Demonstrating a systems approach for integrating disparate data streams to inform decisions on children\u2019s environmental health

Elaine A Cohen Hubal,Rachel Slover,David M Reif,Ashley Mullikin,John C Little,Nicole M Deluca

doi:10.1186/s12889-022-12682-3

Abstract

BackgroundThe use of systems science methodologies to understand complex environmental and human health relationships is increasing. Requirements for advanced datasets, models, and expertise limit current application of these approaches by many environmental and public health practitioners.MethodsA conceptual system-of-systems model was applied for children in North Carolina counties that includes example indicators of children’s physical environment (home age, Brownfield sites, Superfund sites), social environment (caregiver’s income, education, insurance), and health (low birthweight, asthma, blood lead levels). The web-based Toxicological Prioritization Index (ToxPi) tool was used to normalize the data, rank the resulting vulnerability index, and visualize impacts from each indicator in a county. Hierarchical clustering was used to sort the 100 North Carolina counties into groups based on similar ToxPi model results. The ToxPi charts for each county were also superimposed over a map of percentage county population under age 5 to visualize spatial distribution of vulnerability clusters across the state.ResultsData driven clustering for this systems model suggests 5 groups of counties. One group includes 6 counties with the highest vulnerability scores showing strong influences from all three categories of indicators (social environment, physical environment, and health). A second group contains 15 counties with high vulnerability scores driven by strong influences from home age in the physical environment and poverty in the social environment. A third group is driven by data on Superfund sites in the physical environment.ConclusionsThis analysis demonstrated how systems science principles can be used to synthesize holistic insights for decision making using publicly available data and computational tools, focusing on a children’s environmental health example. Where more traditional reductionist approaches can elucidate individual relationships between environmental variables and health, the study of collective, system-wide interactions can enable insights into the factors that contribute to regional vulnerabilities and interventions that better address complex real-world conditions.

Highlights

The use of systems science methodologies to understand complex environmental and human health relationships is increasing
The results describe relationships between each of these health outcomes and the remaining physical environment, social environment, and health outcome variables for all counties in North Carolina
Group 1 contains 6 counties with some of the highest Toxicological Prioritization Index (ToxPi) vulnerability scores, all ranking 89 or greater out of the 100 North Carolina counties. These counties are located mainly along the central southern border of North Carolina except for Edgecombe and Lenoir counties that are northeast of the others, and their ToxPi charts show strong influences from all three categories of operational orienters (Fig. S5). These counties are influenced by percent of household heads without a high school diploma and percent of children living in poverty

Summary

Introduction

The use of systems science methodologies to understand complex environmental and human health relationships is increasing. Et al [4] argue that a systems science approach offers powerful, underutilized tools to develop guidance for intervention design and implementation to address global environmental health priorities. These researchers identify systems dynamic modeling methodologies and chart a path for applying these tools to address complex environmental health problems. The goal of these proposals is to extend the scope of considerations that support robust policy decisions and actions

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Results

Discussion

Conclusion