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National Disease Monitoring and Tracking Network


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Tracking Chronic Disease and Monitoring Environmental Exposures in Texas

Currently, we as a nation do not have a system that can document possible links between environmental hazards and chronic diseases the same way that we identify and track infectious disease. Only with comprehensive incidence and prevalence data along with chemical exposure data can associations between health and the environment be documented effectively. Monitoring populations known to be at risk for environmental exposures would help to assure early diagnosis, appropriate treatment, and useful patient education. A reliable tracking system would provide health care professionals and public health officials with solid research, resulting in better diagnoses and faster response time to isolated outbreaks.

What Is A National Disease Monitoring and Tracking Network?

The Pew Environmental Health Commission released a report in September 2000 calling for a nationwide disease monitoring and tracking network. The network would facilitate the work of public health departments in identifying chronic disease clusters and enable physicians to have a greater impact on their patients’ health. The national Network would consist of two major components:

  • Chronic Disease Tracking – A network of local, state, and federal public health agencies in all 50 states would join together to track the incidence and prevalence of certain chronic diseases. The national Network would link existing state registries and national databases like the National Hospital Discharge Survey, the National Ambulatory Medical Care Survey and the National Health Interview Survey to develop a complete picture of chronic disease in this country and identify environmental health gaps.

  • Biomonitoring – The Network would build on the population-based National Health and Nutrition Examination Survey (NHANES) and increase the number of chemicals in the human body that CDC monitors. This expansion of NHANES would enable public health officials to accurately identify exposures that have occurred and gain an understanding of whether the exposures have an impact on health. This expanded monitoring would improve NHANES’s ability to track exposures at the state and regional levels as well as nationally. 

What Is The Problem?

To date there is still no comprehensive system that enables public health officials to explore the connections between chronic diseases and conditions and environmental exposures and hazards. The tracking programs that do exist at the state and local level are inconsistent because there are no agreed-upon minimum standards or requirements for environmental health tracking. In addition, much of the data collected are never analyzed or interpreted in a way that could identify targets for further action. However,

  • A nationwide survey indicates that the general public believes that tracking chronic disease already occurs and that physicians already have information about environmental exposures and their links to human health.

  • In focus groups throughout the nation, physicians also stated that they believed chronic disease tracking already occurs, at least statewide, and that existing government programs are tracking environmental exposures in an extensive and useful manner.

How Has Texas Taken A First Step Toward Effective Monitoring And Tracking?

Birth defects are the leading cause of infant mortality in the United States. Approximately 6,500 deaths annually and an average of 150,000 babies are born every year with some type of birth defect. In Texas alone, about 10,000 babies are born with one or more major structural malformations every year. Birth defects are the 2nd leading cause of death among infants in Texas and the 7th leading cause of premature death among all Texans.

Texas is one of the few states that has attempted to understand this growing chronic condition. After officials noticed an unexpected cluster of babies born with anencephaly, a fatal neural tube disorder characterized by an underdeveloped brain and incomplete formation of the skull, a birth defects registry was created on the southeast Texas/Mexico border. Since then Texas has been able to track birth defects cases and identify the frequency of different types of birth defects.

However, even with a birth defects registry, health officials are stalled in establishing strong education and prevention plans that address potential environmental hazards and links to birth defects. The registry, inconsistent among jurisdictions throughout the state, provides no mechanism to compare data regionally in Texas or nationally from state to state. The current registry system can track the incidence and prevalence of birth defects in Texas, but health officials cannot compare it to exposure data to determine, for example, whether mothers with higher levels of certain chemicals in their bodies are more likely to have an infant with a birth defect. We can only obtain this information with a comprehensive monitoring and tracking network based on sound data.

What Do Health Care Providers Want?

Focus groups with physicians and health care providers in Texas revealed the need for a better monitoring and tracking system for chronic disease and the demand for sound science linking environmental exposures to human health. Health care professionals expect a tracking system that will:

  • Provide reliable and consistent information;

  • Represent an unbiased body of resources that are unaffected by external forces like special interest groups or industry focused research, and;

  • Provide useful and accessible feedback that will be beneficial to health care providers as well as patients.

What Will It Take to Invest In Our Public Health’s Future?

The national cost of chronic disease is staggering: Chronic disease contributes to 4 of every 5 deaths annually and $325 billion in annual health care and lost productivity. The benefits of a chronic disease tracking and exposure-monitoring network far outweigh the costs that are associated with chronic disease care. The cost of this national Network is $275 million annually: less than 0.1% of health care costs related to chronic disease. 

The Medical And Public Health Communities Support A National Disease Monitoring and Tracking Network

More than 30 health and environmental organizations support the Nationwide Health Tracking Network. They include: American Academy of Pediatrics, American Public Health Association, American Lung Association, American Cancer Society, Inc., Association of Public Health Laboratories, March of Dimes Birth Defects Foundation, Asthma and Allergy Foundation of America, Association of State and Territorial Health Officials, Natural Resources Defense Council, U.S. Public Interest Research Group, and state groups like the Connecticut State Medical Society. 

How Can Health Care Providers Become Involved?

For more information about the National Disease Monitoring and Tracking Network, please contact the Physicians for Social Responsibility at (202) 667-4260, x223 or Email:



Read the reports and studies on children's environmental health by CLICKING HERE.