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Cerón A. Environmental and Social Factors Associated with High Chronic Kidney Disease Mortality Rates in Municipalities of Guatemala: An Ecological Study of Municipal-Level Mortality Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085532. [PMID: 37107814 DOI: 10.3390/ijerph20085532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/25/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023]
Abstract
The purpose of this study was to determine the association between social and environmental indicators and high mortality rates from chronic kidney disease (CKD) in municipalities of Guatemala. An ecological study of municipal-level factors associated with CKD mortality in Guatemala was conducted. Crude mortality rates were calculated for the 2009-2019 period for each of the country's 340 municipalities, by gender and age groups. Municipal-level social and environmental indicators were used as independent variables. Linear regression was used for bivariate and multivariate analysis. A total of 28,723 deaths from CKD were documented for the 2009-2019 period. Average crude mortality rate for all ages for the country's 340 municipalities was 70.66 per 100,000 [0-502.99]. Very highly positive associations with high mortality rates were found in two agrarian territories where land use is mainly for permanent crops (e.g., sugar cane, coffee, rubber, banana, plantain, African palm) and pastures for cattle, with very low percentages of land covered by forests or protected areas. Social factors related to poverty and environmental factors related to agricultural use of land may play a role in the high CKD mortality rates documented in a cluster of municipalities of Guatemala.
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Affiliation(s)
- Alejandro Cerón
- Department of Anthropology, University of Denver, Denver, CO 80208, USA
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Baumann AA, Hooley C, Kryzer E, Morshed AB, Gutner CA, Malone S, Walsh-Bailey C, Pilar M, Sandler B, Tabak RG, Mazzucca S. A scoping review of frameworks in empirical studies and a review of dissemination frameworks. Implement Sci 2022; 17:53. [PMID: 35945548 PMCID: PMC9361268 DOI: 10.1186/s13012-022-01225-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The field of dissemination and implementation (D&I) research has grown immensely in recent years. However, the field of dissemination research has not coalesced to the same degree as the field of implementation research. To advance the field of dissemination research, this review aimed to (1) identify the extent to which dissemination frameworks are used in dissemination empirical studies, (2) examine how scholars define dissemination, and (3) identify key constructs from dissemination frameworks. METHODS To achieve aims 1 and 2, we conducted a scoping review of dissemination studies published in D&I science journals. The search strategy included manuscripts published from 1985 to 2020. Articles were included if they were empirical quantitative or mixed methods studies about the dissemination of information to a professional audience. Studies were excluded if they were systematic reviews, commentaries or conceptual papers, scale-up or scale-out studies, qualitative or case studies, or descriptions of programs. To achieve aim 1, we compiled the frameworks identified in the empirical studies. To achieve aim 2, we compiled the definitions from dissemination from frameworks identified in aim 1 and from dissemination frameworks identified in a 2021 review (Tabak RG, Am J Prev Med 43:337-350, 2012). To achieve aim 3, we compile the constructs and their definitions from the frameworks. FINDINGS Out of 6017 studies, 89 studies were included for full-text extraction. Of these, 45 (51%) used a framework to guide the study. Across the 45 studies, 34 distinct frameworks were identified, out of which 13 (38%) defined dissemination. There is a lack of consensus on the definition of dissemination. Altogether, we identified 48 constructs, divided into 4 categories: process, determinants, strategies, and outcomes. Constructs in the frameworks are not well defined. IMPLICATION FOR D&I RESEARCH This study provides a critical step in the dissemination research literature by offering suggestions on how to define dissemination research and by cataloging and defining dissemination constructs. Strengthening these definitions and distinctions between D&I research could enhance scientific reproducibility and advance the field of dissemination research.
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Affiliation(s)
- Ana A Baumann
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, USA.
| | - Cole Hooley
- School of Social Work, Brigham Young University, Provo, USA
| | - Emily Kryzer
- BJC HealthCare, Community Health Improvement, St. Louis, USA
| | | | - Cassidy A Gutner
- ViiV Healthcare, Research Triangle Park, NC, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Sara Malone
- Brown School of Social Work, Washington University in St. Louis, St. Louis, USA
| | - Callie Walsh-Bailey
- Brown School of Social Work, Washington University in St. Louis, St. Louis, USA
| | - Meagan Pilar
- Department of Infectious Diseases, Washington University School of Medicine, Washington University in St. Louis, St. Louis, USA
| | - Brittney Sandler
- Bernard Becker Medical Library, School of Medicine, Washington University in St. Louis, St. Louis, USA
| | - Rachel G Tabak
- Brown School of Social Work, Washington University in St. Louis, St. Louis, USA
| | - Stephanie Mazzucca
- Brown School of Social Work, Washington University in St. Louis, St. Louis, USA
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Karmaoui A, Sereno D, Maia C, Campino L, El Jaafari S, Taybi AF, Hajji L. A conceptual model for understanding the zoonotic cutaneous leishmaniasis transmission risk in the Moroccan pre-Saharan area. Parasite Epidemiol Control 2022; 17:e00243. [PMID: 35243048 PMCID: PMC8856991 DOI: 10.1016/j.parepi.2022.e00243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 11/03/2022] Open
Abstract
Leishmanioses are of public health concern in Morocco, mainly the Zoonotic Cutaneous Leishmaniasis (ZCL) endemic in the Moroccan pre-Saharian area. Transmission of this disease depends on eco-epidemiological and socio-economic conditions. Therefore, a multivariable approach is required to delineate the risk and intensity of transmission. This will help outline main disease risk factors and understand interactions between all underlying factors acting on disease transmission at a local and regional scale. In this context, we propose a new conceptual model, the Biophysical-Drivers-Response-Zoonotic Cutaneous Leishmaniasis (BDRZCL), adapted to the Pre-Saharian area. The proposed model highlights how the physical and human drivers affect the environment and human health. The incidence of ZCL is linked to human activity and biophysical changes or by their interactions. The human response added to risk drivers are the main components that influence the biophysical part. This model improves our understanding of the cause-effect interactions and helps decision-makers and stakeholders react appropriately.
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Gomes BM, Rebelo CB, Alves de Sousa L. Public health, surveillance systems and preventive medicine in an interconnected world. One Health 2022. [DOI: 10.1016/b978-0-12-822794-7.00006-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Hrudey SE, Bischel HN, Charrois J, Chik AHS, Conant B, Delatolla R, Dorner S, Graber TE, Hubert C, Isaac-Renton J, Pons W, Safford H, Servos M, Sikora C. Wastewater Surveillance for SARS-CoV-2 RNA in Canada. Facets (Ott) 2022. [DOI: 10.1139/facets-2022-0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Wastewater surveillance for SARS-CoV-2 RNA is a relatively recent adaptation of long-standing wastewater surveillance for infectious and other harmful agents. Individuals infected with COVID-19 were found to shed SARS-CoV-2 in their faeces. Researchers around the world confirmed that SARS-CoV-2 RNA fragments could be detected and quantified in community wastewater. Canadian academic researchers, largely as volunteer initiatives, reported proof-of-concept by April 2020. National collaboration was initially facilitated by the Canadian Water Network. Many public health officials were initially skeptical about actionable information being provided by wastewater surveillance even though experience has shown that public health surveillance for a pandemic has no single, perfect approach. Rather, different approaches provide different insights, each with its own strengths and limitations. Public health science must triangulate among different forms of evidence to maximize understanding of what is happening or may be expected. Well-conceived, resourced, and implemented wastewater-based platforms can provide a cost-effective approach to support other conventional lines of evidence. Sustaining wastewater monitoring platforms for future surveillance of other disease targets and health states is a challenge. Canada can benefit from taking lessons learned from the COVID-19 pandemic to develop forward-looking interpretive frameworks and capacity to implement, adapt, and expand such public health surveillance capabilities.
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Affiliation(s)
- Steve E. Hrudey
- Professor Emeritus, Analytical & Environmental Toxicology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2G3 Canada
| | - Heather N. Bischel
- Associate Professor, Department of Civil & Environmental Engineering, University of California, Davis, Davis, CA 95616 USA
| | - Jeff Charrois
- Senior Manager, Analytical Operations and Process Development Teams, EPCOR Water Services Inc, Edmonton, AB T5K 0A5 Canada
| | - Alex H. S. Chik
- Project Manager, Wastewater Surveillance Initiative, Ontario Clean Water Agency, Mississauga, ON L5A 4G1 Canada
| | - Bernadette Conant
- Past Chief Executive Officer, Canadian Water Network, Waterloo, ON N2L 3G1 Canada
| | - Rob Delatolla
- Professor, Civil Engineering, University of Ottawa, Ottawa, ON K1N 6N5 Canada
| | - Sarah Dorner
- Professor, Civil, Geological & Mining Engineering, Polytechnique Montréal, Montréal, PQ H3T 1J4 Canada
| | - Tyson E. Graber
- Associate Scientist, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1 Canada
| | - Casey Hubert
- Professor, Campus Alberta Innovates Program Chair in Geomicrobiology, Department of Biological Sciences, University of Calgary, Calgary, AB T2N 1N4 Canada
| | - Judy Isaac-Renton
- Professor Emerita, Dept. Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Calgary, AB, T2N 3V9 Canada
| | - Wendy Pons
- Professor, Bachelor of Environmental Health Program Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON N2P 2N6 Canada
| | - Hannah Safford
- Associate Director of Science Policy, Federation of American Scientists, Arlington, VA 22205 USA
| | - Mark Servos
- Professor & Canada Research Chair, Department of Biology, University of Waterloo, Waterloo, ON N2L 3G1 Canada
| | - Christopher Sikora
- Medical Officer of Health, Edmonton Region, Alberta Health Services, Edmonton, AB T5J 3E4 Canada
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Haddaji N. Environmental contaminants and antibiotic resistance as a One Health threat. One Health 2022. [DOI: 10.1016/b978-0-12-822794-7.00010-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Post LA, Benishay ET, Moss CB, Murphy RL, Achenbach CJ, Ison MG, Resnick D, Singh LN, White J, Chaudhury AS, Boctor MJ, Welch SB, Oehmke JF. Surveillance Metrics of SARS-CoV-2 Transmission in Central Asia: Longitudinal Trend Analysis. J Med Internet Res 2021; 23:e25799. [PMID: 33475513 PMCID: PMC7861038 DOI: 10.2196/25799] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/09/2020] [Accepted: 01/20/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND SARS-CoV-2, the virus that caused the global COVID-19 pandemic, has severely impacted Central Asia; in spring 2020, high numbers of cases and deaths were reported in this region. The second wave of the COVID-19 pandemic is currently breaching the borders of Central Asia. Public health surveillance is necessary to inform policy and guide leaders; however, existing surveillance explains past transmissions while obscuring shifts in the pandemic, increases in infection rates, and the persistence of the transmission of COVID-19. OBJECTIVE The goal of this study is to provide enhanced surveillance metrics for SARS-CoV-2 transmission that account for weekly shifts in the pandemic, including speed, acceleration, jerk, and persistence, to better understand the risk of explosive growth in each country and which countries are managing the pandemic successfully. METHODS Using a longitudinal trend analysis study design, we extracted 60 days of COVID-19-related data from public health registries. We used an empirical difference equation to measure the daily number of cases in the Central Asia region as a function of the prior number of cases, level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. RESULTS COVID-19 transmission rates were tracked for the weeks of September 30 to October 6 and October 7-13, 2020, in Central Asia. The region averaged 11,730 new cases per day for the first week and 14,514 for the second week. Infection rates increased across the region from 4.74 per 100,000 persons to 5.66. Russia and Turkey had the highest 7-day moving averages in the region, with 9836 and 1469, respectively, for the week of October 6 and 12,501 and 1603, respectively, for the week of October 13. Russia has the fourth highest speed in the region and continues to have positive acceleration, driving the negative trend for the entire region as the largest country by population. Armenia is experiencing explosive growth of COVID-19; its infection rate of 13.73 for the week of October 6 quickly jumped to 25.19, the highest in the region, the following week. The region overall is experiencing increases in its 7-day moving average of new cases, infection, rate, and speed, with continued positive acceleration and no sign of a reversal in sight. CONCLUSIONS The rapidly evolving COVID-19 pandemic requires novel dynamic surveillance metrics in addition to static metrics to effectively analyze the pandemic trajectory and control spread. Policy makers need to know the magnitude of transmission rates, how quickly they are accelerating, and how previous cases are impacting current caseload due to a lag effect. These metrics applied to Central Asia suggest that the region is trending negatively, primarily due to minimal restrictions in Russia.
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Affiliation(s)
- Lori Ann Post
- Buehler Center for Health Policy and Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Elana T Benishay
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Charles B Moss
- Institute of Food and Agricultural Sciences, University of Florida, Gainsville, FL, United States
| | - Robert Leo Murphy
- Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Chad J Achenbach
- Divison of Infectious Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Michael G Ison
- Divison of Infectious Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Danielle Resnick
- International Food Policy Research Institute, Washington, DC, United States
| | - Lauren Nadya Singh
- Buehler Center for Health Policy and Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Janine White
- Buehler Center for Health Policy and Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Azraa S Chaudhury
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Michael J Boctor
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Sarah B Welch
- Buehler Center for Health Policy and Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - James Francis Oehmke
- Buehler Center for Health Policy and Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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8
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Azadi T, Sadoughi F, Khorasani-Zavareh D. Using the Modified Delphi Method to Propose and Validate Components of a Child Injury Surveillance System for Iran. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2020; 18:1k. [PMID: 33633521 PMCID: PMC7883356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Child injuries are a worldwide public health concern. An injury surveillance system (ISS) has a beneficial impact on child injury prevention, but an evidence-based consensus on frameworks is necessary to establish a child ISS. OBJECTIVES To investigate key components of a child ISS and to propose a framework for implementation. METHODS Data were gathered through interview with experts using unstructured questions to identify child ISS functional components. Qualitative data was analyzed using content analysis method. Then, the Modified Delphi method was used to validate functional components. Based on the outcomes of the content analysis, a questionnaire with closed questions was developed to be presented to a group of experts. Consensus was achieved in two rounds. DISCUSSION In round I, 117 items reached consensus. In round II, five items reached consensus and were incorporated into the final framework. Consensus was reached for 122 items comprising the final framework and representing seven key components: goals of the system, data sources, data set, coalition of stakeholders, data collection, data analysis, and data distribution. Each component consisted of several sub-components and respective elements. CONCLUSION This agreed framework will assist to standardize data collection, analysis, and distribution to detect child injury problem and provide evidence for preventive measures.
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Affiliation(s)
- Tania Azadi
- , School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Farahnaz Sadoughi
- Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Davoud Khorasani-Zavareh
- , Safety Promotion and Injury Prevention Research Center, Health in Disaster and Emergency Department, School of Health, Safety and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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9
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Azadi T, Sadoughi F, Khorasani-Zavareh D. Using modified Delphi method to propose and validate the components of a child injury surveillance system for Iran. Chin J Traumatol 2020; 23:274-279. [PMID: 32921558 PMCID: PMC7567898 DOI: 10.1016/j.cjtee.2020.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 07/15/2020] [Accepted: 08/01/2020] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Child injuries are a public health concern globally. Injury surveillance systems (ISSs) have beneficial impact on child injury prevention. There is a need for evidence-based consensus on frameworks to establish child ISSs. This research aims to investigate the key components of a child ISS for Iran and to propose a framework for implementation. METHODS Data were gathered through interview with experts using unstructured questions from January 2017 to December 2018 to identify child ISS functional components. Qualitative data were analyzed using content analysis method. Then, modified Delphi method was used to validate the functional components. Based on the outcomes of the content analysis, a questionnaire with closed questions was developed and presented to a group of experts. Consensus was achieved in two rounds. RESULTS In round I, 117 items reached consensus. In round II, 5 items reached consensus and were incorporated into final framework. Consensus was reached for 122 items comprising the final framework and representing 7 key components: goals of the system, data sources, data set, coalition of stakeholders, data collection, data analysis and data distribution. Each component consisted of several sub-components and respective elements. CONCLUSION This agreed framework will assist in standardizing data collection, analysis and distribution, which help to detect child injury problems and provide evidence for preventive measures.
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Affiliation(s)
- Tania Azadi
- Health Information Management Department, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Farahnaz Sadoughi
- Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran,Corresponding author.
| | - Davoud Khorasani-Zavareh
- Safety Promotion and Injury Prevention Research Center, Health in Disaster and Emergency Department, School of Health, Safety and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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González-Alcaide G, Llorente P, Ramos-Rincón JM. Systematic analysis of the scientific literature on population surveillance. Heliyon 2020; 6:e05141. [PMID: 33029562 PMCID: PMC7528878 DOI: 10.1016/j.heliyon.2020.e05141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/01/2020] [Accepted: 09/29/2020] [Indexed: 01/04/2023] Open
Abstract
Introduction Population surveillance provides data on the health status of the population through continuous scrutiny of different indicators. Identifying risk factors is essential for the quickly detecting and controlling of epidemic outbreaks and reducing the incidence of cross-infections and non-communicable diseases. The objective of the present study is to analyze research on population surveillance, identifying the main topics of interest for investigators in the area. Methodology We included documents indexed in the Web of Science Core Collection in the period from 2000 to 2019 and assigned with the generic Medical Subject Heading (MeSH) “population surveillance” or its related terms (“public health surveillance,” “sentinel surveillance” or “biosurveillance”). A co-occurrence analysis was undertaken to identify the document clusters comprising the main research topics. Scientific production, collaboration, and citation patterns in each of the clusters were characterized bibliometrically. We also analyzed research on coronaviruses, relating the results obtained to the management of the COVID-19 pandemic. Results We included 39,184 documents, which reflected a steady growth in scientific output driven by papers on “Public, Environmental & Occupational Health” (21.62% of the documents) and “Infectious Diseases” (10.49%). Research activity was concentrated in North America (36.41%) and Europe (32.09%). The USA led research in the area (40.14% of documents). Ten topic clusters were identified, including “Disease Outbreaks,” which is closely related to two other clusters (“Genetics” and “Influenza”). Other clusters of note were “Cross Infections” as well as one that brought together general public health concepts and topics related to non-communicable diseases (cardiovascular and coronary diseases, mental diseases, diabetes, wound and injuries, stroke, and asthma). The rest of the clusters addressed “Neoplasms,” “HIV,” “Pregnancy,” “Substance Abuse/Obesity,” and “Tuberculosis.” Although research on coronavirus has focused on population surveillance only occasionally, some papers have analyzed and collated guidelines whose relevance to the dissemination and management of the COVID-19 pandemic has become obvious. Topics include tracing the spread of the virus, limiting mass gatherings that would facilitate its propagation, and the imposition of quarantines. There were important differences in the scientific production and citation of different clusters: the documents on mental illnesses, stroke, substance abuse/obesity, and cross-infections had much higher citations than the clusters on disease outbreaks, tuberculosis, and especially coronavirus, where these values are substantially lower. Conclusions The role of population surveillance should be strengthened, promoting research and the development of public health surveillance systems in countries whose contribution to the area is limited.
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Affiliation(s)
| | - Pedro Llorente
- Denia Public Health Center, Conselleria de Sanitat i Salut Publica, Alicante, Spain.,Defence Institute of Preventive Medicine, Ministry of Defence, Madrid, Spain
| | - José-Manuel Ramos-Rincón
- Department of Internal Medicine, General University Hospital of Alicante, Alicante, Spain.,Department of Clinical Medicine, Miguel Hernandez University of Elche, Alicante, Spain
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Environmental Health Surveillance System for a Population Using Advanced Exposure Assessment. TOXICS 2020; 8:toxics8030074. [PMID: 32962012 PMCID: PMC7560317 DOI: 10.3390/toxics8030074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 09/12/2020] [Accepted: 09/17/2020] [Indexed: 01/14/2023]
Abstract
Human exposure to air pollution is a major public health concern. Environmental policymakers have been implementing various strategies to reduce exposure, including the 10th-day-no-driving system. To assess exposure of an entire population of a community in a highly polluted area, pollutant concentrations in microenvironments and population time–activity patterns are required. To date, population exposure to air pollutants has been assessed using air monitoring data from fixed atmospheric monitoring stations, atmospheric dispersion modeling, or spatial interpolation techniques for pollutant concentrations. This is coupled with census data, administrative registers, and data on the patterns of the time-based activities at the individual scale. Recent technologies such as sensors, the Internet of Things (IoT), communications technology, and artificial intelligence enable the accurate evaluation of air pollution exposure for a population in an environmental health context. In this study, the latest trends in published papers on the assessment of population exposure to air pollution were reviewed. Subsequently, this study proposes a methodology that will enable policymakers to develop an environmental health surveillance system that evaluates the distribution of air pollution exposure for a population within a target area and establish countermeasures based on advanced exposure assessment.
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Lin S, Lu Y, Lin Z, Romeiko XX, Marks T, Zhang W, Khwaja HA, Dong G, Thurston G. Identifying and evaluating school environmental health indicators. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:16624-16639. [PMID: 32133611 DOI: 10.1007/s11356-020-08092-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 02/12/2020] [Indexed: 06/10/2023]
Abstract
Children's health, attendance, and academic performance may be affected by school environmental hazards. While prior studies evaluated home environment and health, few have evaluated indicators of school in-/outdoor environment and health. This study addresses this knowledge gap by systematically reviewing and evaluating outdoor and indoor indicators of school environment and student's health and performance in New York State (NYS). We also evaluate statistical methodologies to address highly correlated indicators and integrate multiple exposures. Multiple school environmental indicators were identified from various existing NYS datasets. We summarized data sources, completeness, geographic and temporal coverage, and data quality for each indicator. Each indicator was evaluated by scientific basis/relevance, analytic soundness/feasibility, and interpretation/utility, and validated using objective NYS data. Finally, advanced variable selection methods were described and discussed. We have identified and evaluated multiple school environmental health indicators. It was found that mold and moisture problems, ventilation problems, ambient ozone, and PM2.5 levels are among the top priorities of school environmental issues/indicators in NYS, which were also consistent while using NYS data. Choice of best variable selection method should be made based on the research questions and data characteristics. The school environmental health indicators identified, and variable selection methods evaluated, in this study could be used by other researchers to help school officials and policy makers initiate prevention programs.
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Affiliation(s)
- Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 1 University Place, Room 212D, Rensselaer, NY, 12144, USA.
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA.
| | - Yi Lu
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 1 University Place, Room 212D, Rensselaer, NY, 12144, USA
| | - Ziqiang Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 1 University Place, Room 212D, Rensselaer, NY, 12144, USA
| | - Xiaobo Xue Romeiko
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 1 University Place, Room 212D, Rensselaer, NY, 12144, USA
| | - Tia Marks
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 1 University Place, Room 212D, Rensselaer, NY, 12144, USA
| | - Wangjian Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 1 University Place, Room 212D, Rensselaer, NY, 12144, USA
| | - Haider A Khwaja
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 1 University Place, Room 212D, Rensselaer, NY, 12144, USA
- Wadsworth Laboratory, New York State Department of Health, Albany, NY, USA
| | - Guanghui Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - George Thurston
- Department of Environmental Medicine, School of Medicine, New York University, New York, NY, USA
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Blangiardo M, Boulieri A, Diggle P, Piel FB, Shaddick G, Elliott P. Advances in spatiotemporal models for non-communicable disease surveillance. Int J Epidemiol 2020; 49 Suppl 1:i26-i37. [PMID: 32293008 PMCID: PMC7158067 DOI: 10.1093/ije/dyz181] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 08/07/2019] [Indexed: 12/03/2022] Open
Abstract
Surveillance systems are commonly used to provide early warning detection or to assess an impact of an intervention/policy. Traditionally, the methodological and conceptual frameworks for surveillance have been designed for infectious diseases, but the rising burden of non-communicable diseases (NCDs) worldwide suggests a pressing need for surveillance strategies to detect unusual patterns in the data and to help unveil important risk factors in this setting. Surveillance methods need to be able to detect meaningful departures from expectation and exploit dependencies within such data to produce unbiased estimates of risk as well as future forecasts. This has led to the increasing development of a range of space-time methods specifically designed for NCD surveillance. We present an overview of recent advances in spatiotemporal disease surveillance for NCDs, using hierarchically specified models. This provides a coherent framework for modelling complex data structures, dealing with data sparsity, exploiting dependencies between data sources and propagating the inherent uncertainties present in both the data and the modelling process. We then focus on three commonly used models within the Bayesian Hierarchical Model (BHM) framework and, through a simulation study, we compare their performance. We also discuss some challenges faced by researchers when dealing with NCD surveillance, including how to account for false detection and the modifiable areal unit problem. Finally, we consider how to use and interpret the complex models, how model selection may vary depending on the intended user group and how best to communicate results to stakeholders and the general public.
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Affiliation(s)
- Marta Blangiardo
- UK Small Area Health Statistics Unit
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, Imperial College London, London, UK
| | - Areti Boulieri
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, Imperial College London, London, UK
| | - Peter Diggle
- Centre for Health Informatics, Computing and Statistics (CHICAS), Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Frédéric B Piel
- UK Small Area Health Statistics Unit
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, Imperial College London, London, UK
| | - Gavin Shaddick
- Department of Mathematics, University of Exeter, Exeter, UK
| | - Paul Elliott
- UK Small Area Health Statistics Unit
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, Imperial College London, London, UK
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Edokpolo B, Allaz-Barnett N, Irwin C, Issa J, Curtis P, Green B, Hanigan I, Dennekamp M. Developing a Conceptual Framework for Environmental Health Tracking in Victoria, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101748. [PMID: 31108844 PMCID: PMC6572157 DOI: 10.3390/ijerph16101748] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/06/2019] [Accepted: 05/10/2019] [Indexed: 11/16/2022]
Abstract
Victoria’s (Australia) Environment Protection Authority (EPA), the state’s environmental regulator, has recognized the need to develop an Environmental Health Tracking System (EHTS) to better understand environmental health relationships. To facilitate the process of developing an EHTS; a linkage-based conceptual framework was developed to link routinely collected environmental and health data to better understand environmental health relationships. This involved researching and drawing on knowledge from previous similar projects. While several conceptual frameworks have been used to organize data to support the development of an environmental health tracking system, Driving Force–Pressure–State–Exposure–Effect–Action (DPSEEA) was identified as the most broadly applied conceptual framework. Exposure and effects are two important components of DPSEEA, and currently, exposure data are not available for the EHTS. Therefore, DPSEEA was modified to the Driving Force–Pressure–Environmental Condition–Health Impact–Action (DPEHA) conceptual framework for the proposed Victorian EHTS as there is relevant data available for tracking. The potential application of DPEHA for environmental health tracking was demonstrated through case studies. DPEHA will be a useful tool to support the implementation of Victoria’s environmental health tracking system for providing timely and scientific evidence for EPA and other decision makers in developing and evaluating policies for protecting public health and the environment in Victoria.
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Affiliation(s)
- Benjamin Edokpolo
- Environmental Public Health Unit, Environment Protection Authority Victoria, 200 Victoria Street, Carlton, Victoria 3053, Australia.
| | - Nathalie Allaz-Barnett
- Environmental Public Health Unit, Environment Protection Authority Victoria, 200 Victoria Street, Carlton, Victoria 3053, Australia.
| | - Catherine Irwin
- Environmental Public Health Unit, Environment Protection Authority Victoria, 200 Victoria Street, Carlton, Victoria 3053, Australia.
| | - Jason Issa
- Environmental Public Health Unit, Environment Protection Authority Victoria, 200 Victoria Street, Carlton, Victoria 3053, Australia.
| | - Pete Curtis
- Environmental Public Health Unit, Environment Protection Authority Victoria, 200 Victoria Street, Carlton, Victoria 3053, Australia.
| | - Bronwyn Green
- Environmental Public Health Unit, Environment Protection Authority Victoria, 200 Victoria Street, Carlton, Victoria 3053, Australia.
| | - Ivan Hanigan
- School of Public Health, University Centre for Rural Health, The University of Sydney, Sydney 2006, Australia.
- The Centre for Air pollution, energy and health Research (CAR), Woolcock Institute of Medical Research, Sydney 2006, Australia.
- Centre for Research and Action in Public Health, University of Canberra, Canberra 2617, Australia.
| | - Martine Dennekamp
- Environmental Public Health Unit, Environment Protection Authority Victoria, 200 Victoria Street, Carlton, Victoria 3053, Australia.
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia.
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Ban J, Du Z, Wang Q, Ma R, Zhou Y, Li T. Environmental Health Indicators for China: Data Resources for Chinese Environmental Public Health Tracking. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:44501. [PMID: 30990728 PMCID: PMC6785224 DOI: 10.1289/ehp4319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Many developed countries use environmental public health tracking to gain a better understanding of the link between environmental hazards and public health. To respond to complicated environmental health issues, the National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), has begun to build a Chinese Environmental Public Health Tracking (CEPHT) system. On behalf of the CEPHT, authors provide insight into the CEPHT's development, current status, and future plans. In the initial stage of CEPHT, an indicator framework linking environment and public health that included a list of publicly available data sources regarding environmental hazards, public health outcomes, and risk factors in China was developed. An analysis of data availability, along with a comparison between CEPHT's indicator system and other tracking networks, revealed the existence of barriers and gaps in data integration that affect China's ability to track environmental public health. The lack of access to data, combined with inadequate data quality, has led to difficulties linking environmental hazards to their effects on public health. Current CEPHT efforts will help integrate environmental factors and exposure data with public health outcomes. For the near future, CEPHT plans to focus on increasing collaboration among data tracking agencies, improving data quality, and expanding proper data sharing. https://doi.org/10.1289/EHP4319.
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Affiliation(s)
- Jie Ban
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zonghao Du
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qing Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Runmei Ma
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ying Zhou
- Division of Environmental Hazards and Health Effects, Environmental Health Tracking Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Dixit S, Arora NK, Rahman A, Howard NJ, Singh RK, Vaswani M, Das MK, Ahmed F, Mathur P, Tandon N, Dasgupta R, Chaturvedi S, Jethwaney J, Dalpath S, Prashad R, Kumar R, Gupta R, Dube L, Daniel M. Establishing a Demographic, Development and Environmental Geospatial Surveillance Platform in India: Planning and Implementation. JMIR Public Health Surveill 2018; 4:e66. [PMID: 30291101 PMCID: PMC6231830 DOI: 10.2196/publichealth.9749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/11/2018] [Accepted: 06/18/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Inadequate administrative health data, suboptimal public health infrastructure, rapid and unplanned urbanization, environmental degradation, and poor penetration of information technology make the tracking of health and well-being of populations and their social determinants in the developing countries challenging. Technology-integrated comprehensive surveillance platforms have the potential to overcome these gaps. OBJECTIVE This paper provides methodological insights into establishing a geographic information system (GIS)-integrated, comprehensive surveillance platform in rural North India, a resource-constrained setting. METHODS The International Clinical Epidemiology Network Trust International established a comprehensive SOMAARTH Demographic, Development, and Environmental Surveillance Site (DDESS) in rural Palwal, a district in Haryana, North India. The surveillance platform evolved by adopting four major steps: (1) site preparation, (2) data construction, (3) data quality assurance, and (4) data update and maintenance system. Arc GIS 10.3 and QGIS 2.14 software were employed for geospatial data construction. Surveillance data architecture was built upon the geospatial land parcel datasets. Dedicated software (SOMAARTH-1) was developed for handling high volume of longitudinal datasets. The built infrastructure data pertaining to land use, water bodies, roads, railways, community trails, landmarks, water, sanitation and food environment, weather and air quality, and demographic characteristics were constructed in a relational manner. RESULTS The comprehensive surveillance platform encompassed a population of 0.2 million individuals residing in 51 villages over a land mass of 251.7 sq km having 32,662 households and 19,260 nonresidential features (cattle shed, shops, health, education, banking, religious institutions, etc). All land parcels were assigned georeferenced location identification numbers to enable space and time monitoring. Subdivision of villages into sectors helped identify socially homogenous community clusters (418/676, 61.8%, sectors). Water and hygiene parameters of the whole area were mapped on the GIS platform and quantified. Risk of physical exposure to harmful environment (poor water and sanitation indicators) was significantly associated with the caste of individual household (P=.001), and the path was mediated through the socioeconomic status and density of waste spots (liquid and solid) of the sector in which these households were located. Ground-truthing for ascertaining the land parcel level accuracies, community involvement in mapping exercise, and identification of small habitations not recorded in the administrative data were key learnings. CONCLUSIONS The SOMAARTH DDESS experience allowed us to document and explore dynamic relationships, associations, and pathways across multiple levels of the system (ie, individual, household, neighborhood, and village) through a geospatial interface. This could be used for characterization and monitoring of a wide range of proximal and distal determinants of health.
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Affiliation(s)
- Shikha Dixit
- Research, SOMAARTH Demographic, Development and Environmental Surveillance Site, The INCLEN Trust International, New Delhi, India
| | - Narendra K Arora
- Research, Epidemiology, The INCLEN Trust International, New Delhi, India
| | - Atiqur Rahman
- Department of Geography, Faculty of Natural Sciences, Jamia Millia Islamia, New Delhi, India
| | - Natasha J Howard
- Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, Australia.,South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Rakesh K Singh
- Research, SOMAARTH Demographic, Development and Environmental Surveillance Site, The INCLEN Trust International, New Delhi, India
| | - Mayur Vaswani
- Research, SOMAARTH Demographic, Development and Environmental Surveillance Site, The INCLEN Trust International, New Delhi, India
| | - Manoja K Das
- Research, SOMAARTH Demographic, Development and Environmental Surveillance Site, The INCLEN Trust International, New Delhi, India
| | | | - Prashant Mathur
- National Cancer Registry Program, National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bangalore, India
| | - Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajib Dasgupta
- Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
| | - Sanjay Chaturvedi
- Department of Community Medicine, University College of Medical Sciences, University of Delhi, New Delhi, India
| | - Jaishri Jethwaney
- Department of Research, Indian Council for Social Science Research, New Delhi, India
| | | | - Rajendra Prashad
- Office of Chief Medical Officer, Department of Health, Palwal, India
| | - Rakesh Kumar
- Indian Council of Medical Research, New Delhi, India
| | | | - Laurette Dube
- McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Mark Daniel
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australia.,Department of Medicine, St. Vincent's Hospital, The University of Melbourne, Melbourne, Australia
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Affiliation(s)
- Rob Lyerla
- College of Health and Human Services, Western Michigan University, Kalamazoo, MI, USA
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Environmental Public Health Tracking Program Advances and Successes: Highlights From the First 15 Years. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2017; 23 Suppl 5 Supplement, Environmental Public Health Tracking:S4-S8. [PMID: 28763380 DOI: 10.1097/phh.0000000000000626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Over the past 15 years, the National Environmental Public Health Tracking Program (Tracking Program) has advanced technologically and programmatically, evolving from an abstract concept to a mature program. The Tracking Program, in collaboration with national, state, and local partners, uses data and expertise to identify and address environmental public health needs and improve public health capacity across the United States. Examples of the successful application of environmental public health tracking include informing health impact assessments and filling data gaps. The Tracking Program plans to continue working to direct innovative programs and solutions that protect and improve community health in years to come. With support from the Tracking Program, health departments can enhance their abilities to plan and conduct environmental public health activities.
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Rudolph L, Gould S. Climate Change and Health Inequities: A Framework for Action. Ann Glob Health 2016; 81:432-44. [PMID: 26615079 DOI: 10.1016/j.aogh.2015.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Linda Rudolph
- Center for Climate Change and Health, Public Health Institute, Oakland, CA.
| | - Solange Gould
- School of Public Health, University of California, Berkeley, CA
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Environmental public health tracking: driving environmental health information. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2016; 21 Suppl 2:S4-11. [PMID: 25621444 DOI: 10.1097/phh.0000000000000173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Historically, public health professionals lacked the capacity to evaluate and conduct key investigations into the health of their environment. By bringing together environmental and health effects data from a variety of data sources, the National Environmental Public Health Tracking Network (Tracking) allows users to easily analyze and research the relationships between human health and the environment. OBJECTIVE As the Tracking Network has matured, its information has been used to guide public health actions, generate hypothesis, and demonstrate relationships between environment and health outcomes. PARTICIPANTS The Tracking Network is composed of state, local, and national environment and public health partners. SETTINGS The Environmental Public Health Tracking Network is part of the National Center for Environmental Health at the Centers for Disease Control and Prevention. DESIGN Tracking standardizes existing data from diverse sources while leveraging technologies and applying sound communication practices to provide a user-friendly interface for the data system by all types of users.
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Namulanda G. Biomonitoring and environmental public health tracking. JOURNAL OF ENVIRONMENTAL HEALTH 2015; 77:36-38. [PMID: 25985537 PMCID: PMC5794030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
As part of our continuing effort to highlight innovative approaches and tools to improve the health and environment of communities, the Journal is pleased to publish a bimonthly column from the Centers for Disease Control and Prevention’s (CDC’s) Environmental Public Health Tracking Network (Tracking Network). The Tracking Network is a system of integrated health, exposure, and hazard information and data from a variety of national, state, and city sources. The Tracking Network brings together data concerning health and environmental problems with the goal of providing information to help improve where we live, work, and play. Environmental causes of chronic diseases are hard to identify. Measuring amounts of hazardous substances in our environment in a standard way, tracing the spread of these over time and area, seeing how they show up in human tissues, and understanding how they may cause illness is critical. The Tracking Network is a tool that can help connect these efforts. Through these columns, readers will learn about the program and the resources, tools, and information available from CDC’s Tracking Network. The conclusions of this article are those of the author(s) and do not necessarily represent the views of CDC. Gonza Namulanda is a health scientist with the Environmental Health Tracking Branch. She works primarily on the biomonitoring and childhood blood lead content areas and electronic health records and metadata for environmental public health tracking.
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Choi BC. What Could Be Future Scenarios?-Lessons from the History of Public Health Surveillance for the Future: --A keynote address presented at the 8th World Alliance for Risk Factor Surveillance (WARFS) Global Conference on October 30, 2013, Beijing, China. AIMS Public Health 2015; 2:27-43. [PMID: 29546093 PMCID: PMC5690367 DOI: 10.3934/publichealth.2015.1.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 03/02/2015] [Indexed: 02/05/2023] Open
Abstract
This article provides insights into the future based on a review of the past and present of public health surveillance-the ongoing systematic collection, analysis, interpretation, and dissemination of health data for the planning, implementation, and evaluation of public health action. Public health surveillance dates back to the first recorded epidemic in 3180 BC in Egypt. A number of lessons and items of interest are summarised from a review of historical perspectives in the past 5,000 years and the current practice of surveillance. Some future scenarios are presented: exploring new frontiers; enhancing computer technology; improving epidemic investigations; improving data collection, analysis, dissemination and use; building on lessons from the past; building capacity; and enhancing global surveillance. It is concluded that learning from the past, reflecting on the present, and planning for the future can further enhance public health surveillance.
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Affiliation(s)
- Bernard C.K. Choi
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Government of Canada, Ottawa, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
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Kearney GD, Namulanda G, Qualters JR, Talbott EO. A decade of environmental public health tracking (2002-2012): progress and challenges. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2015; 21 Suppl 2:S23-35. [PMID: 25621442 PMCID: PMC5667361 DOI: 10.1097/phh.0000000000000181] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The creation of the Centers for Disease Control and Prevention Environmental Public Health Tracking Program spawned an invigorating and challenging approach toward implementing the nation's first population-based, environmental disease tracking surveillance system. More than 10 years have passed since its creation and an abundance of peer-reviewed articles have been published spanning a broad variety of public health topics related primarily to the goal of reducing diseases of environmental origin. OBJECTIVE To evaluate peer-reviewed literature related to Environmental Public Health Tracking during 2002-2012, recognize major milestones and challenges, and offer recommendations. DESIGN A narrative overview was conducted using titles and abstracts of peer-reviewed articles, key word searches, and science-based search engine databases. MAIN OUTCOMES Eighty published articles related to "health tracking" were identified and categorized according to 4 crossed-central themes. The Science and Research theme accounted for the majority of published articles, followed by Policy and Practice, Collaborations Among Health and Environmental Programs, and Network Development. CONCLUSIONS Overall, progress was reported in the areas of data linkage, data sharing, surveillance methods, and network development. Ongoing challenges included formulating better ways to establish the connections between health and the environment, such as using biomonitoring, public water systems, and private well water data. Recommendations for future efforts include use of data to inform policy and practice and use of electronic health records data for environmental health surveillance.
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Affiliation(s)
- Gregory D Kearney
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville North Carolina (Dr Kearney); Division of Environmental Hazards & Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Namulanda and Dr Qualters); and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Talbott)
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Qualters JR, Strosnider HM, Bell R. Data to action: using environmental public health tracking to inform decision making. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2015; 21 Suppl 2:S12-22. [PMID: 25621441 PMCID: PMC5703058 DOI: 10.1097/phh.0000000000000175] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Public health surveillance includes dissemination of data and information to those who need it to take action to prevent or control disease. The concept of data to action is explicit in the mission of the Centers for Disease Control and Prevention's (CDC's) National Environmental Public Health Tracking Program (Tracking Program). The CDC has built a National Environmental Public Health Tracking Network (Tracking Network) to integrate health and environmental data to drive public health action (PHA) to improve communities' health. OBJECTIVE To assess the utility of the Tracking Program and Tracking Network in environmental public health practice and policy making. DESIGN We analyzed information on how Tracking (all program components hereafter referred to generally as "Tracking") has been used to drive PHAs within funded states and cities (grantees). Two case studies are presented to highlight Tracking's utility. SETTING Analyses included all grantees funded between 2005 and 2013. PARTICIPANTS Twenty-seven states, 3 cities, and the District of Columbia ever received funding. MAIN OUTCOME MEASURES We categorized each PHA reported to determine how grantees became involved, their role, the problems addressed, and the overall action. RESULTS Tracking grantees reported 178 PHAs from 2006 to 2013. The most common overall action was "provided information in response to concern" (n = 42), followed by "improved a public health program, intervention, or response plan" (n = 35). Tracking's role was most often either to enhance surveillance (24%) or to analyze data (23%). In 47% of PHAs, the underlying problem was a concern about possible elevated rates of a health outcome, a potential exposure, or a potential association between a hazard and a health outcome. PHAs were started by a request for assistance (48%), in response to an emergency (8%), and though routine work by Tracking programs (43%). CONCLUSION Our review shows that the data, expertise, technical infrastructure, and other resources of the Tracking Program and Tracking Network are driving state and local PHAs.
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Affiliation(s)
- Judith R Qualters
- Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Office of Non-infectious Diseases, Injury and Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Moysés SJ, Pucca Junior GA, Paludetto Junior M, Moura LD. [Progresses and challenges to the Oral Health Surveillance Policy in Brazil]. Rev Saude Publica 2014; 47 Suppl 3:161-7. [PMID: 24626593 DOI: 10.1590/s0034-8910.2013047004329] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 08/25/2012] [Indexed: 11/21/2022] Open
Abstract
This comprehensive critical review, carried out in a descriptive-discursive style, presents the oral health surveillance policy currently in force in Brazil. Based on an appraisal of the national and international literature on the subject of health surveillance, it examines the formulation of a scientific and political agenda for oral health surveillance, which is anchored in the institutions of the Brazilian Public Health System. The accomplishment of this agenda is exemplified by the presentation of the most recent Brazilian Oral Health survey (SBBrasil 2010). A conclusive summary is presented on the search for a theoretical and methodological convergence of both the identification of the obstacles and weaknesses still detectable in this policy, and the recognition of its virtues already confirmed by important advances and achievements.
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Strosnider H, Zhou Y, Balluz L, Qualters J. Engaging academia to advance the science and practice of environmental public health tracking. ENVIRONMENTAL RESEARCH 2014; 134:474-81. [PMID: 25038624 PMCID: PMC4909327 DOI: 10.1016/j.envres.2014.04.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 04/25/2014] [Accepted: 04/29/2014] [Indexed: 05/27/2023]
Abstract
Public health agencies at the federal, state, and local level are responsible for implementing actions and policies that address health problems related to environmental hazards. These actions and policies can be informed by integrating or linking data on health, exposure, hazards, and population. The mission of the Centers for Disease Control and Prevention׳s National Environmental Public Health Tracking Program (Tracking Program) is to provide information from a nationwide network of integrated health, environmental hazard, and exposure data that drives actions to improve the health of communities. The Tracking Program and federal, state, and local partners collect, integrate, analyze, and disseminate data and information to inform environmental public health actions. However, many challenges exist regarding the availability and quality of data, the application of appropriate methods and tools to link data, and the state of the science needed to link and analyze health and environmental data. The Tracking Program has collaborated with academia to address key challenges in these areas. The collaboration has improved our understanding of the uses and limitations of available data and methods, expanded the use of existing data and methods, and increased our knowledge about the connections between health and environment. Valuable working relationships have been forged in this process, and together we have identified opportunities and improvements for future collaborations to further advance the science and practice of environmental public health tracking.
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Affiliation(s)
- Heather Strosnider
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Environmental Health Tracking Branch, 1600 Clifton Road, MS-F60, Atlanta, GA 30333, USA.
| | - Ying Zhou
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Environmental Health Tracking Branch, 1600 Clifton Road, MS-F60, Atlanta, GA 30333, USA.
| | - Lina Balluz
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Environmental Health Tracking Branch, 1600 Clifton Road, MS-F60, Atlanta, GA 30333, USA.
| | - Judith Qualters
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Office of the Director, 1600 Clifton Road, MS-F60, Atlanta, GA, 30333, USA.
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Functions of environmental epidemiology and surveillance in state health departments. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2012; 18:453-60. [PMID: 22836537 DOI: 10.1097/phh.0b013e31822d4c01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Public health surveillance and epidemiology are the foundations for disease prevention because they provide the factual basis from which agencies can set priorities, plan programs, and take actions to protect the public's health. Surveillance for noninfectious diseases associated with exposure to agents in the environment like lead and pesticides has been a function of state health departments for more than 3 decades, but many state programs do not have adequate funding or staff for this function. Following the efforts to identify core public health epidemiology functions in chronic diseases, injury, and occupational health and safety, a workgroup of public health environmental epidemiologists operating within the organizational structure of the Council of State and Territorial Epidemiologists has defined the essential core functions of noninfectious disease environmental epidemiology that should be present in every state health department and additional functions of a comprehensive program. These functions are described in terms of the "10 Essential Environmental Public Health Services" and their associated performance standards. Application of these consensus core and expanded functions should help state and large metropolitan health departments allocate resources and prioritize activities of their environmental epidemiologists, thus improving the delivery of environmental health services to the public.
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Iqbal S, Clower JH, King M, Bell J, Yip FY. National carbon monoxide poisoning surveillance framework and recent estimates. Public Health Rep 2012; 127:486-96. [PMID: 22942466 DOI: 10.1177/003335491212700504] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Unintentional, non-fire-related (UNFR) carbon monoxide (CO) poisoning is a leading cause of poisoning in the United States. A comprehensive national CO poisoning surveillance framework is needed to obtain accurate estimates of CO poisoning burden and guide prevention efforts. This article describes the current national CO poisoning surveillance framework and reports the most recent national estimates. METHODS We analyzed mortality data from the National Vital Statistics System multiple cause-of-death file, emergency department (ED) and hospitalization data from the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample and Nationwide Inpatient Sample, hyperbaric oxygen treatment (HBOT) data from HBOT facilities, exposure data from the National Poison Data System, and CO alarm prevalence data from the American Housing Survey and the National Health Interview Survey. RESULTS In the United States, 2,631 UNFR CO deaths occurred from 1999 to 2004, an average of 439 deaths annually. In 2007, there were 21,304 (71 per one million population) ED visits and 2,302 (eight per one million population) hospitalizations for confirmed cases of CO poisoning. In 2009, 552 patients received HBOT, and from 2000 to 2009, 68,316 UNFR CO exposures were reported to poison centers. Most nonfatal poisonings were among children (<18 years of age) and females; hospitalizations and deaths occurred more frequently among males and elderly people (>65 years of age). More poisonings occurred during winter months and in the Midwest and Northeast. CONCLUSIONS UNFR CO poisoning poses a significant public health burden. Systematic evaluation of data sources coupled with modification and expansion of the surveillance framework might assist in developing effective prevention strategies.
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Affiliation(s)
- Shahed Iqbal
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Air Pollution and Respiratory Health Branch, Atlanta, GA 30333, USA.
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Choi BCK. The past, present, and future of public health surveillance. SCIENTIFICA 2012; 2012:875253. [PMID: 24278752 PMCID: PMC3820481 DOI: 10.6064/2012/875253] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 07/11/2012] [Indexed: 05/05/2023]
Abstract
This paper provides a review of the past, present, and future of public health surveillance-the ongoing systematic collection, analysis, interpretation, and dissemination of health data for the planning, implementation, and evaluation of public health action. Public health surveillance dates back to the first recorded epidemic in 3180 B.C. in Egypt. Hippocrates (460 B.C.-370 B.C.) coined the terms endemic and epidemic, John Graunt (1620-1674) introduced systematic data analysis, Samuel Pepys (1633-1703) started epidemic field investigation, William Farr (1807-1883) founded the modern concept of surveillance, John Snow (1813-1858) linked data to intervention, and Alexander Langmuir (1910-1993) gave the first comprehensive definition of surveillance. Current theories, principles, and practice of public health surveillance are summarized. A number of surveillance dichotomies, such as epidemiologic surveillance versus public health surveillance, are described. Some future scenarios are presented, while current activities that can affect the future are summarized: exploring new frontiers; enhancing computer technology; improving epidemic investigations; improving data collection, analysis, dissemination, and use; building on lessons from the past; building capacity; enhancing global surveillance. It is concluded that learning from the past, reflecting on the present, and planning for the future can further enhance public health surveillance.
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Affiliation(s)
- Bernard C. K. Choi
- Injury Prevention Research Centre, Medical College of Shantou University, Shantou 515041, China
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5
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Development of a French epidemiological surveillance system of workers producing or handling engineered nanomaterials in the workplace. J Occup Environ Med 2011; 53:S103-7. [PMID: 21654409 DOI: 10.1097/jom.0b013e31821b1d68] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Concern has been raised about the potential impact of nanomaterials exposure on human health, and France has decided to implement a timely epidemiological surveillance tool of workers likely to be exposed to engineered nanomaterials that could accompany the development of nanotechnologies. METHODS A comprehensive review of the toxicological and epidemiological literature has been conducted together with an exploratory study among French companies producing or handling nanoobjects. RESULTS A double surveillance system is proposed consisting of a prospective cohort survey and repeated cross-sectional studies. The aim of the cohort is (1) to monitor long-term health effects and (2) to allow of further research. Setting-up an exposure registry is the first planned step. CONCLUSIONS The protocol is about to be submitted to the French Government for approval and funding.
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Shire JD, Marsh GM, Talbott EO, Sharma RK. Advances and current themes in occupational health and environmental public health surveillance. Annu Rev Public Health 2011; 32:109-32. [PMID: 21219165 DOI: 10.1146/annurev-publhealth-082310-152811] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The essential purpose of public health surveillance is to monitor important health outcomes and risk factors and provide actionable information to practitioners, policy makers, researchers, and the public to prevent or ameliorate exposure, disease, and death. Although separate 1970s-era acts of Congress made possible the creation of modern occupational health and environmental public health surveillance, these acts also led to fragmented responsibilities and unconnected data across federal agencies. Having a well-defined purpose for systematically collecting relevant data is key, and state and local programs play a crucial role in conducting meaningful surveillance and connecting it with evidence-based outreach and interventions. Congress has directed monies to environmental public health surveillance and capacity has improved, yet no analagous funding has occurred to address the fragmentation found within occupational health surveillance. This article provides a review of the advances and important themes within occupational health and environmental public health surveillance over the past decade.
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Affiliation(s)
- Jeffrey D Shire
- Department of Epidemiology, University of Pittsburgh, Pennsylvania 15261, USA.
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A review of frameworks for developing environmental health indicators for climate change and health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:2854-75. [PMID: 21845162 PMCID: PMC3155333 DOI: 10.3390/ijerph8072854] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 06/24/2011] [Accepted: 06/29/2011] [Indexed: 11/17/2022]
Abstract
The role climate change may play in altering human health, particularly in the emergence and spread of diseases, is an evolving area of research. It is important to understand this relationship because it will compound the already significant burden of diseases on national economies and public health. Authorities need to be able to assess, anticipate, and monitor human health vulnerability to climate change, in order to plan for, or implement action to avoid these eventualities. Environmental health indicators (EHIs) provide a tool to assess, monitor, and quantify human health vulnerability, to aid in the design and targeting of interventions, and measure the effectiveness of climate change adaptation and mitigation activities. Our aim was to identify the most suitable framework for developing EHIs to measure and monitor the impacts of climate change on human health and inform the development of interventions. Using published literature we reviewed the attributes of 11 frameworks. We identified the Driving force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework as the most suitable one for developing EHIs for climate change and health. We propose the use of EHIs as a valuable tool to assess, quantify, and monitor human health vulnerability, design and target interventions, and measure the effectiveness of climate change adaptation and mitigation activities. In this paper, we lay the groundwork for the future development of EHIs as a multidisciplinary approach to link existing environmental and epidemiological data and networks. Analysis of such data will contribute to an enhanced understanding of the relationship between climate change and human health.
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Zullig KJ, Hendryx M. Health-related quality of life among central Appalachian residents in mountaintop mining counties. Am J Public Health 2011; 101:848-53. [PMID: 21421943 PMCID: PMC3076406 DOI: 10.2105/ajph.2010.300073] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2010] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the health-related quality of life of residents in mountaintop mining counties of Appalachia using the 2006 national Behavioral Risk Factor Surveillance System. METHODS Dependent variables included self-rated health; the number of poor physical, poor mental, and activity limitation days (in the past 30 days); and the Healthy Days Index. Independent variables included metropolitan status, primary care physician supply, and Behavioral Risk Factor Surveillance System behavioral and demographic variables. We compared dependent variables across 3 categories: mountaintop mining (yes or no), other coal mining (yes or no), and a referent nonmining group. We used SUDAAN MULTILOG and multiple linear regression models with post hoc least squares means to test mountaintop mining effects after adjusting for covariates. RESULTS Residents of mountaintop mining counties reported significantly more days of poor physical, mental, and activity limitation and poorer self-rated health (P < .01) compared with the other county groupings. Results were generally consistent in separate analyses by gender and age. CONCLUSIONS Mountaintop mining areas are associated with the greatest reductions in health-related quality of life even when compared with counties with other forms of coal mining.
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Affiliation(s)
- Keith J Zullig
- Department of Community Medicine, School of Medicine, West Virginia University, Morgantown, 26506-9190, USA.
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Arreaza ALV, Moraes JCD. Vigilância da saúde: fundamentos, interfaces e tendências. CIENCIA & SAUDE COLETIVA 2010; 15:2215-28. [DOI: 10.1590/s1413-81232010000400036] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 04/28/2008] [Indexed: 11/21/2022] Open
Abstract
O presente artigo resgata inicialmente as formas, conteúdo e projeção operacional da vigilância epidemiológica como instrumento indispensável para o campo do saber e práticas da saúde pública. Em seguida, verificamos que o modelo de vigilância da saúde estabelece uma ampliação desse conceito operacional de vigilância, ao integrar as práticas coletivas e individuais em diferentes dimensões das necessidades de saúde, que incluem além do controle de riscos e danos, os determinantes ecossociais. Na sequência, buscamos dimensionar os distintos níveis de atuação desta prática sanitária articulados às intervenções de promoção, proteção e recuperação, sob uma lógica regionalizada e integralizada do Sistema Único de Saúde brasileiro. Por fim, argumentamos que todo o arcabouço conceitual-operacional de vigilância da saúde se constitui como uma base política e sanitária para a consolidação do paradigma da promoção da saúde no campo da Saúde Coletiva.
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National environmental public health tracking program: providing data for sound public health decisions. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2009; 14:505-6. [PMID: 18849769 DOI: 10.1097/01.phh.0000338361.36209.87] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Effective environmental public health surveillance programs: a framework for identifying and evaluating data resources and indicators. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2009; 14:543-51. [PMID: 18849774 DOI: 10.1097/01.phh.0000338366.74327.c9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The complexity and multidisciplinary nature of environmental public health (EPH) surveillance call for a systematic framework and a concrete set of criteria to guide development, selection, and evaluation of environmental public health indicators. Environmental public health indicators are the foundation of a comprehensive EPH surveillance system, providing quantitative summary measures and descriptive information about spatial and temporal trends of hazard, exposure, and health effects over person, place, and time. A case-synthesis review of environmental regulatory and public health indicator models was employed to develop a framework and outline a methodological approach to EPH surveillance system development, including the selection of content areas and the corresponding data and environmental public health indicators. The framework is organized around three assessment phases: (1) scientific basis and relevance, (2) analytic soundness, and (3) feasibility, interpretation and utility. By outlining a process and identifying important constructs and criteria, the framework provides practitioners with an effective and systematic tool for making scientifically valid programmatic decisions about EPH content development. Improved decision making ensures more effective EPH surveillance systems and enhanced opportunities to understand and protect the public health from environmental threats.
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Tracking associations between ambient ozone and asthma-related emergency department visits using case-crossover analysis. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2009; 14:581-91. [PMID: 18849779 DOI: 10.1097/01.phh.0000338371.53242.0e] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Traditional environmental public health surveillance consists of separately measuring hazards, exposures, and health outcomes. The Environmental Public Health Tracking (EPHT) Network seeks to accrue additional information by linking hazard or exposure data to health outcomes data. A natural progression is to consider tracking the "link" itself, that is, to track the association between an environmental hazard and a health outcome. The Maine EPHT Program conducted a case-crossover analysis to measure associations between daily estimated ambient ozone and particulate matter (PM2.5) and asthma-related emergency department (ED) visits for 2000-2003. We found an overall association of 7 percent (95% confidence interval, 4-11) excess asthma-related ED visits per 10-ppb increase in ozone averaged over 4 days (lag 0-3). The association was positive in the first 3 years and negative in the last. The excess risk was concentrated among females aged 15 to 34 and males younger than 15. The methodology for tracking associations between ambient air quality and acute morbidity is not generalizable to most other EPHT topic areas, but there are ample reasons to pursue this activity. The analysis can potentially help evaluate the effectiveness of regulatory and intervention programs, as well as inform us about trends, sensitive subpopulations, and changing potency of air constituents.
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Abelsohn A, Frank J, Eyles J. Environmental public health tracking/surveillance in Canada: a commentary. Healthc Policy 2009; 4:37-52. [PMID: 19377354 PMCID: PMC2653708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Although public debate in Canada about climate change and air pollution is louder than ever, the state of the environment remains a relatively neglected determinant of health, and environmental public health infrastructure and programs are poorly developed. Health Canada has only recently begun to develop a national environmental public health tracking or surveillance system. The authors review progress on environmental public health tracking in other jurisdictions and suggest a strategic approach to the development of a coherent national system of sensitive, targeted surveillance indicators for environmental health by addressing the following questions: Which environmental hazards and exposures, and which health effects along the continuum from "release" to "health effect," should be tracked? Which indicators are scientifically robust and practical for tracking environmental health problems in Canada?
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Affiliation(s)
- Alan Abelsohn
- Department of Family and Community Medicine, Centre for Environment, University of Toronto, Toronto, ON
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Implementing the Environmental Public Health Tracking Network. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2008; 14:507-14. [DOI: 10.1097/01.phh.0000338362.43833.3b] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Smolders R, Casteleyn L, Joas R, Schoeters G. Human biomonitoring and the INSPIRE directive: spatial data as link for environment and health research. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2008; 11:646-59. [PMID: 18821423 DOI: 10.1080/10937400801909002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Recently, there has been a rapid gain of interest in the availability, applicability, and integration of different types of spatial data for environment and health issues. The INSPIRE Directive (Directive 2007/2/EC) aims at providing better and easily accessible spatial information in Europe for the formulation and implementation of community policy on the environment by triggering the creation of a European spatial information infrastructure that delivers integrated spatial information services to potential users. Human biomonitoring (HBM) significantly contributes to the already existing data on environment and health because of its specific nature of providing information on the internal dose of chemicals rather than their mere presence in different environmental compartments. However, due to the intrinsic nature of HBM data, a number of issues need to be dealt with if HBM data are to be used to its full capacity in a geographic information systems (GIS) environment and within the INSPIRE directive. The current article highlights some of these issues, and discusses a number of options to improve the geographical relevance of HBM data for their optimal use within the INSPIRE Directive framework. The main aim of this publication is to illustrate that HBM has a significant contribution to make to the INSPIRE Directive, although some kind of data aggregation will be necessary to protect individual privacy. If HBM data wants to have a significant contribution to spatial information used to assist policymaking and on the surveillance or tracking of the direct or indirect impact of such policies, the HBM data need to be compatible with other data collected within the other themes of the INSPIRE Directive.
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Expert Panel Recommendations on Elder Mistreatment Using a Public Health Framework. J Elder Abuse Negl 2008. [DOI: 10.1300/j084v15n02_03] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Joner MD, Woodall WH, Reynolds MR. Detecting a rate increase using a Bernoulli scan statistic. Stat Med 2008; 27:2555-75. [DOI: 10.1002/sim.3081] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Ali R, Wheitner D, Talbott EO, Zborowski JV. Connecting environmental health data to people and policy: integrating information and mobilizing communities for environmental public health tracking. J Community Health 2007; 32:357-74. [PMID: 17922206 DOI: 10.1007/s10900-007-9053-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Evaluation of available data is a critical preliminary step in the assessment of local environmental health. As part of a multi-organizational initiative to improve environmental health in the Pittsburgh, Pennsylvania region, the University of Pittsburgh Center for Healthy Environments and Communities (CHEC) interviewed 70 experts in the academic, government, non-profit, and private sectors and reviewed print and electronic resources to characterize environmental and public health data available in the region. The objectives of this undertaking were: to provide a conceptual framework for categorizing data locally on environmental hazards, exposures and health endpoints, to describe and evaluate the types of environmental public health data available nationally and locally, to identify existing endeavors to gather and categorize such data, and to present case studies on the real-life relevance of the availability or lack of availability of environmental health data. The purpose and relevance of this project, the evolution of the methodology, successes and challenges met, and anticipated next steps are presented. This process description and resulting comprehensive report is available to communities, at both the state and local health department level as well as lay community members, engaged in similar endeavors, to characterize their local and regional environmental health landscape. The framework outlined serves as background for a related statewide environmental health project sponsored by the Pennsylvania Department of Health through the Pennsylvania Consortium on Interdisciplinary Environmental Policy (PCIEP) and potentially as a foundation for community-based data evaluation for the National Environmental Public Health Tracking Program.
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Affiliation(s)
- Robbie Ali
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, 130 DeSoto Street, Pittsburgh, PA 15261, USA
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Graber JM, Macdonald SC, Kass DE, Smith AE, Anderson HA. Carbon monoxide: the case for environmental public health surveillance. Public Health Rep 2007; 122:138-44. [PMID: 17357355 PMCID: PMC1820437 DOI: 10.1177/003335490712200202] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Judith M. Graber
- Environmental and Occupational Health Unit, Center for Disease Control and Prevention, Maine Department of Health and Human Services, Augusta, ME
| | | | - Daniel E. Kass
- Environmental Surveillance and Policy, Environmental and Occupational Disease Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY
| | - Andrew E. Smith
- Environmental and Occupational Health Unit, Center for Disease Control and Prevention, Maine Department of Health and Human Services, Augusta, ME
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Abstract
Which consequences can be drawn from genome-based knowledge and how can it be responsibly and timely translated into policies and practice? What are recent developments in genetics and molecular biology, what are the challenges, what are the risks of these developments? Which policies can provide an acceptable balance between providing strong protection of individuals'interests and needs while enabling society to benefit from the genomic advances and empowering individuals? How can molecular medicine contribute to more effective and efficient health care services, and what infrastructures and policies can already now be implemented to assure a benefit for population health? Thus, Public Health Genomics (PHG) tries to answer these challenging questions. This integration of genomics into the aims of public health is called Public Health Genomics (PHG) and is defined as "the responsible and effective translation of genome-based knowledge and technologies into public policy and health services for the benefit of population health".
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Affiliation(s)
- Helmut Brand
- Landesinstitut für den Offentlichen Gesundheitsdienst NRW (lögd), Bielefeld, BRD.
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Payne-Sturges D, Gee GC. National environmental health measures for minority and low-income populations: tracking social disparities in environmental health. ENVIRONMENTAL RESEARCH 2006; 102:154-71. [PMID: 16875687 DOI: 10.1016/j.envres.2006.05.014] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2005] [Revised: 05/18/2006] [Accepted: 05/23/2006] [Indexed: 05/03/2023]
Abstract
Healthy People 2010 [US Department of Health and Human Services, 2004. Healthy People 2010. Available: http://www.healthypeople.gov/Publications/ [accessed May 22, 2004]] has established as a top priority the elimination of health disparities. Current research suggests that characteristics of the social, physical and built environment contribute to these disparities. In order to track progress and to assess the potential contributions of the various components of the "environment," tools specific to environmental health disparities are required. In this paper, we discuss one potential tool, a set of candidate measures that may be used to track disparities in outcomes, as well as measures that may be used analytically to assess potential causal pathways. Several other reports on health and environmental measures have been produced, including the Environmental Protection Agency's (EPA) America's Children and the Environment. However, there has not been a comprehensive discussion about environmental measures that focus on racial, ethnic and socioeconomic disparities in health. Therefore, we focus on measures specific to historically disadvantaged populations. Based on a conceptual framework that views health disparities as partially driven by differential access to resources and exposures to hazards, we group the measures into four categories: social processes, environmental contaminants/exposures, bodyburdens of environmental contaminants, and health outcomes. We provide a few examples to illustrate each category, including residential segregation, PM(2.5) exposures, blood mercury concentrations, and asthma morbidity and mortality. These measures and categories are derived from a review of environmental health disparities from several disciplines. As a next step in a long-term effort to better understand the relationship between social disadvantage, environment, and health disparities, we hope that the proposed measures and literature review serve as a foundation for future monitoring of environmental health disparities. These efforts may aid community organizations, local agencies, scientists and policy makers in allocating resources and developing interventions.
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Affiliation(s)
- Devon Payne-Sturges
- Office of Children's Health Protection, US Environmental Protection Agency, Ariel Rios Bldg. MC 1107A, 1200 Pennsylvania Ave., NW, Washington, DC 20460, USA.
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Payne-Sturges D, Zenick H, Wells C, Sanders W. We cannot do it alone: Building a multi-systems approach for assessing and eliminating environmental health disparities. ENVIRONMENTAL RESEARCH 2006; 102:141-5. [PMID: 16545364 DOI: 10.1016/j.envres.2006.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2005] [Revised: 01/24/2006] [Accepted: 01/26/2006] [Indexed: 05/07/2023]
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Kyle AD, Balmes JR, Buffler PA, Lee PR. Integrating research, surveillance, and practice in environmental public health tracking. ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:980-4. [PMID: 16835047 PMCID: PMC1513336 DOI: 10.1289/ehp.8735] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The Centers for Disease Control and Prevention in the U.S. Department of Health and Human Services is working with selected state and local health departments, academic centers, and others to develop an environmental public health tracking initiative to improve geographic and temporal surveillance of environmental hazards, exposures, and related health outcomes. The objective is to support policy strategies and interventions for disease prevention by communities and environmental health agencies at the federal, state, and local levels. The first 3 years of the initiative focused on supporting states and cities in developing capacity, information technology infrastructure, and pilot projects to demonstrate electronic linkage of environmental hazard or exposure data and disease data. The next phase requires implementation across states. This transition could provide opportunities to further integrate research, surveillance, and practice through attention to four areas. The first is to develop a shared and transparent knowledge base that draws on environmental health research and substantiates decisions about what to track and the interpretation of results. The second is to identify and address information needs of policy and stakeholder audiences in environmental health. The third is to adopt mechanisms for coordination, decision making, and governance that can incorporate and support the major entities involved. The fourth is to promote disease prevention by systematically identifying and addressing population-level environmental determinants of health and disease.
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Affiliation(s)
- Amy D Kyle
- School of Public Health, University of California, Berkeley, California, USA.
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English PB, Roberts EM, Van den Eeden SK, Ray GT. Progress in pediatric asthma surveillance I: the application of health care use data in Alameda County, California. Prev Chronic Dis 2006; 3:A91. [PMID: 16776892 PMCID: PMC1637799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The ability to conduct community-level asthma surveillance is increasingly crucial for public health programming and child health advocacy. We explored the potential and limitations of health care use records from both public and private sources for asthma surveillance in a California county. METHODS We combined administrative patient record data from Kaiser Permanente of Northern California and Medi-Cal (the California Medicaid program) for Alameda County residents during 2001. We assessed the resulting data set for completeness, population representation, consistency with external data, and internal indicator consistency. RESULTS Our resulting data set included records for 226,383 children younger than 18 years. Completeness of Medicaid data was affected by managed care market share, reducing our usable data set size to 176,789, approximately equal to one of every two children in the county or one of every 3 person-months. External data documenting hospitalization rates due to asthma were poorly correlated with hospitalization rates (r = 0.2120, P = .20) but highly correlated with emergency department visits (r = 0.8607, P <.001) in the resulting data set. High internal consistency of indicators suggested that the data set represented a broad spectrum of health care access and quality of care congruent with clinical aspects of the disease. CONCLUSION The utility of these data is affected by logistical and administrative factors, including the health care payment structure and the market shares of care providers. These factors can be expected to similarly affect the utility of this approach in other counties. Our ability to generate county-level health statistics for comparison with other locations was limited, although the data set appeared well suited for within-county geographic analysis. In light of these findings, these data have the potential to expand the local health surveillance capacity of communities.
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Affiliation(s)
- Paul B English
- California Department of Health Services, Environmental Health Investigations Branch
| | - Eric M Roberts
- California Department of Health Services, Environmental Health Investigations Branch
| | | | - G. Thomas Ray
- Kaiser Permanente of Northern California, Division of Research, Oakland, Calif
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