National Monitoring and Tracking for Chronic Diseases

You may be aware that the United States has a national infectious disease surveillance system. When an infectious disease outbreak occurs, our public health system is mobilized to identify the cause and implement measures to stop the spread. In contrast, chronic diseases and conditions such as asthma, cancer and learning disabilities that may be linked to environmental factors are not tracked, despite their growing prevalence and impact on our health care system, economy, and quality of life.

Chronic diseases account for three of every four deaths each year in the U.S. About 100 million Americans—more than a third of our population –— suffer from a chronic disease or condition. The annual economic toll of chronic disease is estimated to be $325 billion.

At the urging of groups such as the former Pew Environmental Health Commission, The Trust for America's Health, PSR, Health-Track, the American Academy of Pediatrics, the American Public Health Association (APHA), and the Association of State and Territorial Health Officials (ASTHO), the Centers for Disease Control and Prevention (CDC) has proposed a plan to develop a new, national network to track chronic diseases and monitor environmental exposures, especially for children.

CDC Seeks Health Care Provider Input

CDC seeks health care provider input into designing a system that will help address environmental health gaps, and that will be useful to health care providers. GBPSR, in conjunction with national PSR, has been working to gather input from physicians and others regarding this proposed system, and to make people aware of the need for it. In 2002 we conducted a focus group with area physicians to solicit such input. Comments, concerns, and suggestions were then transmitted via PSR National to the CDC.

Network Components

The network could provide information on the environmental factors that contribute to chronic diseases and conditions, thus arming health care providers with tools for identifying people at high risk for certain conditions and helping to prevent the onset of disease.

Components include:

• Chronic disease tracking: A network of local, state, and federal public health agencies in all 50 states to track the incidence and prevalence of certain chronic diseases and conditions such as asthma; birth defects; developmental disorders; cancers, especially childhood cancers; and neurological diseases such as Alzheimer’s, multiple sclerosis, and Parkinson's.

• Biomonitoring: A system to monitor the burden of certain chemicals in the human body to more accurately identify exposures. This could be an expanded version of CDC's current exposure monitoring program, the National Health and Nutrition Examination Survey (NHANES). This national survey is conducted each year and assesses the population's exposure to an increasing number of toxic substances from blood and urine samples.

The project to mobilize health care provider support for the system has been funded by The Pew Charitable Trusts.

To see the work PSR has done go to EnviroHealthAction: Chronic Disease and the Environment.