Approaches to community concerns: applied public health

Public health workers are challenged to address community health concerns believed to be related to environmental exposures. The challenge is heightened when there are multiple potential exposures and numerous health concerns. In a community in Washington State, we employed different approaches depending on the specificity of diagnosis and the relation of the disease to environmental exposures. For diseases with specific diagnoses and questionable associations with environmental exposures, we began by determining whether rates of disease were higher than expected. Different approaches were needed for three different health concerns. Major limitations were estimating community population counts and obtaining comparison rates from published literature. Despite limitations, epidemiologic data developed at a relatively low cost were useful in assisting the community in understanding its health status.