MN Tracking Network

From Vision to Impact

Tracking Facilitated DiscussionMay 15, 2012

Road Map

• Minnesota Tracking Network

• Tracking in Action (examples)

• Questions

Tracking Network (2012)

Network includes 23 states, NYC, and 5 academic partners

MN Legislation

• In 2007 the MN Legislature established the MN Environmental Health Tracking and Biomonitoring Program

o External Advisory Panel

• Goals similar to National Tracking Network; with the addition of 4 biomonitoring pilot projects

Data & Measures

Hazard

•Air Quality

•Drinking Water

•Environmental Tobacco Smoke*

Exposure

(Biomonitoring)

•Lead

•PFCs*

•Mercury*

Health

•Asthma

•COPD*

•Heart attacks

•CO poisonings

•Birth defects

•Reproductive outcomes

•Cancer

•Climate change* Added by Minnesota Tracking Network

Timeline

Outreach & Testing(Spring 2011)

Redesign & Expansion

(Spring 2012)

Portal Launch(Fall 2010)

Coming in 2012New maps & dataE-learning modulesCustom data access

Target Audiences

Local Health Departments

Researchers

Non-Profit Organizations

State & Local Agencies

Public, Policymakers

Audiences (cont’d)

• Local Public Health Association of MN• LHD data user groups• City and county elected officials• Legislators; house/senate research staff• MN Reference Library• MPCA, MDA• American Lung Association• MN Cancer Alliance

Data Portal: https://apps.health.state.mn.us/mndata

Key Features

• One-stop shop for health & environment data

• Nationally consistent measures (indicators)

• Interactive maps & queries

Outreach Tools

• Webinars & demonstrations • Seminars• Email updates• Facebook, Twitter• News articles

Usability Testing

• User-centered testing (interviews) to evaluate portal content

• Analyze data; look for patterns; make enhancements

Lessons Learned

• Avoid long titles

• Use plain language

• Focus on top tasks

Tracking in Action

Tracking = public health surveillance

Evaluation

Tracking in Action

• Use data to evaluate policy: carbon monoxide poisoningso CO poisonings result in hospitalizations,

emergency department visits, and deathso In 2007-2009 MN passed a new CO alarm

law (MS 299F.50 to 299F.51)o Tracking data is used to evaluate trends &

effectiveness of policy

Tracking in Action

• Use data to evaluate priorities: assessment & planningo We are facing challenging economic times;

assessment and planning process requires tough choices

o Tracking data is used to evaluate public health priorities; identify vulnerable areas/populations

Tracking in ActionSecondhand Smoke Exposure*

*Nonsmoking adults in Minnesota, 2003-2010, Minnesota Adult Tobacco Survey

Bridging the Gap

• Exposure data are essential to understand the relationship between health & environment

• Soil• Water• Air• Food

• However, these data (extent and frequency) often are not collected/available

What is Biomonitoring?

Biomonitoring directly measures the amount of an environmental chemical (or chemical breakdown product) in people’s bodies

Use in Public Health Practice

• Track trends over time

• Identify disparities in exposure

• Evaluate interventions to reduce exposure

• Set priorities for public health action, research, and policy

Example: Blood Lead Levels

Source: Murdock, EMBO Reports 2005

Biomonitoring in MNEnvironmental Health Tracking and Biomonitoring (MN Statutes 144.995-144.998)

•MDH will conduct a pilot biomonitoring program of 4 projects in communities “likely to be exposed”

•Develop recommendations for an ongoing state biomonitoring program

Perfluorochemical (PFC) Project

• In 2008 measured 7 PFCs in blood of 196 East Metro residents

• Higher PFOS, PFOA, PFHxS levels compared to US

• Blood levels correlated with concentrations in well water

• Follow-up conducted in 2010

Results: PFCs in Blood

Mercury in Blood*

*Percent of U.S. women of child-bearing age with blood mercury above the health concern level, by race/ethnicity

Biomonitoring Programs

• CDC’s National Biomonitoring Program (NHANES)

• State/local programs: Minnesota, California, Washington, New York City

http://www.cdc.gov/exposurereport/

Next Steps• Expand biomonitoring data on portal

• Maintain program capacity

• Conduct strategic planning for targeted population exposure tracking

o Gather input from stakeholderso Focus on children and pregnant women o Prioritize chemicalso Recommend ongoing program for MN

Measuring Impact: Air quality and Health

• Air quality is associated with a variety of adverse health outcomes

• Exposures to fine particles are a primary driver of air pollution alerts in MNo Sources include: cars, trucks, buses, construction

equipment, electric generators, wood-burning and wildfires, coal and oil industries

Fine Particle Pollution: PM2.5

Measuring Impacts (local level)

Regulatory or Policy Changes

Reductions in Population Exposures

Reductions in Adverse Health

Outcomes

• PM2.5 • Respiratory diseases• Cardiovascular disease• Hospitalizations and

Deaths

MN Air Initiatives

2003 2004 2005 2006 2007 2008 2009Early Implementation Implementation

Project Green Fleet retrofits

Baseline Period

2005-2009 continuous

Heavy Duty Diesel Rule

late 2006

Ultra Low Sulfur Fuel

2007

Clean Air Interstate RuleAdopted 2005; remanded 2008

MERP: Allen S. Kingemissions controls

coal to natural gasMERP: High Bridge

MERP: Riversidecoal to natural gas

24-hr PM2.5 NAAQS revision

Source: MN Pollution Control Agency

Source: MN Pollution Control Agency

AQI: Number of Unhealthy Air Days in MN

Measuring Air Pollution Health Impacts

Hospitalizations Amount attributable to PM2.5 in 2003-2009 Percent # hosp. per year

Total respiratory 1.9% 224COPD + asthma 2.3% 110Asthma 2.3% 54

Associations found in the MSP metro for PM2.5 and respiratory hospitalizations

Air Pollution Health Impacts Over Time

Hospitalizations Time period

Amount attributable to PM2.5

Percent # hosp./yrTotal respiratory 2003-2005

2006-20072008-2009

3.0%2.6%

--

354309

--COPD + asthma 2003-2005

2006-20072008-2009

3.3%2.9%

--

154140

--Asthma 2003-2005

2006-20072008-2009

3.8%----

92----

Coming in 2012• New data & features

o New cancer types (7)o Childhood immunizationso Climate change (heat stress)o Population characteristicso Biomonitoring (additional chemicals)o Air pollution impacts on healtho E-learning modules

• Custom data access

• Expanded outreach & evaluation

Evaluating New Data Topics

• Developmental disabilities (autism)• Pesticide poisonings• Private well water (arsenic)• Radon• Smoking, obesity

Success Stories

Vision

• Access to broad public health data sets

• Inform public health actions; evaluate effectiveness

• Promote healthy choices; protect future generations

Keeping Informed

• Subscribe for email updates

• Attend seminars (quarterly)

• Request a demonstration

Web site: http://www.health.state.mn.us/tracking

Contributors (many!)

• Data stewards (MDH, MPCA)

• National Tracking Network (CDC, grantees)

• LPHA, LHDs, NACCHO

https://apps.health.state.mn.us/mndata

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Questions?Chuck StroebelJean Johnson