Databases: Environment & Health Prof. H. Van Loon

Aims To build up databases to realise the disclosure of existing data To integrate and to interprete the data monitored in order to clarify and assess the health status of the Flemish population To map the health risks linked with selected and measured data

Objectives Creation of database: Cancer register; Vital health statistics: birth, Population, mortality; SPE; Minimal clinical data “Routine” analysis of the database: cluster research, multivariate analysis, disease mapping “Rapid inquiry facility” Extension of database with environmental and measured records Analysis of data from spatial and temporal point of view

Realisations Disclosure of the most important existing datasets by a web based application via a controlled access: password and license-system. Disease mapping of a broad scope of disease categories Possibility for “rapid inquiry facility” is present Data for cluster analysis are available (e.g. report low birth weight)

Difficulties Conceptual level: – Differences in vision: extensive (more data for more rational) versus restrictive (more data for better control) – Differences in priorities: accessibility of the data versus linkage – Differences in understanding: record linkage on individual, spatial en temporal level. Operational level: – Impact of outsourced of IT technology – Possessive and restrictive attitude of “data owners” creates complex procedures (privacy) – Cost of data (what is the price of data ?)

Deficiencies Absence of a tool for easy integration of “local data”. Download procedure of tables, as a result of data selection, is not available Lack of investment for the development of experts environment and health. Canalisation of “questions and answers” is not functioning

Problems Transfer of “know how” seems difficult by lack of continuity of expertise Management of the license system on the population level. Procedures for answering questions

The future Consolidation of procedures for data loading in the database Generalise the access procedure for different types of users Addition of “local data” Strengthening the capacity and analysis expertise Addition of relevant scientific documentation in the database via weblinks

Recommandations To invest in this kind of tools in order to – Integrate more data – Permit more people to comment on the data – Which creates added value in the difficult topic of environment and health. To develop expertise and analysis capacity To operationalise the Rapid inquiry facility

Conclusions The developped database is a “small for date” child, who needs the normal vaccines in order to prevent the common predictable illnesses and who needs a clean environment to permit normal growth