Using Public Health Data to Assess Vulnerability and Cumulative Impacts to Health Jerald A....
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Transcript of Using Public Health Data to Assess Vulnerability and Cumulative Impacts to Health Jerald A....
Using Public Health Data to Assess Vulnerability and
Cumulative Impacts to Health
Jerald A. Fagliano, M.P.H., Ph.D.Environmental and Occupational Health Surveillance Program
New Jersey Department of Health and Senior Services
April 13, 2011Clean Air Council
Outline
• What public health data sets are available?
• Data resources:– Environmental Public Health Tracking– http://nj.gov/health/epht– NJ State Health Assessment Data (NJ SHAD)– http://nj.gov/health/shad
• Using public health data to assess cumulative impacts
Key Data Sets Relevant to Environmental Public Health
• Vital Events– Births– Deaths– Infant and fetal deaths
• Health Outcome Registries– Cancers– Birth defects
• Administrative Data– In-patient hospitalization and emergency department
• Laboratory Reports on Exposure – Childhood blood lead
EPHT and NJ SHAD
• State Health Assessment Data (NJ SHAD) system, a public health data resource– Includes custom data query, public health
indicators, and links to reports
• NJ Environmental Public Health Tracking program supports and uses NJ SHAD as its data portal– Part of national EPHT Network with CDC, 25
States, and New York City
Health Disparity Priority Areas:
AsthmaCancer
Heart DiseaseKidney Disease
DiabetesHIV/AIDS
ImmunizationInfant Mortality
ObesityInjuries
Violence
Environmental Public Health
Tracking:Air Quality
Drinking WaterLead ExposureBirth OutcomesInfant Outcomes
CancersCO Poisoning
AsthmaHeart Attack
Occup. Injuries
Age-Adjusted Death Rate due to Heart Disease, NJ
and US,2000-2006
Age-Adjusted Death Rate due to Heart
Disease, by Race/Ethnicity,
2006
Percent of Live Births with Low Birth Weight ,
2001-2005
Percent of Children Under Age 5 Years of Age Living in Poverty, 2000
Percent of Infants with Low Birth
Weight, by Mother’s
Education and Prenatal Care,
2000-2007
Diseases of the heart
Malignant neoplasms Cerebrovascular diseases
All causes of death
Age-Adjusted Death Rates by Race/Ethnicity,
State of NJ,2000-2006
Age-Adjusted Death Rate due to
Cancers, by County and
Race/Ethnicity,2004-2006
Planned Improvements to NJ SHAD
• Dynamic mapping of query output
• Additional data sets:– Hospitalization and emergency department– Childhood lead exposure– Cancer
• Secure portal for access to data at finer geographic and temporal scales
Public Health Measures as Cumulative Impact Measures
• Public health measures are measures of “cumulative impact” from:– Heritable risk factors– Personal behaviors– Community/social stressors – Environmental and occupational exposures
• Challenge is in understanding how these factors interact to produce health impacts
• May indicate degree of potential vulnerability to added environmental stressors
Health Outcome Indicators of Vulnerability to Environmental Impact
• General measures of health– Mortality (age-adjusted rates)
• Overall, cardiovascular, cancer
– Infant and fetal mortality– Low birth weight among singleton, term births
• More specific measures– Childhood lead exposure – Hospitalization and emergency department use due to asthma or
heart attack– Cancer incidence
• Leukemia, lymphoma, bladder, lung
– Birth defects• Clefts, neural tube defects, heart anomalies
For more information:
• Environmental Public Health Tracking– http://nj.gov/health/epht– http://ephtracking.cdc.gov
• NJ State Health Assessment Data– http://nj.gov/health/shad
• Strategic Plan to Eliminate Health Disparities in New Jersey– http://nj.gov/health/omh/plan