Establishing an environmental public health tracking system in the UK

Introduction: Historically Europe's public health movement was based on addressing the impact of our environment on individual and community health and well-being. While the quality of our environment has improved considerably over the last few decades, there is abundant evidence that it continues to exert a powerful effect on public health. While estimates of the impact of the environment on health vary and the nature of environmental stressors changed over the decades, the public has consistently identified basic environmental amenity such as litter, fly tipping, noise, bonfires, housing disrepair, street lighting, and derelict land as being critical 'front-line' issues. These immediate interferences with day to day life have objective impacts on both health and quality of life. However, little is known about interactions between lifestyle and environmental factors, and the role of the contemporary environment in health is complex and multifaceted. This is especially important given the disproportionate exposure of, and effect on, vulnerable populations such as deprived communities and children. Methods: A multi-disciplinary confederation of surveillance, horizon scanning, exposure assessment, research, and integration of data and intelligence on hazards, exposures and outcomes is required. These are the fundamentals of an Environmental Public Health Tracking System established in Sandwell including the routine analysis of public health nuisance, the efficacy of local authority practice, local horizon scanning, and the innovative use of industrial quality control methods to target interventions as well as the routine surveillance of environmental insult and environmentally related disease to generate plausible and focussed hypotheses for research. Results/Discussion: The Sandwell system introduced in 2011 has already produced some notable products receiving WHO endorsement, influencing practice, focusing research and is being taken up by other regions in England and Wales.