TM

At A Glance

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

SAFER • HEALTHIER • PEOPLETM

The National Environmental Public Health 

Tracking Program:

Healthy Informed Communities

 2007 

FL

VT

NH

MA

RI

CT

NJ

DE

MD

New York City, NY

University of

Medicine & Dentistry

of New Jersey

Tulane University

AK

HI

University of

Pittsburgh

WA

OR

CA

UT

NM

WI

MO

PA

NY

MT ME

ID

WY

NV

ND

SD

NE

CO

AZ

KS

OK

TX

AR

LA

MN

IA

IL IN

MI

OH

WV VA

GA

NC

SC

MS AL

TN

KY

J

J

J

University 

of

California,

Berkeley 

J

 CDC Grantee Funded for Network Implementation

J Academic Partners for Excellence

CDC’s Environmental Public Health Tracking Program Grantees
Environmental Public Health Tracking: Providing Information to 

Drive Actions to Protect Health 

Americans are concerned about hazards and health 

impacts related to environmental exposures. Citizens 

and policy makers want access to current, relevant, 

and accurate information about environmental 

exposures and health outcomes to facilitate individual, 

community, state, and national decision-making about 

adopting strategies to reduce the burden of disease 

attributable to the environment. 

The U.S. Congress appropriated funding to the Centers 

for Disease Control and Prevention (CDC) in Fiscal 

Year (FY) 2002 to develop the National Environmental 

Public Health Tracking Program (Tracking Program). 

The Tracking Program, with the National Environmental 

Public Health Tracking Network (Tracking Network) 

as its cornerstone, is CDC’s response to calls for better 

understanding of how the environment can affect 

people’s health. 

Uses of Tracking Data

• Quantify the magnitude of a problem

• Detect unusual trends and occurrences

• Document the distribution and spread of a hazard

or health event and identify populations at risk

• Plan and evaluate protective and preventive measures 

• Facilitate research

• Develop information that can inform clinical care

providers and stimulate individual-health action

• Detect changes in health practice

Program Funding

Fiscal Year Appropriation (millions)

2002 17.5

2003 27.5

2004 27.4*

2005 24.4

2006 24.2

*In 2004, CDC instituted a new budget structure

CDC’s National Environmental Public Health Tracking Program

The mission of the Tracking Program is to provide 

information communities can use to improve their 

health. This information will come from a nationwide 

network that integrates health data and environmental 

data. Over the last four years, CDC’s Tracking Program 

has laid the foundation of this national system by 

making grants to state and local health departments.

In FY 2006, CDC moved from planning and capacity 

building to the implementation of the Tracking 

Network. CDC funded 16 state and 1 local health 

departments to build and implement state-based 

tracking networks. The state and local data systems 

will feed into the Tracking Network. These grants 

will improve information technology but will also 

expand environmental public health tracking capacity. 

They will continue training public health workers and 

develop better ways to make information accessible 

on the Tracking Network to those who need it to take 

action.

In addition, CDC is funding four schools of public 

health to support state and local health departments 

and investigate possible links between health effects 

and the environment. CDC has also awarded funding 

to professional national organizations to develop 

educational materials and tools to build environmental 

public health tracking capacity among state and local 

health officials and other critical partners. CDC also 

has established a memorandum of understanding with 


Environmental Public Health Indicators Project 

activities is available at www.cdc.gov/nceh/tracking/

projects/home.htm, and information about partners in 

the Tracking Program is available at www.cdc.gov/

nceh/tracking/partnerships.htm. 

the National Aeronautics and Space Administration 

and, through the Department of Health and Human 

Services, with the Environmental Protection Agency to 

promote collaboration on tracking-related initiatives. 

A list of state and local program grantees and their 

A Picture of America: Our Health and Environment 

Starting in 2008, the Tracking Program plans to release 

a report every two years. The report will present a 

broad view of the status of and emerging trends in the 

relation between health and the environment from the 

perspective of environmental public health practice 

and service. It is expected to include an overview of 

priority environmental hazards, exposures, health 

effects, and interventions, and it will describe tracking 

accomplishments and how data can be used locally and 

nationally to measure, evaluate, and set goals to reduce 

environmental exposure. These goals may involve 

regulations, policies, public health interventions, or 

other measures. 

Tracking uses environmental public health indicators 

(EPHIs) to measure the health of a community. EPHIs 

provide information about an environmental hazard, 

exposure, or health outcome, or a relationship among 

them. When observed over time or across geographies, 

an EPHI may show patterns or trends, and is intended 

to inform policy and guide action. For example, 

because the amount of lead in paint in older homes 

is difficult to measure, practitioners use blood lead 

measurements in children to indicate both the lead 

paint hazard and the risk for childhood lead poisoning. 

For more information about EPHIs, visit www.cdc.gov/

nceh/indicators. 

Tracking in Action 

CDC and its partners have made great strides in laying 

the foundation for an information network that can 

guide health protection decisions. Since 2002, 21 states 

and 3 cities have used CDC grants to expand tracking 

capacity and demonstrate to the public what tracking 

can do.

By September 2006, state and local tracking grantees 

had completed more than 50 projects linking health and 

environmental data. Projects looked at asthma, cancer, 

birth defects, pesticide poisoning, and autoimmune and 

neurodegenerative diseases. About 60% of programs 

specifically examined how air quality affects health 

conditions, such as asthma, cancer, and birth outcomes. 

Almost 50% of state and local tracking programs 

conducted water-related projects. 

These pilot programs and collaborations have already 

begun to pay off in faster responses to environmental 

public health questions and in action to prevent disease. 

Since FY 2002, tracking has led to 38 public health 

actions to prevent or control potential adverse health 

effects from environmental exposures. The following 

are examples of grantee tracking activities and how 

grantees are using tracking data to protect health. 

Massachusetts: The Massachusetts Tracking Program 

found a statistically significant association between 

the presence of moisture problems in a school and the 

prevalence of pediatric asthma,, indicating a need for 

public health follow-up or intervention and providing 

information for policy changes aimed at reducing 

mold and moisture in schools. The Tracking Program 


is working with school officials to identify how to 

remediate the moisture problems. 

New Hampshire: After a local physician told a local 

newspaper about a suspected cancer cluster, New 

Hampshire Gov. John Lynch asked the state health and 

environmental services departments to investigate. The 

pilot tracking program gave investigators access to 14 

years of health and environmental data that showed the 

cancer incidence in Claremont was actually less than 

expected for similar communities and for the state as a 

whole. 

New Mexico: The New Mexico Tracking Program 

is helping determine whether action is necessary to 

reduce drinking water exposure to arsenic at a municipal 

level or at individual wells. The New Mexico Tracking 

Program identified populations at risk for arsenic 

exposure in their drinking water and provided a method 

to treat and remove arsenic at the tap.

Utah: The Utah Department of Health received a 

call from a citizen concerned about cases of cancer 

in his neighborhood. In the past, a similar call would 

have prompted a study that would have taken a year 

to complete, with most of that time spent waiting for 

data. Using an analytic tool developed with tracking 

funds, the Utah Tracking Program was able to conduct 

two independent investigations of the rates of cancer 

centered on the citizen’s residential location and 

prepare a short report in an afternoon. The Utah 

Tracking Program then could assure the resident that 

the likelihood of cancer in his vicinity was no greater 

than in the state as a whole. This is a substantial 

improvement in the time and cost required for cancer 

investigations in the past and in the services Utah is 

able to provide to the public.

Wisconsin: Data from the Wisconsin Tracking 

Program on exposure to trichloroethylene (TCE) from 

an industrial plant prompted the facility’s owner—who 

was in compliance with all applicable emission permit 

requirements—to voluntarily agree to change the 

manufacturing process in the plant to eliminate TCE 

emissions. This project reduced community TCE 

exposure and serves as a model for how the use of air 

pollutant data to identify high-risk communities can 

translate into reduced exposure to air toxics.

Future Directions

The pilot projects have established a proof of concept 

and can serve as models for the next round of the 

nationwide effort. The challenges they have overcome 

are providing guidance for the implementation phase 

of the Tracking Program. Next steps in building the 

Tracking Network are the following: 

• FY 2007, implementation and testing of a Web-based 

version of the Tracking Network, which includes 

tools for searching, selecting, analyzing, exchanging, 

displaying, and visualizing data. 

• FY 2008, Web-based Tracking Network deployed 

making information accessible to researchers, public 

health and environmental practitioners, policy 

makers, and the public. 

For more information or additional copies of this document, please contact 

Centers for Disease Control and Prevention 

National Center for Environmental Health, MS F52 

4770 Buford Hwy, Atlanta, GA 30341

1-800-CDC-INFO; cdcinfo@cdc.gov

www.cdc.gov/nceh/tracking

December 2007

CS115844