Environmental Public Health Tracking, Climate Change, and Health Disparities in DC

Laura Anderko PhD RN, Georgetown University, John Davies-Cole PhD MPH, District of Columbia Department of Health and Andrew Strunk BS, Boston University

DC Department of Health, Center for Policy Planning and Evaluation (CPPE)
 12 member Technical Advisory Group
 Public health, community organizations, academia

 University students assisted in data collection and analysis for both Phases

DC EPHT: PHASE I Climate Change and Health Indicators

Climate Change and Environmental Indicators
 Pilot-tested data on 25 climate change and health indicators including green house gas emissions, temperature changes, heat related deaths.

DC EPHT: PHASE II Capacity Building Grant

Phase II
Data used from 2007-2010

 Environmental Hazard Data-Air quality
 ozone  particulate matter

 Health Effects-Hospitalizations
 asthma  myocardial infarction

 Demographic characteristics
    geocode/ward (Exposure Data) age race gender

Environmental Air Quality Indicators

Particulate Matter

PM2.5
PM2.5 Concentration (Monthly Average), 2007-2010
PM2.5 concentration (ug/m^3)
25 20 15 10 5 0 Observed PM2.5 Concentration EPA Standard

PM10
PM10 Concentration (Monthly Average), 2007-2010
PM 10 concentration (ug/m^3)
160 140 120 100 80 60 40 20 0

Observed PM10 concentration EPA Standard

January June November April September February July December May October

January June November April September February July December May October

Ozone Concentration
Max 8-hour ozone concentration (monthly average), 2007-2010
0.08 0.07 0.06 0.05 0.04 0.03 0.02 0.01 0 Monthly average of daily max 8-hour ozone concentration EPA standard

Ozone concentration (ppm)

November

January

January

January

November

November

January

September

September

September

September

November

May

May

May

March

March

March

March

May

July

July

July

July

Health Effects

Trends in Hospitalizations

Asthma

Demographics and Disparities

Gender
Asthma Hospitalizations (2007-2010)
No. of hospitalizations
1000

Age
Asthma Hospitalizations (2007-2010)
No. of hospitalizations
500

1200

400
300 200 100 0 2007 2008 2009 2010 Age (in years)

800
600 400 200 0 2007 2008 Year 2009 2010 Male Female

Race
Asthma Hospitalizations by Race (20072010)
1600 1400

No. of hospitalizations

1200 1000 800 600 400 200 0 2007 2008 Year 2009 2010 Black White Other Unknown

Findings 2007-2010 Hospitalizations for Asthma
 African Americans accounted for approximately 90% of all asthma hospitalizations  The majority of the asthma hospitalizations occurred from Wards 5 and 8, accounting for 44% of all cases in the District of Columbia  Females accounted for approximately 61.5 percent of all asthma-related hospitalizations between 2007 and 2010

Acute Myocardial Infarction

Acute Myocardial Infarction

Monthly AMI Hospitalizations (2007-2010)
80 70

No. of hospitalizations

60 50 40 30 20 10 0

AMI Hospitalizations by Race (2007-2010)
600

500

No. of hospitalizations

400

300

2007 2008 2009

200

2010

100

0 Black White Race Other Unknown

Findings: Focus on Disparities
 For each year studied, women were significantly more likely to be admitted to the hospital with asthma than were men,  Children 0-9 years of age were more likely to be hospitalized for asthma when compared to other age groups,  African Americans were significantly more likely to be hospitalized for both asthma and myocardial infarction.

Conclusions
 Environmental Public Health Tracking can be used successfully to explore climate change and public health effects particularly in EJ communities