The Right Track: ASTHO’s Environmental Public Health Tracking Fellowship

November 19, 2018|12:48 p.m.| ASTHO Staff

From the air we breathe to the water we drink, our health is directly impacted by the health of our environment. But how many of us have considered the possible threat of Radon, the potentially poisonous gas, seeping into our newly acquired dream home? Or how to make time-sensitive decisions about protecting our family’s health during a wildfire smoke event? Fortunately, CDC’s Environmental Public Health Tracking Program is working around the clock, focusing their state-based efforts on protecting people from these and other possible health threats.

Since 2002, CDC has funded 26 state and and city health departments to implement local tracking programs and data networks. As a grantee state, health departments collect data indicating potential exposure to chemicals, compounds, and toxins, displaying them on a state portal and then feeding this data onto the National Environmental Public Health Tracking (EPHT) Network. This national network is a publicly accessible interface that provides access to a wealth of data on the environment, exposures, health effects, and population characteristics.

ASTHO’s Tracking Fellowship

Since 2008, a partnership between ASTHO and CDC has provided states and territories that are not funded by CDC’s program with an opportunity to build capacity in their state through a unique fellowship model. Over the past eleven years, ASTHO’s Environmental Public Health Tracking Fellowship Program has provided up to four state and local health departments per year with support to build tracking capacity by conducting individual pilot projects. Projects span the breadth of environmental health topics, including air and water quality, lead poisoning, portal development, and heat stress. The fellow is mentored by a CDC-grantee state that provides them with guidance, technical assistance, and hosts an on-site visit to the agency to learn about key tracking topics. To date, ASTHO’s fellowship program has supported 43 projects across 26 state, local, and territorial health departments.

Reversing the Traditional Site Visit

In the 2017-2018 fellowship round, a first-of-its-kind “reverse” site visit occurred between the ASTHO fellow from the Commonwealth of the Northern Mariana Islands (CNMI) and their mentor grantee state, the Washington State Department of Health (WADOH). The project built upon another project from the previous year that saw a fellow from CNMI explore vector borne disease surveillance under the guidance of the Florida Department of Health.

In May 2018, two staff from WADOH’s EPHT team travelled to CNMI’s Commonwealth Healthcare Corporation (CHCC). Over the course of five days, WADOH’s staff introduced CHCC to the fundamentals of tracking. A basic needs assessment was conducted, followed by hands-on surveillance training related to mapping human and mosquito populations for mosquito abatement and vector borne disease prevention activities. Training was adapted to fit the needs of CHCC’s priorities and resources, leading to the establishment of a permanent surveillance solution that utilized a combination of paid and free or open source software, enhancing the capacity for CNMI to integrate surveillance techniques into activities outside the scope of environmental health, such as food safety reporting across food and drink establishments, schools, daycares, and other public facilities.

Tina Echeverria, research investigator on WADOH’s EPHT team, was one of the staff members who provided this technical assistance. According to Echeverria, “Many doors are opened through the fellowship program. Successful fellows foster relationships with not only the mentor agency but with programs, data sources, and technology experts within their jurisdiction and beyond to achieve a goal with a lasting impact.”

As the first CDC grantee team to provide technical assistance on a reverse-site visit, the WADOH team saw the immediate benefits to the fellow’s agency. “Overall, we would strongly endorse the reverse site visit, particularly for grantees who have limited technological resources and initial infrastructure for establishing a tracking program. Visiting [the CNMI] work site allowed us to understand their resources and tailor our training and guidance appropriately,” Echeverria says. “Being onsite revealed a need to introduce freeware GIS solutions in addition to teaching work flows with ESRI products. Another benefit was the ability to connect with multiple programs and staff. During our visit we had the opportunity to meet with the emergency preparedness team, epidemiologists, field samplers, and IT staff. These conversations provided valuable information on the vision, barriers, and potential for establishing a multi-disciplinary tracking program.”

The experience also provided a glimpse into the unique challenges faced by territories and how CDC might expand the nationwide tracking network to the territories. “For grantees from health agencies with more advanced technological resources, visiting the fellow’s state could be valuable for gaining an understanding of the structure and systems necessary for a large-scale tracking program,” says Echeverria.

With over a decade of success, ASTHO’s EPHT Fellowship Program continues to demonstrate the strength of continuous learning around tools that inform public health practice and policy, thereby enhancing collaboration and supporting data-driven decisions that protect and improve community health. The most recent funding opportunity for the fellowship has been announced. States and territories are encouraged to apply. More information can also be found on ASTHO’s Environmental Health website.

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