Maryland Public Health Strategy for Climate Change Prince George’s County Site Visit Clifford S. Mitchell, MS, MD, MPH Director, Environmental Health Bureau Prevention and Health Promotion Administration October 11, 2013 Largo, MD
Site Visit Agenda 11:00 – 11:15 am ………… …………Welcome/Introductions 11:15 – 11:30 am ………… …………Overview of Climate Change Project, Site Visit Goals 11:30 am – 12:15 pm …….. ………...Discussion of Local Health Data, Priorities, Possible Contributions of DHMH Climate Change Project 12:15 – 12:30 pm …………………….Environmental Health Data Portal Demonstration 12:30 – 12:45 pm ………………………Next Steps 12:45 – 1:00 pm ………………………..Wrap -Up Prevention and Health Promotion Administration August 28, 2013 2
GOALS Review overall project Discuss PG County Local Health Priorities Discuss ways in which climate change might affect local priorities Identify products (forecasts, models) that might assist PGCHD in achieving its goals Discuss one possible regional project (asthma) Prevention and Health Promotion Administration August 28, 2013 3
Welcome and Introductions PROJECT TEAM – Maryland Department of Health and Mental Hygiene – University of Maryland College Park – CDC – Other Partners Prevention and Health Promotion Administration August 28, 2013 4
Climate Change Project PI Clifford Mitchell Support Tanisha Knight Program Epi Outreach Manager Nancy Servatius and Ann Liu Crystal Romeo Katie Moore Mickey Wu Prevention and Health Promotion Administration August 28, 2013 5
Maryland Public Health Strategy for Climate Change Based on CDC BRACE framework (building resistance against climate effects) 4 year cooperative agreement Also operates within context of Maryland Climate Change Action Plan Prevention and Health Promotion Administration August 28, 2013 6
Maryland Public Health Climate Change Strategy Maryland University of Maryland Department of Health School of Public Health and Mental Hygiene Regional Climate Change Forecast Local health department Intervention option 1 Vulnerability Disease burden Intervention assessment projections option 2 Intervention option 3 Adaptation plan development and Evaluation implementation Prevention and Health Promotion Administration August 28, 2013 7
Climate Forecast/ Vulnerability Assessment Maryland Environmental Public Health Tracking Disease/Outcome Burden Estimates Injuries and Water borne Respiratory Food borne Vector borne temperature-related illness and diseases illnesses disease health events injuries Develop and Evaluate Interventions Develop Maryland Public Maryland Health Climate Change Climate Change Strategy Action Plan Evaluation, Feedback, Dissemination
Local Public Health Department Mini-grants Enable public health professionals in local health departments (LHDs) to utilize climate forecast projections Help LHDs implement climate mitigation and/or adaptation strategies necessary to protect public health Evaluate the mitigation and/or adaptation strategy used to determine the quality of improvement and to incorporate refined inputs Prevention and Health Promotion Administration August 28, 2013 10
Local Public Health Department Projects Proposals developing in Fall, 2013 – Baltimore City – Prince Georges County – Washington County – Wicomico County Prevention and Health Promotion Administration August 28, 2013 11
Health Statistics (Prince George’s County)
Provided by Ann Liu, PhD, MPH Mickey Wu, MPH Elizabeth Young, MPH PRELIMINARY BASELINE HEALTH STATISTICS
Total Injury Rates 8000 7314 7169 6856.1 7000 6000 Age Adjusted Rate (per 100,000) 5000 ED visits 4000 Hospitalizations Deaths 3000 2000 1000 591.9 577.3 574.9 56.5 51 48.8 0 2008 2009 2010 Year Data source: Injuries in Maryland: Statistics on Injury-related Emergency Department Visits, Hospitalizations, and Deaths Report (years 2008-2010*) Age-adjusted rates of total injuries (per 100,000 population) *Data by jurisdiction not available until 2008; report not available for 2011 Prevention and Health Promotion Administration August 28, 2013 14
Motor Vehicle Injuries 1600 1,417.80 1408.9 1400 1335.5 1200 Age Adjusted Rate (per 100,000) 1000 800 ED visits Hospitalizations Deaths 600 400 200 96.1 84.1 74.1 N/A N/A N/A 0 2008 2009 2010 Year Data source: Injuries in Maryland: Statistics on Injury-related Emergency Department Visits, Hospitalizations, and Deaths Report (years 2008-2010*) Age-adjusted rates of total injuries (per 100,000 population) *Data by jurisdiction not available until 2008; report not available for 2011 Prevention and Health Promotion Administration August 28, 2013 15
Age Adjusted All-Cause Mortality Rates 840 820.6 820 808.2 Age Adjusted Rate (per 100,000) 795.6 800 789.7 780 760 747.8 740 720 700 2007 2008 2009 2010 2011 Year Data source: Maryland Vital Statistics Annual Report (years 2007-2011) Rates of all-cause mortality (per 100,000 population) Prevention and Health Promotion Administration August 28, 2013 16
Age Adjusted Mortality from Diseases of the Heart 240 233.8 235 232.2 230 Age Adjusted Rate (per 100,000) 223.7 224.2 225 220 215 210 203.5 205 200 195 190 185 2007 2008 2009 2010 2011 Year Data source: Maryland Vital Statistics Annual Report (years 2007-2011) Rates of all-cause mortality (per 100,000 population) Prevention and Health Promotion Administration August 28, 2013 17
Acute MI for Prince George’s County (ED Visits) 150 148 148 Age Adjusted Rate (per 100,000) 146 144 144 142 141 140 138 136 2007 2008 2009 Year Data source: ED visits of Acute MI from DHMH EPHT: Infectious Disease and Environmental Health Administration (years 2007-2009) http://eh.dhmh.md.gov/idehaweb/query.aspx All rates are age-adjusted rate per 100,000 population Prevention and Health Promotion Administration August 28, 2013 18
Heat Stress for Prince George’s County Heat Stress (ED Visit) 12 11.2 Age Adjusted Rate (per 100,000) 10 8 7.4 6.8 6 ED visits 4.4 4 2 0 2007 2008 2009 2010 Year Data source: DHMH Environmental Public Health Tracking: Heat Stress Indicator Age-adjusted rates of heat stress (per 100,000 population) Prevention and Health Promotion Administration August 28, 2013 19
Asthma Emergency Department (ED) Visits 80 72.3 70.4 69.8 69.7 67.8 70 61.2 61.1 57.7 57.3 60 55.7 Age Adjusted Rate (per 10,000) 50 PG County 40 Maryland 30 20 10 0 2011 2010 2009 2008 2007 Hospitalization rates include Maryland residents hospitalized in Maryland, Washington, D.C. and Pennsylvania. All rates per 10,000 population and are age-adjusted to the 2000 U.S. Standard Population as published by NCHS Prevention and Health Promotion Administration August 28, 2013 20
Asthma Hospitalizations 25.0 19.8 20.0 18.8 18.5 18.5 17.7 Age Adjusted Rate (per 10,000) 17.3 17.3 16.8 16.2 16.0 15.0 PG County Maryland 10.0 5.0 0.0 2011 2010 2009 2008 2007 Prevention and Health Promotion Administration August 28, 2013 21
Epidemiological Methods Applied for MACP Inpatient hospitalization rates include out-of- state data (in addition to MD data) to get a clearer picture of Asthma in MD Out-of-state data includes: – Washington, D.C. (DC) – Pennsylvania (PA) – Delaware (DE) – West Virginia (WV) Prevention and Health Promotion Administration August 28, 2013 22
Maryland Asthma Rates ( Excluding Out-of-State Data) Prevention and Health Promotion Administration August 28, 2013 23
Maryland Asthma Rates ( Including Out-of-State Data) Prevention and Health Promotion Administration August 28, 2013 24
EPHT Asthma Data Prevention and Health Promotion Administration August 28, 2013 25
Climate Change Projections (Prince George’s County)
Provided by University of Maryland School of Public Health Amir Sapkota, PhD Chengsheng Jiang, PhD EXCESSIVE HOT DAYS
Monthly Exceedance Days (TMX90) Prevention and Health Promotion Administration [Date] 28
Monthly Exccedance Days (TMX95) Prevention and Health Promotion Administration August 28, 2013 29
Monthly Exceedance Days (TMX99) Prevention and Health Promotion Administration August 28, 2013 30
Season Exceedance Days (TMX90) Spring Summer Autumn Winter Prevention and Health Promotion Administration August 28, 2013 31
Annual Exceedance Days (TMX95) Prince Georges Worchester Maryland Prevention and Health Promotion Administration August 28, 2013 32
Provided by Environmental Public Health Tracking (EPHT) John Braggio, PhD, MPH Mickey Wu, MPH POLLEN INDICATOR
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