Environment and Public Health Indicators

A new study, Tracking Health and the Environment: A Pilot Test of Environmental Public Health Indicators looks at the relationship between environmental indicators and public health measures. In the study, the Johns Hopkins Center for Excellence in Environmental Public Health Tracking assembled three sets of indicators to test the relationships.

From the abstract:

To advance the use of indicators, the Johns Hopkins Center for Excellence in Environmental Public Health Tracking piloted three pairs of indicators: 1) air toxics and leukemia in New Jersey, 2) mercury emissions and fish advisories in the United States, and 3) urban sprawl and obesity in New Jersey. These analyses illustrate the feasibility of creating environmental hazard, exposure, and health outcome indicators, examining their temporal and geographic trends, and identifying their temporal and geographic relationships. They also show the importance of including appropriate caveats with the findings. The authors' investigations demonstrate how existing environmental health data can be used to create meaningful indicator measures to further the understanding of environment-related diseases and to help prioritize and guide interventions. Indicators are the foundation of environmental public health tracking, and increased use and development of them are necessary for the establishment of a nationwide tracking network capable of linking environmental exposures and health outcomes.

Not surprisingly, I like the idea of wider use of indicators to understand trends and relationships. I also like the idea of trying to get outside of a single-field area of focus to look at the broader set of indicators to see the interrelationships.

This is an important step, but I suspect only a first step. As the work progresses, I would like to see greater studies on how public policy decision-making about land use and transportation planning, for example, or social service provisions, or economic development policy affect both environmental and public health indicators.

The message that community indicators practitioners understand instinctively and are trying to share with the world is that we live in an interconnected system where our actions have consequences. Only a comprehensive look at indicators of the quality of life in a community has a chance to understand where we are making progress, where we struggle, and how our decisions affect the future of our community.

Here's how the authors conclude their study:

Several lessons can be drawn from the development of the indicators presented in this paper. First, indicator development is restricted by the availability, reliability, and consistency of data. Second, multidisciplinary expertise and collaboration are needed to design and track indicators that will be useful for policy. Finally, because indicator projects may not be controlled studies, their results are often difficult to interpret. Great care must be taken in the communication of findings about environmental exposure and disease relationships to the public. Words should be carefully chosen, caveats should be highlighted and repeated, and clear legends should be placed on every graphic. For linkage indicators examining both hazard/exposure and outcomes, it must be emphasized that conjunction or lack thereof provides only exploratory and potentially suggestive data about distributions and trends. Controlled analyses are generally needed to draw firmer conclusions.

Read over the study, and keep forwarding these kinds of articles!