conditions, crime and cohesion, ambient noise, traffic flow, and air quality. Efforts to monitor and understand environmental influences on children’s health have been facilitated by the systematic collection of regional, neighborhood, and community-level information. Demographic and economic data about neighborhoods (e.g., census tracts), communities, cities, and states have been collected and made available to planners and researchers every 10 years as part of the decennial census. The emerging American Community Survey has been proposed as the vehicle for more frequent collection of these detailed local data. Continued collection of these data is vital. Other local and regional environmental data are also necessary for health planners and researchers to specify gradients in the impact of different influences. Improving the availability of data at the neighborhood, community, or regional level can improve the ability of a local community to target its own efforts and institute community-specific interventions. (See recommendations 8, 9, and 10 for additional recommendations affecting state efforts to monitor and improve children’s health.)

Recommendation 5: Federal agencies and departments, particularly the Environmental Protection Agency and the U.S. Department of Health and Human Services, should promote the systematic collection, dissemination, and linkage of data on children’s exposure to toxins, air pollution, and other environmental conditions, as well as data on policies likely to affect children’s health. The Census Bureau should continue to collect and distribute local-area data and facilitate efforts to match these data to existing sources of information on children’s health and its influences.

The geographic dimension of health patterns can be exploited only if subjects’ locations (e.g., home, school, workplace addresses) have been coded with geographic identifiers and these geocoded data are made available to the planning and research communities.

Recommendation 6: Government and private agencies and academic organizations that conduct health-related surveys or compile administrative data should geocode addresses (i.e., provide geographic identifiers) in ways that facilitate linkages to census-based and other neighborhood, community, city, and state data on environmental conditions. With adequate protections to ensure the confidentiality and security of individual data, they should also make geocoded data as accessible as possible to the research and planning communities.

Access to Data by Research and Planning Communities

The importance of maintaining the confidentiality and privacy of data on specific individuals is clear. In the case of health data, specific rules govern the acquisition and use of data. Data are necessary, however, to inform and guide



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