National Office
CSTE
2872 Woodcock Blvd
Suite 303
Atlanta, GA 30341
770-458-3811
770-458-8516
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The State Environmental Health Indicators Collaborative (SEHIC)
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Environmental Public Health Indicators (EPHI) were first described by the CDC/CSTE environmental public health indicators project in 2000 (www.cdc.gov/nceh/indicators/). These indicators, along with other public health indicators developed by CSTE, were identified in part to provide a means of placing non-infectious diseases and conditions under surveillance towards building a comprehensive National Public Health Surveillance System (NPHSS).1 Since that time, the National Environmental Public Health Tracking Program has begun to enhance environmental health surveillance capacity nationally and among state health departments by encouraging the linkage of environmental and health data using standardized, systematic methods. These efforts included the development measures that provide consistent and standardized methods for comparing public health surveillance and environmental monitoring data across multiple states. In 2004, the State Environmental Public Health Indicators Collaborative (SEHIC) was established to develop a pilot set of EPHI. While this work is being led by state-level environmental epidemiologists, support for the program’s efforts is being provided by the CDC’s National Center for Environmental Health and the Council of State and Territorial Epidemiologists (CSTE).
The primary goal of SEHIC was to convene a group of willing state level environmental health practitioners as collaborators to develop and compare indicators for use within environmental health surveillance and practice.
In their most basic form, EPHI are descriptive summary measures derived from existing environmental health programs that can be used to enhance environmental health practice by improving the accessibility, availability and distribution of information for decision-making. |
Purpose and Goals of Environmental Public Health Indicators
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First, it is proposed that EPHIs can serve as summary measures that describe elements of environmental sources, hazards, exposures, health effects, and intervention and prevention activities that may stand alone or be combined to describe their interaction.
Second, indicators can also be used to assess positive and negative environmental determinants of health including measures of the built environment and “healthy people in healthy places”.
Third, EPHIs are intended to serve as communication tools for making environmental health information available to stakeholders including environmental health partners, policy makers and the general public.
Fourth, EPHIs can identify areas for intervention and prevention and evaluate the outcomes of specific policies or programs aimed at improving environmental public health.
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SEHIC work to date
SEHIC chose to first develop and pilot indicators related to air quality, asthma and drinking water. Three working groups were formed, each focusing on one of the identified topic areas. Preliminary indicators and topic areas were selected based on existing knowledge regarding relationships between environmental sources, hazards, exposures and health effects, the interests of collaborators, and perceived ease of development. Once topic areas were selected, SEHIC engaged CDC programs, CSTE and additional state partners to pilot the indicators, participate in refining key measures, generate tools for indicator development, and to provide feedback on background materials framing the project.
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Within each of the three topic areas, several preliminary measures have been identified and individual states are in the process of piloting these measures using state level data resources. The templates and “how-to-guides” used to outline each indicator and its measures are based on previous CSTE/CDC indicator collaborations.2,3 The template offers a mechanism to evaluate the strengths and weaknesses of each indicator measure by describing the significance, background, data sources, data quality and limitations. For each indicator measure, the “how to” guide outlines step-by-step methods to systematically replicate the derivation of measures in a standard way. Future goals of SEHIC are to evaluate the findings of the initial pilot of the indicators, refine indicator templates and guidance documents for wider implementation, standardize reporting formats, and expand the number of indicators and topic areas.
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Three working group meetings were held, in September 2005, February 2006, and March 2007. Plans for development of a preliminary document with indicator results are underway and scheduled for release in August 2006.
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| For more information or to become part of the State Environmental Health Indictors Collaborative (SEHIC) please contact: Erin Simms esimms@cste.org |
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| Current Participants: |
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Steering Committee Working Group:
Kristen Malecki, Team Co-lead, Wisconsin Department of Health and Family Services
Lesa Roberts, Team Co-lead, Kansas Department of Health & Environment
Amy Kyle, University of California, Berkeley
Jim Vanderslice, Washington State Department of Health
Catherine Thomsen, University of California, Berkeley
Paul English, California Department of Health Services
John Braggio, Maryland Department of Health and Mental Hygiene
Jean Johnson, Minnesota Department of Health |
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Drinking Water Working Group:
Kristen Malecki , Team Co-Lead, Wisconsin Department of Health and Family Services
Jim VanDerslice, Team Co-Lead, Washington State Department of Health
Betty Dabney, Maryland Department of Health and Mental Hygiene
Jerry Fagliano, New Jersey Department of Health and Senior Services
Barbara Malezewska-Toth, New Mexico Department of Health
Paul Squillace, U.S. Geological Survey
Judy Qualters, Centers for Disease Control and Prevention
Betsy Kagey, Georgia Department of Human Resources |
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Air Quality Working Group:
Greg Kearney, Team Co-Lead, Florida Department of Health
Prakash S. Patel, Team Co-Lead, Florida Department of Health
Paul English, Team Co-Lead, California Department of Health Services
Vickie Boothe, Centers for Disease Control and Prevention
Tammy Eagan, Florida Department of Environmental Protection
Paul Garbe, Centers for Disease Control and Prevention
Judith Graber, Maine Bureau of Health
Amy Kyle, University of California, Berkeley
Lesa Roberts, Kansas Department of Health & Environment |
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Asthma Working Group:
Jean Johnson, Team Co-lead, Minnesota Department of Health
John T. Braggio, Team Co-lead, Maryland Department of Health and Mental Hygiene
Catherine Thomsen, University of California, Berkeley
Wendy Brunner, Minnesota Department of Health
Mandy Burkett, Ohio Department of Health
Sarah Lyon-Callo, Michigan Department of Community Health
Susan Stone, Environmental Protection Agency
Elizabeth A. Wasilevich, Michigan Department of Community Health
Cynthia Weiss, Ohio Department of Health
Cynthia Woodruff, Indiana Primary Health Care Association |
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| Climate Change Working Groups: |
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Excess Morbidity/Mortality due to Climate Change
Sumi Hoshiko, Team Lead, California Department of Health Services
Carol Braun, Missouri Department of Health and Senior Services
Dan Wartenberg, Rutgers University
Paul English, California Department of Health Services
Rachel Collins, Massachusetts Department of Public Health
George Luber, Centers for Disease Control and Prevention
Lori Harris, Missouri Department of Health and Senior Services |
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Population Vulnerabilities to Climate Change
Paul English, Team Lead, California Department of Health Services
Judith Graber, Maine Department of Health and Human Services
Kristen Malecki, Wisconsin Department of Health and Family Services
Fuyuen Yip, Centers for Disease Control and Prevention
Dan Wartenberg, Rutgers University
James Logue, Pennsylvania Department of Health
Cynthia Goodman, Pennsylvania Department of Health |
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Air Quality and Respiratory Morbidity
Christine Davis, Team Lead, Environmental Protection Agency
Syni-An Hwang, New York State Department of Health
Vicki Boothe, Centers for Disease Control and Prevention
Bob Wahl, Michigan Department of Community Health
Shao Lin, New York State Department of Health |
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Vector Borne Disease
Rebecca Shultz, Team Lead, Florida Department of Health
Barbara Toth, New Mexico Department of Health
Prakash Patel, Florida Department of Health |
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| 1Council of State and Territorial Epidemiologists, Position Statement 1994-3, Setting priorities for diseases, conditions and health status indicators or outcomes in the National Public Health Surveillance System |
2Centers for Disease Control and Prevention. Indicators for chronic disease. MMWR 2004; 53 (No. RR-11): 1-116.
3Council of State and Territorial Epidemiologists. Occupational Health Indicators: A Guide for Tracking Occupational Conditions. November 2004. Available at: http://www.cste.org/pdffiles/Revised%20Indicators_12.14.04.pdf |
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