Environmental Health Indicators Bridging the Chasm of Public Health and the Environment: Workshop Summary (2004) / Chapter Skim
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2 Overview of Environmental Health Monitoring and the Use of Indicators
2 Overview of Environmental Health Monitoring and the Use of Indicators
Pages 23-34
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From page 23... ...
Like economic indicators, they are needed because it is not possible to measure everything. Acknowledging a critical environmental health gap, the Pew Environmental Health Commission proposed in 2001 the establishment of a national tracking system to monitor environmentally related exposures and diseases (Pew Environmental Health Commission, 2001)
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From page 24... ...
report The Future of Public Health, which communicated that "the removal of environmental health authority from public health agencies has led to fragmented responsibility, lack of coordination, and inadequate attention to the health dimensions of environmental problems." The Pew Environmental Health Commission continued the discussion and recommended that the nation's environmental health defense system be strengthened, that the environmental precursors of disease be identified and controlled, and that public health's readiness to respond be improved, noted Burke. The commission's recommendations included establishing: · a national baseline tracking network for diseases and exposures; · a nationwide early-warning system for critical environmental health threats; · state pilot tracking programs to test diseases, exposures, and ap proaches for national tracking; · federal investigative response capability; and · tracking links to communities and research.
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Environmental Health Monitoring Priorities Many participants noted that the currently proposed monitoring program has a number of limitations and that priorities would have to be set in order to ensure the success of the program. Burke noted that the Pew Commission identified specific components of a national monitoring system that must be built within the next few years, and these components are reflected in part in the nationwide health tracking bill before Congress.
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Results such as these may suggest areas for future environmental health monitoring. SOURCE: National Health Interview Survey, 1995.
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However, failing to study the health effects of a possible risk factor also poses ethical issues. ENVIRONMENTAL HEALTH INDICATORS The cornerstone of an environmental health monitoring effort is the selection of indicators.
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and others, is that it "provides information about a scientifically based linkage between environment and health"; thus, "an indicator which purely describes the state of the environment or a pure health status indicator with no obvious link to environmental causation, cannot be considered an environmental health indicator." The term environmental health indicator "implies monitoring and action" (Kjellstrom and Corvalan, 1995)
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In environmental public health, indicators are essential for understanding risk and evaluating interventions. William Pease of GetActive Software suggested that an environmental health indicator also must be credible, relevant, and able to be acted on.
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This report will be a cornerstone of the new monitoring-based approach to environmental health. However, the report is still in its infancy, and the tools it describes are not yet available for use by the public health and environmental health communities to help with outcome monitoring.
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From page 31... ...
Indicators at all levels in the DPSEEA framework could apply locally, nationally, or internationally, depending on the context. According to Kjellstrom, this framework has the potential to "bridge the chasm between public health and the environment." The character of the environmental health problem defines the level of the policy decision.
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From page 32... ...
OSTP has called for an approach to risk prioritization that is scientifically sound, understandable to the public, comparable across programs and agencies, and cumulative so that it produces a predictable record over time. Creating a scientifically sound method of ranking environmental health risks that includes public input involves first establishing criteria for the content of environmental health indicators and then selecting criteria for the risk prioritization process, noted Fishhoff.
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From page 33... ...
questioned the removal of environmental health authority from public health agencies, which led to a lack of coordination and inadequate attention to the health dimensions of environmental problems; the Pew Environmental Health Commission (Environmental Health Tracking Project Team, 2000) further recommended that the nation's environmental health defense system be strengthened, reinforcing the basic need for environmental health to respond to a myriad of health challenges.
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From page 34... ...
According to some speakers, environmental health indicators are tools for quantifying the scientific linkage between environment and health. They must be: · simple -- one item; · measurable -- comparable, quantifiable, and rankable; · defensible; · understandable -- able to access information in a usable form; · credible -- "unbiased source," best science; · comprehensible; · actable; · responsive to local needs; and · reflective of societal values on environment and health.
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