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    Framework for a Community Health Observing System for the Gulf of Mexico Region: Preparing for Future Disasters

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    Date Issued
    2020-10-15
    Author
    Sandifer, Paul
    Knapp, Landon
    Lichtveld, Maureen
    Manley, Ruth
    Abramson, David
    Caffey, Rex
    Cochran, David
    Collier, Tracy
    Ebi, Kristie
    Engel, Lawrence
    Farrington, John
    Finucane, Melissa
    Hale, Christine
    Halpern, David
    Harville, Emily
    Hart, Leslie
    Hswen, Yulin
    Kirkpatrick, Barbara
    McEwen, Bruce
    Morris, Glenn
    Orbach, Raymond
    Palinkas, Lawrence
    Partyka, Melissa
    Porter, Dwayne
    Prather, Aric A.
    Rowles, Teresa
    Scott, Geoffrey
    Seeman, Teresa
    Solo-Gabriele, Helena
    Svendsen, Erik
    Tincher, Terry
    Trtanj, Juli
    Walker, Ann Hayward
    Yehuda, Rachel
    Yip, Fuyuen
    Yoskowitz, David
    Singer, Burton
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    DOI
    https://doi.org/10.3389/fpubh.2020.578463
    URI
    https://hdl.handle.net/1969.6/89084
    Abstract
    The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop.
    Citation
    Sandifer P, Knapp L, Lichtveld M, Manley R, Abramson D, Caffey R, Cochran D, Collier T, Ebi K, Engel L, Farrington J, Finucane M, Hale C, Halpern D, Harville E, Hart L, Hswen Y, Kirkpatrick B, McEwen B, Morris G, Orbach R, Palinkas L, Partyka M, Porter D, Prather AA, Rowles T, Scott G, Seeman T, Solo-Gabriele H, Svendsen E, Tincher T, Trtanj J, Walker AH, Yehuda R, Yip F, Yoskowitz D and Singer B (2020) Framework for a Community Health Observing System for the Gulf of Mexico Region: Preparing for Future Disasters. Front. Public Health 8:578463. doi: 10.3389/fpubh.2020.578463
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