States Unable to Detect or Investigate Chronic Disease Clusters
A new survey reveals that state health agencies lack the expertise and resources to identify or study
potential clusters of cancer, birth defects and chronic diseases
potential clusters of cancer, birth defects and chronic diseases
by Bryant Furlow
April 24, 2007—Each year, state health departments receive
over a thousand requests to investigate suspected cancer
clusters in the United States. But they lack the tools or
expertise to do so, reveal scientists at the Michigan Public
Health Institute and Johns Hopkins University.
The study comes seven years after the Pew Environmental
Health Commission and Johns Hopkins scientists first
reported that health authorities in the US lack the basic tools
for identifying environmental risk factors that contribute to
chronic disease. Little appears to have changed in that time.
The researchers surveyed health departments to assess
states' abilities to identify and investigate disease clusters.
Officials from 37 states completed the survey. All reported
investigating cancer clusters. Thirty more had recently
investigated suspected clusters of birth defects and chronic
diseases like multiple sclerosis, lead poisoning, occupational
lung disease, and autism.
Only 12 states have cluster response teams. Most states
lack experts in chronic disease epidemiology or biostatistics.
Some lack access to medical libraries. No state reported
having pre-approved research protocols that would allow
timely and scientifically valid cluster investigations.
The authors of the study recommended that standard
cluster investigation protocols be developed, that a federal
advisory group be created to assist states with cluster
investigations, and that a nationwide database be created to
track states' disease cluster investigations.
over a thousand requests to investigate suspected cancer
clusters in the United States. But they lack the tools or
expertise to do so, reveal scientists at the Michigan Public
Health Institute and Johns Hopkins University.
The study comes seven years after the Pew Environmental
Health Commission and Johns Hopkins scientists first
reported that health authorities in the US lack the basic tools
for identifying environmental risk factors that contribute to
chronic disease. Little appears to have changed in that time.
The researchers surveyed health departments to assess
states' abilities to identify and investigate disease clusters.
Officials from 37 states completed the survey. All reported
investigating cancer clusters. Thirty more had recently
investigated suspected clusters of birth defects and chronic
diseases like multiple sclerosis, lead poisoning, occupational
lung disease, and autism.
Only 12 states have cluster response teams. Most states
lack experts in chronic disease epidemiology or biostatistics.
Some lack access to medical libraries. No state reported
having pre-approved research protocols that would allow
timely and scientifically valid cluster investigations.
The authors of the study recommended that standard
cluster investigation protocols be developed, that a federal
advisory group be created to assist states with cluster
investigations, and that a nationwide database be created to
track states' disease cluster investigations.
| Further Reading Nadia Shalauta Juzych, et al. (2007) Adequacy of state capacity to address noncommunicable disease clusters in the era of environmental public health tracking. American Journal of Public Health 91(S1):S163-S169. Pew Environmental Health Commission. (2000) America's Environmental Health Gap: Why the Country Needs a Nationwide Health Tracking Network. Environmental Health Tracking Project Team. Baltimore, MD: Johns Hopkins School of Hygiene and Public Health. |
Public Health Surveillance