Before discussing the data themselves, we describe several notable endeavors that seek to compile, creatively link, analyze or report data including environmental public health information. Some of these focus upon establishing specific tools, while others aim for broader collaborative efforts. Through describing them, we hope to increase awareness and discussion about collaboration and encourage sharing of resources.
We briefly outline the following projects:
· The PCIEP Roadmap, convened by the PA Department of Environmental Protection
· The data gaps survey of the H.J. Heinz III Center for Science, Economics & the Environment’s Nation’s Ecosystems Report
· Building Environmental Health Capacity, a project of the Allegheny County Health Department
· The Southwestern Pennsylvania Regional Indicators Report, produced by Sustainable Pittsburgh and AtKisson, Inc.
· The Southwestern Pennsylvania Indicators Consortium, spearheaded by John G. Craig, Jr.
· The Community Information Commons, by MAYA Design and 3 Rivers Connect
· HS.net, a project of the Allegheny County Department of Human Services, the United Way of Allegheny County and 3 Rivers Connect
· SOVAT (Spatial OLAP Visualization and Analytical Tool), by Matthew Scotch and Bambang Parmanto, University of Pittsburgh University of Pittsburgh School of Health and Rehabilitation Sciences
· Info-Pitt, spearheaded by the University of Pittsburgh’s University Center for Social and Urban Research
· CDC Environmental Public Health Tracking (state level), a project of the Pennsylvania Department of Health
The Pennsylvania Consortium for Interdisciplinary Environmental Policy (PCIEP) consists of Pennsylvania organizations including the Department of Environmental Protection, the Department of Conservation and Natural Resources, 52 colleges and universities, and Sustainable Pittsburgh. At least seven of these organizations are within the Pittsburgh region. PCIEP is devoted to “improving environmental policy and understanding through government and academic cooperation that encourages interdisciplinary analysis and discourse,” and its four program committees include one on “Human Health and the Environment”.[12]
PCIEP recently formulated a Roadmap Project with the following overall objective: “to develop the knowledge base to help ensure that the activities and resources directed at improving the state of environmental health in Pennsylvania are appropriately deployed”. Among the “unknowns” noted in its draft plan are the following:[13]
· The ability to spatially locate the diseases expected to have environmental causes, and the exposures that may be the causes
· The geographic relationship between exposures and potentially linked diseases
· The extent to which monitoring information already collected by DEP and others is helpful in linking environmental exposures and outcomes
· The comparative risks of exposures that may be linked to health outcomes
As the focus of PCIEP is statewide, regional environmental health data endeavors could be coordinated with PCIEP.
The
Indicators are useful as metrics for designing program agendas and gauging program impacts. There are a number of local initiatives already underway to track and develop indicators useful for setting goals and monitoring trends. As these often involve discussions on data inventory and quality, we include some of them here.
In 2000, the Allegheny County Health Department (ACHD) entered into a cooperative agreement with the National Center for Disease Control and Prevention’s (CDC) National Center for Environmental Health (NCEH) to improve their environmental health capacity, beginning by inviting a national public health expert panel to discuss four focus questions regarding environmental health indicators. These questions included, “Where does one find the data for the environmental indicators?“ They noted that data may come from a variety of sources outside of traditional public health programs, but “may not be readily accessible or located in a central repository.” [15]
Since then, (ACHD) has produced a proposed set of 124 environmental health indicators for 11 environmental quality programs, based largely on their department’s activities and available data. The overall purpose of the project is to “develop a local Environmental Health System that would be used for surveillance, investigation, tracking and evaluation.”[16] Along with developing indicators, the project’s goals and objectives include creating the infrastructure to make data available for the indicators, and creating a single access system for professionals and the general public. The 2002 project newsletter[17] listed the initial indicators, along with details such as the suggested data measure, source, and reporting frequency of each. They were organized under the following topics: Community Environment Indicators, Food Safety, Injury Prevention, Lead Prevention, Drinking Water, Water Pollution, Solid Waste, and Plumbing. The 2004 project newsletter includes an article that discusses local and national efforts to develop environment and health tracking systems, outlines information and suggestions on several aspects of developing such a system, and reviews several previous studies on environmental health tracking systems.[18]
In 1999, the Sustainable Pittsburgh Goals and Indicators Project gathered the input of 250 community leaders to identify “the key elements of our region’s long-term prosperity and quality of life.” The project had nine objectives, including 1) suggesting a long-range regional development agenda and 2) developing, implementing and tracking “new measures/indicators of regional prosperity that ensure balance between the three E’s.” (This refers to Environment, Equity, and Economic development.) Participants met in ten topic teams, including one entitled “Health and Environment.” That topic team defined a number of strategies and indicators linked to 6 goals:
· Enhancing environmental quality by reducing the negative effects of human made pollutants
· Empowering citizens to choose healthy behaviors and adopt sustainable consumption habits
· Improving the health status of the region’s population by eliminating health disparities
· Enhancing environmental and occupation safety by assuring everyone is protected from unsafe conditions
· Enhancing community environments by assuring that everyone has access to safe, decent, affordable housing in safe neighborhoods
· Encouraging sustainable land use practices
Sustainable
Keep in mind that while these broader summary indicators and the underlying data are very useful for measuring regional-level progress, they are generally not specific enough—either geographically or by topic—for more detailed public health uses. However, as is the case with ACHD’s Building Environmental Capacity Project, already-defined goals, strategies and indicators may help us to prioritize which regional environmental health data gaps we should address first.
John G. Craig, Jr., former editor of the Pittsburgh
Post-Gazette, is leading a team that has begun work on a project to coordinate
indicators development for
· The Pittsburgh Region clearly needs a regional indicator system.
· Given current technology and federal-level efforts underway, this is an advantageous time to develop such a system.
· Concentrating efforts on topic areas would allow for greater detail than comprehensive and aggregated “report cards” alone can provide.
· Different topic areas (e.g., health, environment) have different geographic and political configurations, and thus require different approaches.
· The focus should be upon actionable indicators, i.e., data that can inform us in acting to improve current conditions.
Given the quantity and complexity of data in the realms of health and the environment, endeavors to improve data availability, accessibility, linkage, standardization and quality can be successful only through the use of creative technological tools. Data can be improved only through additional sharing and use, and the tools described below that local organizations are developing may help to facilitate this process. As each tool has its strengths and weaknesses, perhaps the different organizations can link resources to more efficiently serve various audiences, and provide an integrated data system with a wealth of functionality.
The Heinz Endowments, Carnegie Library and MAYA Design, a Pittsburgh based technology research lab, have partnered to create a research tool for exploring data on human health and the environment. Utilizing “distributed database technology,” the Environmental Health Initiative created a Beta website which enables novice users to perform complex GIS analyses of health and environmental trends with easy to use data analysis and mapping tools. By pointing and clicking on places on a map and selecting datasets of interest, a user can easily see, for example, the areas of Pennsylvania with the highest rates of breast cancer mortality and the highest level of toxic releases reported to the EPA, side by side with other community health indicators. At the core of this system is the ability to fuse an unlimited amount of disparate data on health statistics, toxic release events and the health effects of exposure to toxins into a single data space, which MAYA calls the Information Commons. As the network of contributors to the Information Commons grows, so does the ability of every citizen of Pennsylvania to become a research activist, creating compelling cases for environmental change through a clearer, data-driven understanding of the link between environmental toxins and human health.[22]
The Allegheny County Department of Human Services (DHS), with 3 Rivers Connect, MAYA Design, and the United Way of Allegheny County, are constructing a GIS (geographic information system) enabled internet data access system with human services information. The publicly accessible initial product will feature locations of human services providers, details about the services they provide, and public transit route information. As DHS oversees a broad range of services in areas including mental health, this project might eventually be pertinent to environmental health data compilation endeavors. However, types of data included in future versions, as well as levels of access granted to different audiences, remains to be determined.[23], [24]
Developed by Matthew Scotch and Bambang Parmanto
within the
The
Info-Pitt is envisioned as the access point for the
Community Information System (CIS, formerly known as the Vacant Property
Project), a collaborative venture coordinated by 10,000 Friends of Pennsylvania
and the Pittsburgh Partnership for Neighborhood Development (PPND), and
involving several other organizations.[28], [29]
We further discuss this endeavor, whose initial focus is to compile and
map out data vacant properties in
In 2002 the Centers for Disease Control’s EPHT program mentioned above funded a partnership between the Pennsylvania Department of Health (PADOH) and the Pennsylvania Department of Environmental Protection (PADEP) to develop a “coordinated and integrated environmental public health tracking network that will include both environmental databases developed and maintained by PADEP as well as environmental health outcome databases developed and maintained by PADOH”.[30] This included initiatives to do the following:
· Collaborate and forge partnerships between traditional health-focused entities (for-profit and non-profit) and environmental monitoring agencies at the federal, state, and local levels
· Expand capacity in the area of personnel expertise and latest technology infrastructure
· Develop standardized electronic data elements
· Build mechanisms for disseminating information to stakeholders.[31]
Because it is a capacity-building project as opposed to a demonstration project, this endeavor has not yet yielded any products (e.g., a web portal or query tool) that allow for data access; nor does it have any available data inventory products. However, several members of its 24-person planning consortium, including several Pittsburgh area representatives, are also involved with the Health and the Environment working group of PCIEP, described above. Thus, the efforts of the two groups will be synchronized.[32]
Somewhat related to this project, the PADOH Bureau of Epidemiology, Division of Environmental Health Assessment is moving forward on some school-based asthma-related work described under the health outcomes section.
Putting political and technical considerations aside for a moment, it is interesting to entertain the possibilities of linking these endeavors together. For example, the Info-Pitt project is seeking to compile a broad range of data on different topics to provide a one-stop “clearinghouse” for community information, including that of the Community Information System (CIS). MAYA’s Community Information Commons could help to link some of their larger government agency-compiled datasets to anecdotal information contributed by citizens, and to smaller datasets compiled by community groups or limited-timeframe studies. This would then provide the general public with information from a variety of sources, easily accessible online. Additionally, the data could be made available to researchers and policy makers through SOVAT, to provide a tool for more in-depth creative analysis and overlap of the various datasets. The RODS lab, whose project is discussed under the Health Outcomes data section, might provide linkages of all of this to more real-time health data, along with data detection and analysis algorithms.