TY  - JOUR
PY  - 2020//
TI  - Framework for a community health observing system for the Gulf of Mexico region: preparing for future disasters
JO  - Frontiers in public health
A1  - Sandifer, Paul
A1  - Knapp, Landon
A1  - Lichtveld, Maureen
A1  - Manley, Ruth
A1  - Abramson, David
A1  - Caffey, Rex
A1  - Cochran, David
A1  - Collier, Tracy
A1  - Ebi, Kristie
A1  - Engel, Lawrence
A1  - Farrington, John
A1  - Finucane, Melissa
A1  - Hale, Christine
A1  - Halpern, David
A1  - Harville, Emily
A1  - Hart, Leslie
A1  - Hswen, Yulin
A1  - Kirkpatrick, Barbara
A1  - McEwen, Bruce
A1  - Morris, Glenn
A1  - Orbach, Raymond
A1  - Palinkas, Lawrence
A1  - Partyka, Melissa
A1  - Porter, Dwayne
A1  - Prather, Aric A.
A1  - Rowles, Teresa
A1  - Scott, Geoffrey
A1  - Seeman, Teresa
A1  - Solo-Gabriele, Helena
A1  - Svendsen, Erik R.
A1  - Tincher, Terry
A1  - Trtanj, Juli
A1  - Walker, Ann Hayward
A1  - Yehuda, Rachel
A1  - Yip, Fuyuen
A1  - Yoskowitz, David
A1  - Singer, Burton
SP  - e578463
EP  - e578463
VL  - 8
IS  - 
N2  - 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.<p />  <p>Language: en</p>
LA  - en
SN  - 2296-2565
UR  - http://dx.doi.org/10.3389/fpubh.2020.578463
ID  - ref1
ER  -