Task 7

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Module 3 — Task 7: Develop Locally Appropriate Indicators

At the completion of this task, the assessment team should have:

An agreed-upon list of indicator selection criteria.
A set of key environmental health indicators.

The mapping process in Task 6 analyzed and described the qualitative relationship among components of an environmental health issue. Task 7 translates that information into quantitative measures through the development of indicators.

Listen as Jonathan Schwartz discusses the process of developing indicators.

Click on the following links to skip to each section:

»	What Are Indicators
»	Develop a List of Potential Indicators
»	Identify Key Indicators Based on Selected Criteria
»	Indicator Development

What Are Indicators

Indicators are tools for quantifying, through direct or indirect measures, a significant aspect of an environmental health issue. They may be used to describe and communicate overall environmental health status and to track trends. In the PACE EH process, indicators are used in developing issue profiles (Task 9), ranking and prioritizing the community’s environmental health concerns (Tasks 10 and 11), and ongoing evaluation (Task 13).

Due in part to local variability, scientific uncertainty, and differing values, there is no national or scientific consensus on a set of environmental health indicators that are most appropriate for use in all communities. This section therefore guides the user in developing environmental health indicators that reflect local conditions and concerns.

Development of an indicator list is one of the most important aspects of the assessment process for ensuring long-term success and results, for several reasons:

Local environmental health assessment and the process of measurably improving local status are most effective and best supported over the long term when meaningful measurements are available to help define areas of concern and to mark change.
Well-developed and clearly communicated indicators will help sustain the effort, despite inevitable turnover among participants.
The process of establishing indicators will highlight any pre-existing issues related to the availability of and the quality of locally useful data. It can also draw attention to the need for improved or increased data collection as a local priority.
Many members of the public, including local policy-makers, respond best to a simple, clear, easy-to-understand message. A good indicator with reliable data is a very effective communication tool for this audience.

Develop a List of Potential Indicators

It may seem that the identification of indicators should come after the collection of data (Task 9). However, relying on existing data to dictate the scope of a community’s environmental health assessment is far too limiting. From a philosophical standpoint, it is important that community values and concerns, not the availability of data, drive the development of indicators.

Example: Lead poisoning

One possible gap in the “web” may be high blood lead levels in children raised in “safe” housing.

The gap is the route of exposure. A viable indicator may be “How many children with elevated blood lead levels live in safe housing but play on playgrounds with equipment dressed with lead-based paint?” Do those figures represent a significant environmental health problem? Can you begin to see how a valuable environmental health action plan might emerge from this process?

Identify Key Indicators Based on Selected Criteria

The previous step likely generated a lengthy list of options for possible indicators. The job now is to select from among these and choose a few that are robust and effectively describe the key elements of concern related to an environmental health issue. Selection criteria (Criteria for Selecting Environmental Health Indicators) will facilitate this process. Use selection criteria to “screen” possible indicators. The following is a list of suggested criteria for selecting indicators of environmental health status. Consider amending this list to reflect the community’s values and interests.

Indicator Development

Pilot site teams approached the indicator development stage in a variety of ways. One team generated reports containing basic information about human health effects, causes/contributors, pathways, and current public health protection factors, related to the issue under investigation. The team then organized three technical “subcommittees” to consider and report back on potential measurements (indicators) related to the issues and to choose three or four indicators they considered most meaningful locally. These were compiled into a “B” list of indicators. After discussion with the team, each subcommittee was tasked with choosing one or two “primary” indicators for each issue. These were compiled into an “A” list of indicators. In general, indicators were included on the “A” list only if data were currently collected and were available. Where data were not being collected or made available, the item was added to a “Data Wish List.” The assessment team intends to circulate the wish list to relevant agencies and individuals to encourage increased data availability and development of new data sources.

Questions to consider

What are indicators? Why is it important to develop local environmental health indicators? Why should development of indicators before identification of existing data?