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Hello, My name is Suzanne Condon and I direct the Environmental Health Programs
here at the Massachusetts Department of Public Health This website represents a 5 yr effort
to make health and environmental data accessible to the public so that the health status of
each Massachusetts community is better understood and the role that environmental factors may
play can be evaluated more efficiently. Determining environmental causes disease is complex. The
information contained in this website can help determine public health actions that
might be warranted but it cannot be used to determine the cause of disease. The website
aims to assist you in understanding the background of an environmental health issue, important
limitations of the data, and it will allow you to explore environmental and health data
for the community you live in. Now let s go through the features of the website and how
to navigate the system. The first page is an introductory page that lists the health
data and environmental data available on our tracking website as well as other information
including important limitations associated with the data. The next page is our gateway
to the website. In the background is a tree meant to imply continued growth of our data
sharing system. Above the tree are a series of leaves with each leaf providing access
to important information If you select the Mass EPHT Program - the webpage provides access
to all the major features of the website including a glossary, a library of weblinks to other
sources of information, and a link to contact us if you have any questions or comments about
the portal. Let's walk through the operation of the portal using cancer data as an example.
After reading through the information provided on the cancer landing page, we can begin to
calculate cancer rates. The section at the bottom of the page gives important information
about getting cancer incidence data from this website and what you need to know in order
to interpret the data. Scroll back up to the top of the page and click on the 'Click here
to map cancer rates' words on the toolbar on the right side of the screen. By clicking
on these words the BEH data sharing agreement will appear. Please read this information
and if you agree with the terms, click the button 'I accept the terms' Next you will
see the cancer rates map viewer, from here we can select the type of cancer rates we
want to calculate. If you do not select males or females you will automatically get data
for both genders combined. Now let's use the drop down menu to select an age category.
For this example, I will select the 0-85+ age group. If your interest relates to cancer
in children and adolescents you can select 0-19 years instead. Now let s select one of
the 23 cancer types, I am going to choose to look at lung and bronchus cancer incidence.
Next we select the years for which we want to calculate a rate. I will choose the 5-year
time period, 2000 to 2004. Now let's select the community we are interested in. Click
on the arrow next to the word community. This will show a list of the 351 cities and towns
in Massachusetts. Simply scroll down to the community of interest and click the mouse
over the city or town name. For this demonstration, let's select the city of Marlborough. Bear
with us, it will take a few seconds for the cancer rates to calculate, but while you are
waiting let's consider that before this portal was developed it would have taken many hours
or even days or weeks to calculate the type of cancer rate information now available in
seconds! You will notice that once the calculation is complete, the map zooms to Marlborough
and the Standardized Incidence Ratio (SIR) or cancer rate is displayed. So, for lung
and bronchus cancers in Marlborough as a whole - the Standardized Incidence Ratio is 97.
Look at the color of the map and the legend below-this means that the rate of lung cancer
in Marlborough is within 15% of the expected rate and is not statistically significantly
different from the rate of lung cancer for the state of Massachusetts as a whole. If
you scroll down to the bottom of the page you will see that there is a table that displays
the observed or the reported number of lung and bronchus cancer diagnoses in Marlborough
between 2000 and 2004. It also displays the expected number of diagnoses based on the
statewide incidence of lung and bronchus cancer during this time period, and the SIR and the
95% confidence intervals for females, males and both genders combined. The confidence
interval is important in best understanding these statistics. There is additional information
at the bottom of this page and links to other documents that further explain the results
and how to interpret them. So we now know that the city of Marlborough does not have
an unusual rate of lung cancer, but what about the pattern of lung cancer within a smaller
geographic area, such as the neighborhood or census tract level. This portal will allow
you see those cancer rates too. But, what if you don't know what census tract the address
is in that you are looking for. Don't worry, most of us don't know the census tract designation
where we live. You can find this by typing your address into the address locator at the
top right hand side of the map. I will use the Marlborough Health Department as my example.
Their address is 140 Main Street in Marlborough. I type this address into the address locator
fields and click over the words 'find address.' You will see a red locator dot on the map.
This indicates where your selected address is in the community you have selected. Now
to identify which census tract your address is in, click on the button to the left that
says 'view census tract SIRs.' You may need to zoom in to determine exactly which CT the
point is in. The zoom in and out buttons are in the upper left corner on the map indicated
with a plus and minus sign. Click the plus to zoom in and the minus to zoom out. Now
we have a map that shows Marlborough divided into its six different Census tracts. We see
that the Health Department is located in CT 321300. We also see reported SIRs and different
shading for each of the CTs. Again, you may need to zoom in to determine exactly which
CT the point is in. Remember the color coded legend we looked at when viewing the data
for the city of Marlborough as a whole? Now let's look at it again in relation to Marlborough's
neighborhoods or CTs. In addition to colors you will now see that one area of the city
also has crosshatching or lines going across the boundaries-this is in CT 321200. The SIR
for that CT 321200 is reported as 51. The crosshatching indicates that the rate of this
cancer is statistically significantly different from the state of Massachusetts. In this case
it means that the rate of lung and bronchus cancer in Marlborough is statistically significantly
lower than that of the state of Massachusetts as a whole. As we did with the citywide data
earlier, if we scroll down to the table below, we can see the cancer rates for that census
tract and the others in Marlborough. Please note, the cancer landing page, the introductory
page and the cancer FAQs, further explain the results and how to interpret them. We
can now choose to add different information to the map indicating cancer rates. If we
click on the check box next to schools, we can see all of the schools in that area. If
we click the box to activate the MA DEP Tier-Classified 21 E hazardous waste site layer, it will overlay
these hazardous waste sites onto your map. For more information and a better understanding
of Tier-Classified sites please refer to the glossary. By opening the Map Legend, we can
see what each of the symbols on the map mean. To open the legend, click on the open box
We can move the legend by clicking on the header and dragging it over to the side. We
can also get more information about a specific location by clicking on the point itself.
The nearest school to our location is almost under the red dot. By clicking on this green
flag (which we can see from the legend is a private school) we see that it is Immaculate
Conception school. To close this box, click on the X and to close the legend, click the
line in the header. To print the map and the table, click in the upper left corner on the
'Print Table and Map as PDF Document' You will need adobe to use the print feature.
If you would like step by step instructions for using the website there is an Instructions
and Use Tips Page that can be accessed by clicking the link in the upper left hand corner
So to summarize, the cancer component of this website or portal allows me to learn more
about cancer, cancer and the environment, and it allows me to actually obtain cancer
incidence rates for the census tract where I live or have an interest as well as in my
community, county, and select regions. This tutorial has largely involved an introduction
to the use of the Standardized Incidence Ratio calculator for cancer. However, the portal
also features other important health information such as pediatric asthma by school throughout
each community in Massachusetts, hospitalization data for asthma and heart attacks, childhood
blood lead levels and much more. We also include environmental data for Massachusetts communities.
I hope this tutorial has helped you in better understanding how to navigate our system.
We look forward to getting feedback from people using the portal and will continue to enhance
and improve the system over time. Thank you for your time and interest in environmental
public health in the commonwealth of Massachusetts.