Environmental Indicators for a Redesigned Community Health Status Indicators Web Application

BACKGROUND:   First released in hard copy formats in 2000 and updated to an online format in 2008 and 2009, the Community Health Status Indicators (CHSI) produces county-specific reports assessing the status of community health for local jurisdictions throughout the United States. Historically, the Health Resources Services Administration hosted the website with continued support from partners including the Centers for Disease Control and Prevention (CDC), the National Library of Medicine, the Public Health Foundation, the Association of State and Territorial Health Officials, National Association of County and City Health Officials, National Association of Local Boards of Health, and Johns Hopkins University School of Public Health. CDC has recently acquired primary responsibility for CHSI and plans to re-launch the website in 2014 with an updated framework, more recent data with a specific focus on social and environmental indicators, and an enhanced user interface. METHODS:   In an effort to provide more actionable data for community health assessment and improvement, the new CHSI website will utilize a population health framework with an enhanced focus of upstream social and environmental determinants of health. New indicators will be based on systematic reviews of the scientific literature and utilize sub-county level data where available.  Examples of new physical environment indicators include census tract concentrations of ozone and particulate matter; cancer risks from air toxics, radon concentrations; food deserts; and physical activity resources. To enhance the ability to identify and address environmental justice issues and disparities, a mapping application will enable users to view these indicators in the context of census tract level social determinants including poverty, educational attainment, and housing costs burden. RESULTS:   The newly revised CHSI will launch in January 2014 with updated data, a more cogent set of indicators, sub-county level social and environmental indicators; and a user-friendly web interface that elucidates the relationship between individual indicators and overall health. A refined set of peer counties will provide a more guided process for comparison and benchmarking.  The ability to map the upstream determinants will enhance the ability to identify populations at the highest risk and address environmental justice issues and associated health disparities. CONCLUSIONS:   With input from stakeholders and collaboration among partners, the new CHSI website will enhance the public’s understanding of how social and physical environments impact population health as well as giving public health agencies and community groups another tool for improving their community’s health that is complementary to other population health and place-based initiatives.