Environmental Public Health Tracking and EH Assessments in Montana National PACE EH Summit Louisville, KY - March 2006 Marjean Heisler Magraw.

Environmental Public Health Tracking and EH

Assessments in Montana

National PACE EH SummitLouisville, KY - March 2006

Marjean Heisler Magraw

EPHT and EH Assessment:

•What is EPHT•Why we did EH Assessments•Use of PACE EH as a tool•Benefits and Challenges

Origin of Environmental Public Health Tracking

• Pew Report to Congress-2000

• 2001- Montana HB 582 called for a feasibility study

• March 2002 The “National Health Tracking Act” was signed

ENVIRONMENTAL PUBLIC HEALTH

TRACKING

CDC’s Vision For EPHT

HealthyInformed

Communities

CDC EPHT Mission

To provide information from a nationwide network of

integrated health and environmental data that drives

actions to improve the health of communities.

Challenges

Data collected by environmental and health entities nationwide is neither comprehensive nor standardized.

We need to begin by defining our needs, enhancing relevant data, and building bridges between agencies.

WA

OR

NV

ID

MT

WYSD

ND

NE

UTCO

AZ

TX

KS

GAALMS

MN

AR

MO

ILIA

MI

OHIN

TN

KY

SC

NC

VAWV

PA

NY

ME

RI

VT NH

CT

DEMD

New York City, NYNJ

Washington, D.C.OK

NM

CA

Houston, TX

Tulane University

Universityof

California,Berkeley

• Planning & Capacity Building Activities • Infrastructure Enhancement & Data Linkage Demonstration

Projects(with a planning & capacity building component)

•  Academic Partners for Excellence • Data Linkage Demonstration Projects

LA

FL

WIMA

University of Pittsburg

First Steps in Montana for Building an EPHT Program

Identify partners Assess EH needs and concerns

Key Partners

• Local public health agencies• Universities• Advocacy Groups• Related Agencies• Tribes• Health Care Providers

Statewide EH Needs Assessment

Survey of PH workforce and partners Community Level EH Assessments

Community EH Assessments

Just one piece of the EPHT plan

Objectives:To obtain community input for EPHTTo increase understanding of health

concerns with possible links to the environment.

To increase capacity at the County/Tribal level

Involving Local PH Departments

• Provided training and support for EH assessments at local level

• Provided support for selected action items

Assessment Requirements

Establish community team and/or advisory group

Involve/inform decision makers (Dept. managers, Boards of Health)

Obtain community input • Surveys• Community Forums/Discussions• Focus Groups

Assessment Requirements (cont.)

Analyze data & generate a ranked list of EH concerns

Prioritize EH concerns for local action

Set action steps

Write a final report which characterizes the area, describes assessment process and results

Challenges for Local PH Departments

Minimal staffing

Minimal resources

Many demands

Lack of technical knowledge/skills

Fear of controversy and inability to address identified concerns

Benefits of EH Assessments

• Obtained community level input for EPHT• Increased county/tribal support/understanding

of the need to integrate public health & environmental data

• Increased community discussion around EH issues

• Allowed local Health Departments to be proactive

Benefits

• Involved/engaged a new group of citizens

• Identified EH issues of concern• Developed assessment skills at local

level

Comments From Contractors

“The community outreach has been good for the department and the community.”

“It (the assessment process) increased cooperation between Health Department programs.

“Several citizens commented that they had concerns about issues and never knew who to talk to about it, and that they were glad to see the survey being conducted.”

Comments From Contractors

“It’s good to hear other strategies and solutions to common problems.”

“Keeping in touch through the trainings and conference calls gives more unity to the project. I feel we are working as a group and not just one county in the state.”

Special Follow-up Projects

Purpose:Provide resources and support to contractors to implement a local action step that addressed a priority concern identified through their EH Assessment.

$5000 max/project.

Benefits of the Special Projects

Some local environmental health concerns identified through the Community Environmental Health Assessments are being addressed.

Citizens see their health department working proactively.

Public knowledge/awareness of EH issues increases.

Benefits of the Special Projects

Local PH professionals are gaining technical skills, and building their capacity to work positively at the community level.

Health departments are working with new community and agency partners.

Health departments are improving communication among local agencies and programs about environmental health issues.

Missoula CountyAction Items

1. Refer vehicle emissions item to the Air Quality Advisory Council for in-depth discussion.

2. Work with other partners and planners in a variety of ways to reduce vehicle miles.

3. Implement an indoor air education campaign focusing on all possible contaminants (radon, mold, tobacco smoke, asbestos, and other chemicals found in homes or workplaces.

Rocky Boy’s Reservation Action Steps

1. Fund an educator position to manage the recommended environmental health priorities and develop agency response protocol.

2. Provide community education about all aspects of the community water system.

3. Publish/distribute a newsletter to update citizens about environmental issues.

Recommended Action Steps – Rocky Boy’s Reservation

4. Develop a sampling and analysis plan, and a source water protection plan for vulnerable private wells. Identify and map locations of abandoned wells.

5. Establish a system for removal, storage, and disposal of car bodies from waterways.

6. Identify resources for a pilot project to remove abandoned mobile homes.

Dawson County Special Project

EH Assessment Priority Concern Addressed: Water Quality

Action Step: Offered water testing for private wells, and provided public education about water quality threats, well testing and disinfection.

Yellowstone County Special Project (1)

EH Assessment Priority Concern Addressed: Food Safety

Action Step Selected to Address Concern: Create a Yellowstone County Food Safety Advisory Group to identify/address food safety related concerns.

Next Steps

• Expand local projects

• Offer PH Institute Course on Assessment

• Link local HDs through web-based reporting systems

• Improve availability of quality health and environmental data

http://www.dphhs.mt.gov/epht/

http://www.cdc.gov/nceh/tracking/