Combining large datasets on exposure and health outcome - evolution of environmental epidemiology.

摘要

Challenges facing health care and environmental epidemiology can be approached through analysis of large observational datasets. This presentation will review the use of electronic health records (EHR) and geocoded pollutant concentrations to assess environmental exposures in the context of population health. One example of an EHR will be reviewed (Cemer HealthFacts, CHF) and the use of this HIPAA compliant deidentified data for understanding the beneficial and adverse health effects of drug treatment will be described. The presentation will then discuss the use of CHF data combined with 3-digit zip codes as well as the zip code tabulation areas to characterize environmental exposures. These approaches allow characterization of changes in health status following alterations in exposures, while also including the prior health status of the individuals being followed. While these large and complex health and environmental exposure datasets present challenges, they also offer useful approaches for characterizing population health.