Environmental public health tracking (EPHT), a type of public health or epidemiologic surveillance, is the ongoing monitoring for and identification of local disease or injury excesses attributable to environmental hazards and the dissemination of these data for development of interventions to prevent and/or reduce the frequency and severity of these occurrences. This proposal seeks to undertake a regional, multi-institutional EPHT project to develop collaborations among neighboring EPHT Partners in the northeast US (e.g, Maine, New Hampshire, Massachusetts, Connecticut, New York and New York City) for surveillance and epidemiologic research, to demonstrate new applications and developments in methods for data linkage, pattern detection and assessment of exposure-disease associations, and to train students and other researchers in the use and interpretation of these approaches for the study of the possible environmental causes of disease. Specifically, in addition to conducting a review of current surveillance methodology, we plan to investigate and validate the addition of new data fields relevant to environmental problems to current reporting systems, such as birth certificates. We will review the current applications of ecologic analysis methods to EPHT, noting limitations and opportunities for improvement, develop training materials illustrating key points with concrete, non-mathematical logic and examples, and provide practical guidance for implementation. We also will explore new methods that exploit the spatial coherence of local environmental exposures, such as geographically weighted regression (GWR) and multivariate methods, conducting specific analyses to demonstrate their strengths and weaknesses for EPHT. We will work with EPHT partners to identify and develop a regional EPHT epidemiologic study focusing on a problem of local importance, such as the reproductive effects of exposure to arsenic in drinking water or air pollution, or assessment of the spatial pattern of childhood cancers and related environmental exposures. Initially, our focus will be on facilitating collaboration and data sharing while accommodating concerns about confidentiality. To provide guidance, we will convene an advisory committee of representatives from partner health agencies, partner environmental agencies, industry, NGOs and the public. We see these efforts as an important step from individual EPHT partner programs towards national EPHT network and collaboration.
