| Use of Health Information Systems in the Russian Federation in the Assessment of Environmental Health Effects Jouni J.K. Jaakkola,1,2 Martin Cherniack,1 John D. Spengler,1 Halûk Özkaynak,1 Bogdan Wojtyniak,3 Andrey Egorov,1 Pavel Rakitin,3 Boris Katsnelson,4 Sergei Kuzmin,4 Larissa Privalova,4 and Natalia V. Lebedeva4 1Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
2Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
3National Institute of Hygiene, Warsaw, Poland
4Environmental Epidemiology Component, Environmental Management Project, Center for Preparation and Implementation for Foreign Projects, Moscow, Russia Abstract
The Russian Federation has made an intensive effort to compile and use information on the environment and human health. In 1996-1997, we evaluated the information that was collected and analyzed on the local (raion) , regional (oblast) , and federal levels with reference to its usefulness in the assessment of environmental health effects. The Russian Federation maintains standardized nationwide institutions that routinely collect health data in polyclinics and hospitals and then report to the national offices. The allocations of the workforce and the broad range of surveyed health outcomes are extensive, but a lack of systematic control of information quality limits the ability to take full advantage of these efforts. On the other hand, the hierarchical system of data collection has advantages over more decentralized or commercial health systems. A major weakness in the current reporting is the aggregation and transformation of data. Although this may not disturb the generation of health statistics, it seriously limits the use of regional and federal level data in the assessment of health effects of environmental exposures. In spite of limitations, some revised approaches to the analysis of existing data may be both feasible and fruitful. Combining information from routine data and newly collected data is likely to be the most effective way to assess the relationship between environmental exposures and diseases. Although there is a strong and justifiable desire to rapidly translate information of environmental health effects into policy alternatives, at present, it seems more useful to emphasize data quality, completeness, and plans for the use of data. Key words: environmental health, morbidity, mortality. Environ Health Perspect 108:589-594 (2000) . [Online 24 May 2000] http://ehpnet1.niehs.nih.gov/docs/2000/108p589-594jaakkola/ abstract.html Address correspondence to J.J.K. Jaakkola, The Nordic School of Public Health, PO Box 12133, S-402 42 Göteborg, Sweden. Telephone: 46-31-693980. Fax: 46-31-691777. E-mail: jouni.jaakkola@nhv.se This study was supported by a World Bank loan to the Russian Federation. Received 20 October 1999 ; accepted 21 January 2000.
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