WPHA Introduction. Bridging the Gap. Current Data Partnerships. Current EPHT Topic Areas

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1 WPHA 2014 Environmental Public Health Tracking: Mapping, Tracking, and Action Paul D. Creswell Senior Epidemiologist Environmental Public Health Tracking Program Wisconsin Bureau of Environmental and Occupational Health Wisconsin Department of Health Services Introduction Pew Environmental Health Commission Report: Pointed to: America s Environmental Health Gap Called for: a Nationwide Health Tracking Network for diseases and exposures 2002: EPHT responds to this need: Provides data on a variety of environmental exposures and outcomes Serves as a repository of state-specific environmental data Bridging the Gap With the right data, I could better address my community s issues. It would be great if I knew how to make my data more useful for local public health. LPHD EPHT Data Owners Current Data Partnerships Current EPHT Topic Areas EPHT currently has data partnerships with: Wisconsin Cancer Reporting System (WCRS) Lead-Safe Wisconsin Wisconsin Department of Natural Resources (DNR) Survey of the Health of Wisconsin (SHOW) Wisconsin Vital Records Service among others Current topics: Childhood lead poisoning Cancer Ambient Air quality (ozone and PM2.5) Water Quality Private well testing Radon Birth Defects Reproductive Outcomes Carbon Monoxide Poisonings Hospitalizations for Heart Attacks Hospitalizations for Asthma Heat vulnerability 1

2 EPHT: State and National EPHT: Resources WI EPHT is a state-level program: WI EPHT is part of the national EPHT: cdc gov/ National EPHT provides some additional measures (e.g., heat stress), while WI EPHT provides Wisconsin specific data (e.g., private well data). The WI EPHT webpage provides County Environmental Health Profiles (CEHPs): CEHPs are summary reports of the data from the WI EPHT portals and website. The profiles provide maps, graphs, and tables for each specific topic area. Data Repositories Public Portal: Provides data-based tools (i.e., charts and maps) for tracking and communicating environmental public health data. Secure Portal: Provides greater data detail as well as integrated tools that facilitate data exploration and analysis. Public Portal Currently the public portal provides data on a variety of measures in a static format. Queries are atomized and users need to start over to view multiple topics. Example: Enhanced Public Portal Example: Some sub-county level data will be available for some measures. The new public portal allows for dynamic queries. Users can tell a story using maps and data. 2

3 Enhanced Portal Features In partnership with ESRI, EPHT is creating an enhanced public portal: Sub-county (census tract) level data will be available for some measures. D i ill ll d Dynamic map will allow users to pan around. Find an address feature will allow for individualized searches. Printing for reports will be enhanced. ArgGIS Online hosting will allow for map mash-ups to tell your data story. What Can You Do With EPHT Data? EPHT aims to assist local public health departments in meeting programmatic needs. EPHT data can assist in priority setting and communication strategies. EPHT data allows for tracking of progress on health initiatives. What Can You Do With Maps? Maps have become an increasingly prevalent way to represent data. Maps are images and a picture is worth 84.1 words! Images make it easier for us to absorb complex information. Maps provide relational data and tell a story. What Can You Do With Maps? Examples Comparisons between regions allow for an understanding of communitylevel needs and assets. Maps can assist in priority setting and allow us to provide evidence-based solutions where they will have the highest utility to partners throughout Wisconsin. Megan Christenson and Emily Reynolds will provide some examples: Megan will discuss how the BRACE project has used EPHT data to address the climate effects in Wisconsin. Emily will provide an example from her work on cancer prevention to illustrate how maps can be used in priority setting and planning of interventions. 3

4 Thanks! 4

5 Tracking, Mapping, and Action Megan Christenson, MS, MPH WPHA Conference May 14, 2014 Building Resilience Against Climate Effects (BRACE) Program Goals Identify health impacts of climate and severe weather events and vulnerable populations Anticipate future trends Monitor health effects Assure systems are in place to detect and respond to emerging health threats Source: 2 Wisconsin s Climate: Historic Temperature Change Wisconsin s Climate: Anticipated Temperature Change Projected Change in Annual Average Temperature (F) from 1980 to 2055 Wisconsin s annual average temperature has warmed by approximately 1.1 F from 1950 to Wisconsin s annual average temperature is expected to warm 4-9 F by the middle of the century. Source: WICCI, Source: WICCI, National Environmental Public Health Tracking (EPHT) Portal Examples using Wisconsin s EPHT Data Source:

6 EPHT heat stress definition: ICD-9 codes of , E900.0, or E900.9 Heat stroke Heat cramps Heat exhaustion Heat fatigue Heat edema (swelling) Heat Stress 7 Heat Stress Hospitalizations and ED Visits in Wisconsin Temperature Distribution: Milwaukee County Hospitalizations 600 ED Visits Note: Data source is the North American Land Data Assimilation System (NLDAS). 10 EPHT Heat Vulnerability County prevalence of diabetes Heart disease hospitalization rates Percent of population below poverty Percent of population that is non-white Percent of population aged 65+ and living alone Percent of population aged 5+ with a disability Population density Percent of forest canopy Percent of developed land use Percent of cultivated crop land use EPHT Heat Vulnerability: Percent of Population 65+ and Living Alone 11 Note: Data source is the 2000 U.S. Census. 12 2

7 EPHT Heat Vulnerability: Percent of Developed Land Use EPHT Heat Vulnerability: Percent of Population Below Poverty Line Note: Data source is the 2001 National Land Cover Database. 13 Note: Data source is the 2000 U.S. Census. 14 BRACE Heat Vulnerability Variables (24 total) Examples using Wisconsin s BRACE Data Population density Health behaviors and outcomes Demographic and socioeconomic factors Natural environment BRACE Heat Vulnerability Index (HVI) Standard methodology to calculate index Variables standardized by transformation into z- score (z-score = number of standard deviations away from the mean) Variables not weighted Heat Vulnerability Index = sum of all z-scores Draft Statewide Analysis

8 Draft Analysis: Milwaukee County Future Applications of HVI Map Use heat vulnerability maps to identify areas of highest risk. Add public transportation routes and existing cooling centers to map. Identify strategic locations for cooling centers based on transportation routes and high risk areas Thank You! Questions/Comments? 21 References Centers for Disease Control and Prevention. Climate-Ready States and Cities Initiative. Centers for Disease Control and Prevention. Environmental Health Tracking Program. html?c=15&i=65&m=-1# Wisconsin s Changing Climate: Impacts and Adaptation. 2011, Wisconsin Initiative on Climate Change Impacts. Nelson Institute for Environmental Studies, University of Wisconsin-Madison and the Wisconsin Department of Natural Resources, Madison, Wisconsin. 22 4

9 The Power of Maps in Public Health May 14, 2014 Geography Matters! Emily Reynolds Community Outreach Specialist WI Comprehensive Cancer Control Program What is GIS? Geographic Information System A map with a database underneath or A database that you can display on a map What can a map with public health data show us? Determine geographic distribution of disease Analyze spatial trends Map populations at risk Assess resource allocation Plan and target interventions Monitor diseases and interventions over time Geographic Distribution over time Analyze spatial trends Credit: US Centers for Disease Control 1

10 Mapping populations at risk Assessing resource allocation. What are some of the tools? Data Integration- layering various types of data (ie environmental, social, historical) Monitoring looking at data over time and geographic location Geocoding- plotting exact locations on maps Statistical Analysis Plan & Target Interventions: Community Outreach Project To provide training and technical assistance to communities to increase capacity for policy, systems, and environmental change for obesity prevention in order to the reduce the risk of cancer Nutrition, Physical Activity, & Obesity Coalitions Geographic distribution of obesity and cancer death Resource Allocation Bayfield Douglas Iron Ashland Vilas Burnett Washburn Sawyer Florence Price Oneida Forest Polk Rusk Barron Marinette Lincoln Langlade Taylor Saint Croix Chippewa MenomineeOconto Dunn Marathon Shawano Door Pierce Eau Claire Clark Pepin Kewaunee Wood Portage Waupaca Brown Outagamie Buffalo Trempealeau Jackson Waushara Manitowoc Winnebago Calumet Monroe Adams La Crosse Juneau MarquetteGreen Lake Fond du LacSheboygan Vernon Columbia Sauk Dodge Richland WashingtonOzaukee Crawford Grant Dane Iowa JeffersonWaukeshaMilwaukee Racine Lafayette Green Rock Walworth Kenosha 2

11 Resource Allocation Part 2 20 Communities Variety of coalitions Geographic diversity Health risk factors and outcomes Rural vs. Urban Current level of investment Bayfield Douglas Iron Ashland Vilas Burnett Washburn Sawyer Florence Price Oneida Forest Polk Rusk Barron Marinette Lincoln Langlade Taylor Saint Croix Chippewa MenomineeOconto Dunn Marathon Shawano Door Pierce Eau Claire Clark Pepin Kewaunee Wood Portage Waupaca Brown Outagamie Buffalo Trempealeau Jackson Waushara Manitowoc Winnebago Calumet Monroe Adams La Crosse Juneau MarquetteGreen Lake Fond du LacSheboygan Vernon Ozaukee Dodge Cashton Columbia Sauk Richland Crawford Dane Iowa JeffersonWaukeshaMilwaukee Grant Racine Lafayette Green Rock Walworth Kenosha Watertown Assessing an intervention. WI Survivorship Forum Brings together providers and cancer survivors from around the state to have a conversation and help address the survivorship chapter priorities. Two of the Goals: Bring providers and survivors together Host the forums in different areas around the state to encourage wide geographic spread After 3 years, are we meeting these two goals? Survivorship Forum Attendance Maps being used in new ways Maps are a great way to communicate! 3

12 5/8/2014 ESRI ArcGIS Google:mapsengine.google.com Community Commons 4

13 National Mapping Resources ESRI communityanalyst.esri.com/ bao.esri.com/ Centers for Disease Control and Prevention County Health Rankings and Roadmaps Community Commons Google Mapping Tool Mapsengine.google.com WI Mapping Resources UW Robinson Map Library WI Department of Public Instruction UW-Extension- Food Security Emily Reynolds Community Outreach Specialist WI Comprehensive Cancer Control Program And others! How could you use maps? In groups of 3 or 4, take 10 minutes to brainstorm a few ideas for how you could use maps in your work? Share it back 5