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Task 9
Module 3 — Task 9: Create Issue Profiles
At the completion of this task, the assessment team should have: - Developed profiles for each environmental health issue
- Adopted a standardized format for organizing information
- Gathered information
- Developed a summary statement about locally relevant EH issues
Click the following links to skip to each section:
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| This task results in a profile for each identified issue. Profiles are simply a way to format information into succinct narrative reports. These reports will be used in Task 10 to rank the community-specific environmental health issues. The profiles can be prepared by one person, or the responsibility can be divided among team members, community volunteers, professional staff, and/or students. It is important to create a uniform format for the profiles. Whatever the process, the goal is to generate a comparable set of information about each issue. |
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| The team will collect comparable information on each issue which may list information known to the local health agency and other organizations/institutions represented on the assessment team, as well as impressions gathered through community-input efforts, related to the issue. By listing relevant standards, the team compiles local and national data reflecting both the current and the desired status of the issue. |
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Issue Profile Development |
| Preparation of issue profiles represents an excellent opportunity to spread the work of the assessment across team members. There will likely be several assessment team members who are authorities in specific scientific or technical fields and who can prepare a profile fairly easily. (Some of these experts will be local health agency staff who might not be directly involved as team members.) What is the health official’s role at this stage, aside from coordination? It is quite useful for someone to serve as a non-technical editor of profiles and ensure clarity for other non-expert team members or to the general public. |
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Environmental and Public Health Data Sources |
| Keep in mind however, data gathering takes considerable time and effort. Work with a range of local, state, federal, and private agencies to obtain the most recent community-specific data. Familiarize the team with the limitations of environmental health data. For example, data collected for other purposes may not be applicable to the environmental health context. |
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| These data provide the initial basis for assessing the health of the community. They can be obtained from state and local health agencies. Typically, incidence data are provided for each cause of death, and the total number of deaths by cause is expressed as a percentage of total deaths in each of nine age groups. Secondary contributors to death (e.g., workplace exposures) may not be noted. |
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| Reportable disease data are also available from state and local health agencies. Reporting requirements differ from state to state, and not all reportable diseases have environmental implications. Find out about reporting requirements in the target community, and try to obtain at least five years of data for diseases that may be related to environmental exposures or endpoints. Evaluate and interpret trends or variations in annual incidence. |
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| Hospital discharge data constitute an important source of morbidity information. Aggregated data sets usually provide information on age, race, sex, method of payment for services, and length of hospital stay. Unfortunately, not all states or hospitals collect discharge data. If the data are available, they will be coded by the International Classification of Diseases (ICD) system. A list of codes for community-acquired diseases and sentinel occupational diseases from the Ninth Revision of the International Classification of Diseases (ICD-9) is provided in Appendix F of the PACE EH guidebook. |
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| Injury data may be available from hospital emergency departments, state and local transportation departments, and emergency medical and ambulance services. Surveillance data are collected using standardized ICD-9-CM E-code categories. A listing of E-codes relevant to community-based environmental health assessments is provided in Appendix G. In addition, the Consumer Product Safety Commission (www.cpsc.gov) collects national data about injuries linked to specific products. Information on unintentional poisonings is available from local or regional poison control centers. |
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Data on Environmental or Quality-of-Life Endpoints |
| When the community’s environmental health status is described in terms of quality-of-life and ecological outcomes, morbidity and mortality data will need to be supplemented with data that reflect physical, biological, and even social attributes (e.g., information on pollutants, land use, endangered species, open space and parks, surface water quality). Data sources will therefore extend beyond health agencies to other levels of government and other sectors. |
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| The most accessible and detailed information sources on populations are the U.S. Census of Housing and the U.S. Census of Population. These provide statistics on households and individuals aggregated in most cases by block or census tract, as well as by zip code, town, state, and nation. Hundreds of demographic data fields (e.g., age, ethnicity, income) as well as behaviors such as commuting times and shopping are included. Census data are available in hard copy, on CD-ROM, and online (www.census.gov). The information is limited, however, by the 10-year intervals between data collection periods.
Other data sources on high-risk populations include the various departments and institutions that work with specific groups (e.g., schools, prisons). If national data do not provide an adequate level of detail, try state agencies or municipal departments of planning, taxation, or community development. |
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| Look for information on exposure factors in the literature on that topic or from professionals in the field. |
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Environmental Agents/Conditions |
| Data on environmental agents and conditions are available from the EPA and state/local environmental agencies, natural resources agencies, pollution control agencies, and health departments.
EPA maintains several monitoring systems to track ambient pollutants in water and air:
- Data on water quality are provided in the biennial State of the Nation’s Waters, a compilation of reports required of each state under the Clean Water Act.
- Ambient air monitoring and emissions data are compiled in the annual Air Quality and Emissions Trends Report.
- Data on ambient air quality (concentrations of six major “constituent pollutants”), collected via a national network of monitors, are available from the Aerometric Information and Retrieval System (AIRS).
- Data on drinking water are derived from state Safe Drinking Water Information System (SDWIS) databases, which include information on violations of drinking water standards for levels of selected contaminants.
?Note: Most of the national data sets are based on reports from states, municipalities, or even individual facilities. If the level of detail is inadequate, seek more specific data from the corresponding state or local agencies. Other sources of data on local conditions include the municipal or state agencies with responsibilities for particular agents such as waste or noise. Private organizations and institutions also might collect data for specific purposes; for example, a local land trust might maintain an open space inventory or database of forest cover. |
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| A wide range of factors might contribute to a particular environmental health issue. Data sources therefore will be similarly diverse. Direct factors, such as emissions of pollutants into the environment, can be described by use of EPA data collected under various regulatory programs.
Potential sources are the Toxics Release Inventory (an annual report from selected industrial sectors on release and transfer of certain chemicals) and the annual Air Quality and Emission Trends Report.
?Note: The local public health agency should be able to identify key information sources for environmental health data and assemble a description of the type and quality of information available. Most other state and municipal agencies maintain some measure of their own activities (e.g., permits issued, compliance rates, number of training seminars conducted) or of community actions (e.g., recycling rates, carpooling statistics). When thinking beyond governmental responses, consider what organizations or groups in the community might be involved in certain activities. For example, a litter cleanup program might track the number of volunteers or the amount of trash picked up; a YMCA might document the utilization of its educational offerings or outreach programs. |
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Questions to Consider: Why is it important to develop a standardized format for organizing information? What are two sources for environmental or public health data that may be useful in creating issue profiles? (Does not have to be resource listed here.) Is it possible to create issue profiles when there is little or no data to?
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