The development of a guide to evaluate the usefulness of data sources for environmental public health surveillance

Background. Public health surveillance is the ongoing systematic collection, analysis, and interpretation of outcome-specific data used to plan, implement, and evaluate public health practice. Data can only be nationally notifiable to the Centers for Disease Control and Prevention (CDC) with an endorsement from the Council of State and Territorial Epidemiologists (CSTE). The CDC is collaborating with CSTE to develop a new national effort to link existing data sources from public health and environmental protection for environmental public health surveillance. A tool is needed to determine if the linkage of existing data sources will produce meaningful data for decision-making.; Aim. Develop a guide for evaluating the usefulness of data sources for environmental public health surveillance.; Methods. I coordinated a group of consultants with diverse public health and environmental science expertise to provide feedback and guidance for this dissertation. The CDC/CSTE environmental public health indicator project was applied to select events and data sources for surveillance. Literature was reviewed on public health and ecology evaluation and data source documentation to determine necessary attributes of data sources for linkage with other existing data sources. I developed the evaluation guide to include attributes and instructions for use of the attributes based on the review of evaluation literature. The evaluation guide was tested on selected data sources.; Results. Selected events and data sources exemplified the use of the evaluation guide. Five data source attributes were identified: data source purpose, event definition, data collection and management, quality assurance, and data reliability. The evaluation guide was tested on two national public health data sources and one national environmental protection data source. The evaluation results showed that the environmental protection data source would not be useful for decision-making when linked with the two public health data sources. The two public health data sources could be linked.; Discussion. Public health practitioners need to determine the feasibility of adapting existing data sources for environmental public health surveillance. Public health practitioners should test the evaluation guide developed in this dissertation on other data sources at the local, state, and national level for its usefulness in planning environmental public health surveillance.