Exploring Integration of Physical Environment Factors into Community Health Planning

Environmental effects, including those associated with pollution, the built environment and a changing climate, have the potential to affect health in many ways. Climate change impacts have the potential to exacerbate existing impacts from other environmental conditions. The Robert Wood Johnson's (RWJ) County Health Rankings and Roadmaps (CHR&Rs) program provides an effective, research-based platform for indicators about a community's overall health, including factors associated with health behaviors, clinical care, social and economic factors, and the physical environment. However, the current list of indicators is limited in the number reflective of the physical environment. Community leaders, stakeholders, and residents have a strong interest in better understanding the contribution that environmental factors play in community health, but are also often times confused about the contributions of environmental factors to health. This study aimed to examine additional data on environmental factors to inform community-based efforts to address "upstream" determinants of health through the use of existing authoritative data, namely the Center for Disease Control's Environmental Public Health Tracking Network and the Environmental Protection Agency's EJScreen database. Three approaches were explored to examine validity for inclusion into the County Health Rankings metrics including an individual determinant-population ratio, individual determinant-density ratio, and through the use of the Getis-Ord General G* toolset to identify statistically significant high and low clusters within the study area of New Jersey. Results indicate that concentrations of values were generally highest around urban areas, cities, and along major roadways, but that geographic scale of the data was an important determination in outcomes observed. These efforts will provide information needed to more systematically integrate consideration of environmental and climate change impacts into community health planning.