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Using Public Health Data to Assess Vulnerability and Cumulative Impacts to Health

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.

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Using Public Health Data to Assess Vulnerability and Cumulative Impacts to Health

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  1. 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

  2. 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

  3. 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

  4. 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

  5. Health Disparity Priority Areas: Asthma Cancer Heart Disease Kidney Disease Diabetes HIV/AIDS Immunization Infant Mortality Obesity Injuries Violence

  6. Environmental Public Health Tracking: Air Quality Drinking Water Lead Exposure Birth Outcomes Infant Outcomes Cancers CO Poisoning Asthma Heart Attack Occup. Injuries

  7. Age-Adjusted Death Rate due to Heart Disease, NJ and US, 2000-2006

  8. Age-Adjusted Death Rate due to Heart Disease, by Race/Ethnicity, 2006

  9. Percent of Live Births with Low Birth Weight , 2001-2005 Percent of Children Under Age 5 Years of Age Living in Poverty, 2000

  10. Percent of Infants with Low Birth Weight, by Mother’s Education and Prenatal Care, 2000-2007

  11. All causes of death Diseases of the heart Age-Adjusted Death Rates by Race/Ethnicity, State of NJ, 2000-2006 Malignant neoplasms Cerebrovascular diseases

  12. Age-Adjusted Death Rate due to Cancers, by County and Race/Ethnicity, 2004-2006

  13. 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

  14. 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

  15. 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

  16. 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

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