Improving environmental exposure and health outreach to children in Puerto Rico: A geographic information systems approach

The Federal Region II Pediatric Environmental Health Specialty Unit (PEHSU), which includes New York, New Jersey, Puerto Rico and the US Virgin Islands, is home to more than 8 million Spanish-speaking individuals according to the United States Census Bureau. This population disproportionately lives in communities with existing patterns of environmental injustice. Particularly, preliminary research has identified unequal distribution of outreach services in Puerto Rico. Geographic Information Systems (GIS), a tool frequently used to analyze demographic or health outcome data, may be useful in informing programs like PEHSU of areas with high need. Surveys in English and Spanish were administered through an anonymous online platform and distributed by email to 50 pediatric environmental health professionals throughout Puerto Rico to determine environmental exposures of greatest concern and opinions on GIS in health outreach initiatives. Using survey responses, Toxic Release Inventory (TRI), demographic data, health indicator data, and ArcGIS 10.1, we identified environmental exposures of concern in Puerto Rico, asthma prevalence, and current PEHSU outreach. In preliminary analysis of survey data, environmental exposures including water contamination (25%), pesticides (18%), air pollution (18%), and land waste (12.5%) were reported. GIS maps of air emission density, land discharge density, and asthma prevalence target hot spots for improving outreach services. Employing GIS as a visual method to match health concerns with exposure data is expected to be useful in identifying at-risk regions and examining correlations between environmental toxicant distribution and pediatric disease prevalence. A better understanding of the geographic distribution of exposures to children and the prevalence of related health outcomes will enhance PEHSU outreach efforts in preventing a number of environmental exposures that children face. Obtaining data for GIS presented a challenge during this study, and thus we recognize a need for ubiquitous data collection and access for this model to be effective.