California's New Environmental Health Tracking Programs
In the wake of 9/11, renewed resources and attention have been given to the nation's public health infrastructure, especially in the areas of surveillance of acute infectious illnesses and monitoring the environment for suspicious peaks of chemical contamination. California should rightly devote resources for preparation for a chemical or biological terrorist attack. However, at the same time, we should not neglect the financial and human toll of chronic disease. Chronic diseases are the cause of approximately 75 percent of deaths in California. Unlike with infectious diseases, clinicians are not mandated to report many chronic diseases and therefore public health agencies are unable to track trends over time to determine if they are changing in specific populations or geographic areas.
Environmental exposures contribute to a significant proportion of many chronic diseases (e.g., 30 percent of childhood asthma exacerbations and 10 percent of childhood neurobehavioral disorders are attributed to environmental exposures). The toll of environmentally-related chronic disease in California is significant. For just nine of these preventable diseases (such as childhood asthma, lead poisoning and childhood cancer) in which cost estimates are available, total costs for Californians are an estimated $10 billion per year. The estimated total costs in California for work-related deaths in 1992 were $20.7 billion. Many workers die each year in California from preventable diseases caused by chemical exposures.
In response to the rising burden of disease caused or exacerbated by environmental factors, the California Legislature passed and the Governor signed Senate Bill 702 in 2001. This law made California the first state in the nation to begin planning an environmental public health surveillance system. The goal of such a system is "to establish ongoing surveillance of the environmental exposures and diseases affecting Californians, with a focus on prevalence and determinants of chronic diseases."
In October 2002, the federal Centers for Disease Control and Prevention provided funding for 17 states,including the Calfornia Department of Health Services (CDHS) , 3 local health departments, and three schools of public health (including UC Berkeley) to begin development of a National Environmental Public Health Tracking Network. This paper describes the goals and challenges of the CDHS and UC Berkeley programs.
- Disease Clusters , Environmental Health Indicators , Environmental Health Tracking , Geographic Information System (GIS)
English PB and Balmes J. 2004.
ís New Environmental Health Tracking Programs. California Medicine 99(4), 32-35. San Francisco