摘要：Objectives. Our goal was to gain an understanding of the extent to which environmental public health tracking (EPHT) has progressed since the release of the 2000 Pew Environmental Health Commission report examining the nation’s EPHT infrastructure. Methods. As a follow-up to the Pew Commission report, we conducted a telephone survey of state practitioners in an effort to assess EPHT trends and changes in state-level capacities and activities over the past several years. Results. We found that new and enhanced federal–state partnerships; improved surveillance, data analysis, and communication capacities; and enhanced support of tracking personnel have provided a foundation for progress in the area of EPHT. Also, the Centers for Disease Control and Prevention’s support of EPHT has strengthened the national environmental public health infrastructure and capacity to track environmental hazards, exposures, and health. Conclusions. Improved funding, data access, and translation of data to prevention activities are critical to sustaining progress in EPHT and developing the evidence base necessary for assessing the longer-term impacts and efficacy of EPHT and related environmental health improvements. The Future of Public Health , the landmark report published by the Institute of Medicine in 1988, provided the following sobering picture of the nation’s environmental public health capacity: “The removal of environmental health authority from public health agencies has led to fragmented responsibility, lack of coordination, and inadequate attention to the public health dimensions of environmental issues.” 1 (p12) In 2000, the Pew Environmental Health Commission at the Johns Hopkins Bloomberg School of Public Health conducted an extensive evaluation of the national environmental public health infrastructure and found a fundamental information gap that precluded epidemiologists and environmental health and risk scientists, among others, from fully understanding the relationships between environmental exposures and the health of the public. The commission also found that there was “no cohesive national strategy to identify environmental hazards, measure population exposures, and track health conditions that may be related to the environment.” 2 (p17) On the basis of these findings, the Pew Commission report called for the establishment of a nationwide health tracking network to support the ongoing collection, integration, analysis, and interpretation of data in the following areas: environmental hazards, exposure to environmental hazards, and related health effects. The commission underscored the importance of such a network in terms of its ability to improve public health prevention and protection capabilities through an enhanced public health infrastructure, extensive and sustained biological monitoring of environmental exposures, and a more skilled public health workforce. These investments in public health capacity would better position the public health community to rapidly respond to emerging threats, guide interventions, and inform policymakers and the public on the relationships between health and the environment. More information on the components of the nationwide health tracking network concept can be found in the Pew Commission report. 2 , 3
