Paul Sandifer, College of CharlestonFollow
Landon Knapp, College of Charleston
Maureen Lichtveld, Tulane UniversityFollow
Ruth Manley, College of Charleston
David Abramson, New York UniversityFollow
Rex Caffey, Louisiana State University
David Cochran, University of Southern MississippiFollow
Tracy Collier, Western Washington University
Kristie Ebi, University of Washington, Seattle
Lawrence Engel, The University of North Carolina at Chapel Hill
John Farrington, Woods Hole Oceanographic InstitutionFollow
Melissa Finucane, RAND Corporation
Christine Hale, Texas A and M University - Corpus ChristiFollow
David Halpern, Scripps Institution of Oceanography
Emily Harville, Tulane University
Leslie Hart, College of Charleston
Yulin Hswen, Harvard Medical School
Barbara Kirkpatrick, Texas A&M UniversityFollow
Bruce McEwen, Rockefeller University
Glenn Morris, University of Florida
Raymond Orbach, The University of Texas at Austin
Lawrence Palinkas, University of Southern California
Melissa Partyka, Mississippi-Alabama Sea Grant ConsortiumFollow
Dwayne Porter, University of South CarolinaFollow
Aric A. Prather, University of California, San Francisco
Teresa Rowles, NOAA Fisheries ServiceFollow
Geoffrey Scott, University of South CarolinaFollow
Teresa Seeman, David Geffen School of Medicine at UCLA
Helena Solo-Gabriele, University of MiamiFollow
Erik Svendsen, National Center for Environmental Health
Terry Tincher, National Center for Environmental Health
Juli Trtanj, National Oceanic and Atmospheric Administration
Ann Hayward Walker, SEA Consulting Group

Document Type


Publication Date



Biological Sciences


Biological, Environmental, and Earth Sciences


© Copyright © 2020 Sandifer, Knapp, Lichtveld, Manley, Abramson, Caffey, Cochran, Collier, Ebi, Engel, Farrington, Finucane, Hale, Halpern, Harville, Hart, Hswen, Kirkpatrick, McEwen, Morris, Orbach, Palinkas, Partyka, Porter, Prather, Rowles, Scott, Seeman, Solo-Gabriele, Svendsen, Tincher, Trtanj, Walker, Yehuda, Yip, Yoskowitz and Singer. The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop.

Publication Title

Frontiers in Public Health



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