Lessons Learned From the Environmental Public Health Tracking Sub-County Data Pilot Project.

OBJECTIVE: Small area data are key to better understanding the complex relationships between environmental health, health outcomes, and risk factors at a local level. In 2014, the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Program (Tracking Program) conducted the Sub-County Data Pilot Project with grantees to consider integration of sub-county data into the National Environmental Public Health Tracking Network (Tracking Network). DESIGN: The Tracking Program and grantees developed sub-county-level data for several data sets during this pilot project, working to standardize processes for submitting data and creating required geographies. Grantees documented challenges they encountered during the pilot project and documented decisions. RESULTS: This article covers the challenges revealed during the project. It includes insights into geocoding, aggregation, population estimates, and data stability and provides recommendations for moving forward. CONCLUSION: National standards for generating, analyzing, and sharing sub-county data should be established to build a system of sub-county data that allow for comparison of outcomes, geographies, and time. Increasing the availability and accessibility of small area data will not only enhance the Tracking Network's capabilities but also contribute to an improved understanding of environmental health and informed decision making at a local level.

Multiple measures on the Environmental Public Health Tracking Network.

SETTING: The Centers for Disease Control and Prevention's National Environmental Public Health Tracking Program is leading an initiative to build a National Environmental Public Health Tracking Network (Tracking Network) that integrates data into a network of standardized electronic data to provide valid scientific information on environmental exposures and adverse health conditions, as well as spatial and temporal relations between them. The Web-based Tracking Network is designed for different audiences including government, the academic community, and the public. A primary goal of the Tracking Network is to allow the exploration of data on health effects, environments, and demographics. The wide variety of data types along with stratifications present a complex problem when developing system functionality to query and display disparate data simultaneously in a comparable way using charts, tables, and maps. OBJECTIVE: While the ability to query and display data that span across geographies and multiple time periods for a single type of data has been the main feature set of the Tracking Network, allowing the same for multiple data types is needed to enable users to explore trends and possible associations among health and environmental data. METHODS: As a first step, a multidisciplinary team was formed to address complex issues related to developing the ability to view multiple measures on the Tracking Network. The team then iterated through steps involving requirements gathering, the segmentation of the requirements into functional areas, submission of proposals to address those functional areas, and finally evaluation of the proposals to address functional areas. CONCLUSIONS: Adding the ability to view multiple measures is an important step to improve Tracking Network users' exploration of the environmental health status of their communities. With this capability, public health practitioners and other users can formulate hypotheses, analyze trends, and explore possible relationships across a wide variety of environmental and health information.

Implementing the environmental public health tracking network: accomplishments, challenges, and directions.

An effective environmental public health surveillance system utilizes health hazard, exposure, and health outcome data to provide public health professionals a picture of the relationship between the environment and health. The environmental monitoring and the health and hazard exposure surveillance systems that currently exist are generally not compatible with one another. There exists a lack of common standards in how data are collected, including where data are collected, the frequency of collection, the characteristics collected, and data formats. Among other uses, the Environmental Public Health Tracking (EPHT) Network will address weaknesses and gaps associated with utilizing and linking these types of data. The Centers for Disease Control and Prevention's EPHT Program has engaged several interdisciplinary partners to help in developing requirements and to identify functionalities to be included in the network. In working toward implementation, EPHT specialists and the partners have begun to develop several major components and address several challenges.