plan, implement,
  and evaluate public health action. This
  requires an electronic network.

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Strategic Plan for the EPHT Network

• To provide information from a nationwide network
  of integrated health and environmental data that
  drives actions to improve the health of
  communities.

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CDC Goals for EPHT Network

• Develop a national Environmental Public Health
  Tracking Network (EPHTN) that
• 1) Is standards-based and PHIN compatible
• 2) Allows direct electronic data reporting and
  linkage within and across health effect,
  exposure, and hazard data
• 3) Interoperates with other public health
  systems.

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CDC Grantees for EnvironmentalPublic Health
Tracking Program FY 2006
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Vital Statistics Collaboration with Health
Tracking in Florida

• Meade Grigg (State Registrar) is on the Florida
  EPHT advisory council
• What has worked well in Florida- simple vital
  stats access procedures for DOH employees other
  researchers- secure electronic access to shared
  copy of SQL Server database (already geocoded to
  FDOH standards)

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Florida ExampleVital Statistics and Health
Tracking

• Live births and fetal deaths are the denominator
  for tracking congenital anomalies (birth defects)
• Geocoded records allow for aggregation at census
  tract level for various time periods of concern
• GIS tools then compare expected to observed rates
  around env. hazards(Rapid Inquiry Facility
  RIF, from the Imperial College of London
  websitehttp//www.sahsu.org )

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Example GIS Analysis of Birth Defects and NPL
Sites in Florida

• Congenital Heart Defects and TCE

RESIDENTIAL AREAS
NPL(SUPERFUND) HAZARDOUS WASTE SITE
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GIS Results Pending More Years of Defect Data
Needed
GIS tools can use SES data as confounders
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Second ExampleLBW and Busy Roadways

• Low Birth Weight (lt 2500g) taken from geocoded
  live births file
• LBW evaluated within 300 meters of roadways with
  gt 10,000 cars per day

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Preliminary Results
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Formation of the Vital Stats / EPHT Partnership
in Florida

• Key personnel identified in EPHT grant app
• Orientation meetings held to understand the data
• Acknowledgment of each partners constraints
• Respect for reservations regarding misuse of
  data
• Share expertise in data, tools, methods
• Share resources rather than try to duplicate them
• Be open to recommendations and ideas

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Guidelines for Vital Statistics/EPHT Partnership

• Follow the Golden Rule
• Meet in person
• Make requests not demands
• Say Please and Thank you
• Whenever possible, provide funding
• Whenever possible, promote their initiatives
  (CHARTS)

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Parting Shot Vital Statistics in the Health
Tracking Network

• Vital Statistics data are very central to health
  tracking goals, so long-termrelationships are
  very important
• By 2010, vital statistics information from all
  EPHT states should be included in some form on
  the Network
• Workgroups (CDC and Grantees) are now discussing
  what specific vital stat information will be on
  the Network

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Florida EPHT Partnerships
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Contact Information

• Environmental Public Health Tracking Program
• Greg Kearney, DrPH, MPH, RS (Principal
  Investigator, Epidemiologist) greg_kearney_at_doh.sta
  te.fl.us , 850-245-4577
• Chris DuClos, MS (IT Manager, Geographic
  Information Systems) chris_duclos_at_doh.state.fl.us
  , 850-245-4264
• Office of Planning, Evaluation, and Data Analysis
• Meade Grigg, State Registrar
• meade_grigg_at_doh.state.fl.us , 850-245-4010
• Ken Jones, Deputy State Registrar
• ken_jones_at_doh.state.fl.us , 904-359-6900 ext.
  1001

• This project is supported by funding provided by
  a CDC Cooperative Agreement to the Florida
  Department of Health. Its contents are the
  responsibility of the authors and do not
  necessarily reflect the views from CDC.