Community-based Environmental Health Assessment, Montana

The mission of the Centers for Disease Control and Prevention's (CDC) Environmental Public Health Tracking (EPHT) Program is to provide information from a nationwide network of health and environmental data to improve community health. Montana was a pilot sites funded from 2002 to 2006 to plan and develop the infrastructure for this nationwide EPHT network. The Montana EPHT program's primary objective was to define environmental health needs, enhance data, and build bridges between agencies. Other objectives included obtaining community input for EPHT, increasing the understanding of environmental causal agents to health concerns, and increasing capacity at the county/tribal level.

The Montana EPHT program provided training and funding for tribal and county-level health departments to conduct environmental health assessments. PACE EH was used as a key resource to guide the process.

The assessment requirements included:

• Establishing a community environmental health team/advisory group;
• Involving and informing decision makers;
• Obtaining input from the community through surveys and public forums;
• Analyzing data to generate a list of EH concerns;
• Ranking and prioritizing EH concerns for local action;
• Setting action steps; and
• Write a final report describing the area, assessment process, and results.

From 2004 to 2006, 17 (three tribal and 14 county) local health departments completed community environmental health assessments. Each assessment was completed during a 10- to 12-month funding cycle.

Challenges include:

• Minimal staffing and resources;
• Many demands on staff time;
• Lack of technical knowledge/skills; and
• An inability to address identified concerns due to a fear of controversy.

Benefits include:

• Broad community input;
• Understanding the need to integrate public health and environmental data by counties/tribes;
• Dialogue among community members and local government agencies;
• Proactive local health department work;
• More/new citizens involved in public health;
• New environmental health issues of concern, developed assessment skills at local level were identified; and
• Action items identified and addressed.

MT EPHT funded seven special follow-up projects in six counties and on one American Indian reservation that identified and addressed local environmental health concerns. Citizens witnessed their local health departments address public environmental health issues. In addition, public knowledge and awareness of environmental health issues increased. Special projects often allowed health departments to work with new community partners and improved communication among local agencies and programs regarding environmental health.