Defense against disease

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A BOSTON GLOBE EDITORIAL

Defense against disease

 

11/8/2002

ANATIONWIDE system for tracking chronic medical conditions would help in determining which might be caused or exacerbated by environmental factors, but there is no such system now. Congress should act early next year to rectify this shortcoming.

An illustration of the need occurred recently in California, where a sharp rise in autism cases baffled health professionals. One study helped rule out two possible causes: a broadened definition of autism and an increase in families with autistic children moving into the state because of its high level of services.

However, the study could not say whether environmental factors might also be at work or whether the spike might be due simply to greater awareness of autism among parents and doctors that led to more reporting. A Danish study this week cast doubt on one suspected cause of autism: the measles, mumps, and rubella vaccine for toddlers.

A nationwide tracking system for chronic conditions, including asthma and birth defects, might have helped the California study and many other investigations. Most autism specialists believe that genetics are a major factor in the brain disorder, which interferes with children's ability to speak, interact socially, or behave normally. But they suspect that some thing or things in the environment might also trigger the disease.

Last spring Senators Edward Kennedy, Hillary Rodham Clinton of New York, and Harry Reid of Nevada cosponsored a bill that would establish a national tracking system. The proposal would bring together existing state systems that already track some chronic diseases, environmental exposures, and other risk factors. It would also provide states with grants to build up new registries and pay for state environmental health investigators. One example of the role such registries can play is the finding that prostate cancer rates are higher in northern latitudes, an apparent reflection of the preventive role that sunlight is believed to play through its activation of vitamin D in the body.

Short of the full-scale network called for in the bill, the US Centers for Disease Control and Prevention already has authority to track disease incidence. This year it has $17 million to help states improve their data collecting. The House should adopt the Senate's proposal to increase that to $30 million for fiscal 2003.

The annual cost of the full network envisioned in the Kennedy bill is estimated at $210 million. This is a substantial sum, but it has to be measured against the devastating toll of chronic diseases, which cause seven of 10 deaths in the United States and annual losses of $325 billion in health care and productivity. A nationwide health tracking network based on uniform standards set by the CDC is long overdue as a part of the nation's public health system.

This story ran on page A22 of the Boston Globe on 11/8/2002.
© Copyright 2002 Globe Newspaper Company.

 

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