Download Using Public Health Data to Assess

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, 2011
Clean Air Council
Outline
• What public health data sets are available?
• Data resources:
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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:
Asthma
Cancer
Heart Disease
Kidney Disease
Diabetes
HIV/AIDS
Immunization
Infant Mortality
Obesity
Injuries
Violence
Environmental
Public Health
Tracking:
Air Quality
Drinking Water
Lead Exposure
Birth Outcomes
Infant Outcomes
Cancers
CO Poisoning
Asthma
Heart 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
All causes of death
Diseases of the heart
Age-Adjusted
Death Rates by
Race/Ethnicity,
State of NJ,
2000-2006
Malignant neoplasms
Cerebrovascular diseases
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:
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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