What is environmental data?
And why should we integrate it into health records?
Every day, your body keeps a kind of record that no doctor can see.
It logs the air you breathed on a smoky afternoon, the chemicals in the water that came out of your tap this morning, the heat you suffered through when your A/C went out, and even the relaxation you felt from that nature walk you took.
Scientists sometimes call this lifetime accumulation of exposures the "exposome," but you don't need the technical term to understand the basic idea that the environment around you is constantly shaping your health.
Despite literally thousands of years of research teaching us about the importance of the environment for health, our health records don’t have this essential information.
Electronic health records (EHRs) contain information on blood pressure, prescriptions, maybe even smoking status. But it’s unlikely to have today's air quality index for your zip code, whether your home has reliable air conditioning, or whether a wildfire sent smoke through your town last week.
That gap is the starting point for ASCENT Research's work, and it's worth understanding clearly.
What is "environmental (health) data," why does it currently live siloed from health records, and what it would take to change that?
What is environmental data?
The broadest definition of environmental data is anything that is not genetic data.
Scientists often say:
Phenotype = Genotype + Environment.
In this sense environmental data constitutes everything that isn’t encoded by the genome. So that includes the air you breathe, the food you eat, the heat waves and cold snaps in your city, the social stressors you deal with, even the exercise you did (or perhaps didn’t) do.
When taken over time to include the cumulative exposures we get the exposome that we mentioned earlier.
Often when we speak of environmental exposures, we separate the physical environment from other aspects of the environment. However, the physical environment, spans a wide range of measurable conditions:
Air quality — particulate matter (like the PM2.5 and PM10 released by wildfire smoke), ozone levels, and other pollutants
Temperature and heat exposure — daily highs, heat wave duration, and access to cooling
Water quality — contamination, lead levels, or supply disruptions
Housing conditions — lead pipes, mold, proximity to industrial sites or highways
Chemical and toxin exposure — occupational exposures, pesticides, and industrial contaminants near a person's home or workplace
Importantly, much of this data is already tracked and collated across the world. Environmental agencies like the US EPA and USGS track air, water, and land quality. NOAA and NASA use combinations of ground and satellite measurements to track weather patterns and greenspace. The information exists. It's just collected and stored somewhere entirely separate from the healthcare system.
Why environmental data hasn't made it into health records
If the data already exists, and we understand its importance for health, why isn't it automatically integrated with health records and utilized for research and clinical care?
Several articles lay out the barriers clearly particularly a 2025 viewpoint article in the Journal of Medical Internet Research (JMIR, 2025) and a 2019 review article from the Annual Review of Public Health (Ann Rev Public Health, 2019).
1. Fragmentation. Environmental data lives in agency databases, satellite feeds, and sensor networks. Health data lives in electronic health record systems built by different vendors, under different standards, for different purposes. Bringing the two together in real time — rather than after the fact, for research — is a significant systems-integration problem.
2. Lack of standardization / ontologies.
There isn't yet a shared, widely adopted way to code "this patient was exposed to elevated PM2.5 levels this week" inside a medical record the way there is for a diagnosis or a lab result. Additionally, the lack of shared field-specific language means that even terms that sound specific like “PM2.5” can mean different things in different situations.
3. Increased Research Difficulty. Researchers depend on standardized data collection procedures and study designs to be able to make research generalizable. Health records were designed to address individual medical needs meaning that translating them to other study designs can be difficult, and this difficulty is magnified when environmental exposures also need to be mapped. Questions around address history recording, temporal linkages, and spatial resolutions arise that are not present in other health record based research studies.
4. Privacy and data-governance questions. Merging location-linked environmental data with a patient's identifiable health record raises legitimate concerns that need careful, deliberate design. It’s not a reason to avoid the work, but it is a reason to do it thoughtfully.
These are just a few of the barriers that exist but the important factor is that none of them are insurmountable. Additionally, addressing them in one scenario helps solve the situation in others.
For example, identifying data sources that can be reliably and in a standardized fashion integrating with EHRs for research purposes, helps to demonstrate their potential value for point of care clinical decision-making. These two scenarios are not the same but the needs of data provenance, standardization, established ontologies, and decreased fragmentation share a lot in common. Additionally, improving the integration of environmental data into clinical care can help to leverage the privacy-preserving functions already created for the use of EHRs in non-environmental research efforts – preventing the need for external researchers to manage sensitive data like address history to better understand how emerging environmental risks are impacting communities. And most importantly, extending EHR-environmental data integration both into research and clinical care brings more people to the table when it comes to investigating and addressing environmental risks.
Why it matters
The stakes here are not abstract. The World Health Organization estimates that, between 2030 and 2050, climate change will contribute to approximately 250,000 additional deaths per year globally, driven by heat exposure, undernutrition, malaria, and diarrheal disease, and that roughly 3.6 billion people already live in areas highly susceptible to climate-related health impacts (WHO, "Climate Change and Health"). These are population-level statistics, but they translate into very specific clinical moments: a patient with COPD whose symptoms worsen during a smoke event; an older adult without air conditioning during a heat wave; a family whose water supply is temporarily compromised after a storm.
Some clinician-focused communities already try to account for some of this. A well-established approach called the CH2OPD2 method — Community, Home, Hobbies, Occupation, Personal habits, Diet, and Drugs — has guided doctors in taking a verbal environmental exposure history for over two decades (CMAJ, 2002). More recent clinical guidance has extended this into a "climate and health history," prompting providers to ask about heat exposure, housing resilience, and access to cooling or clean water (Annals of Global Health, 2026). However, there is a large gap between guidance and clinical practice. A 2021 study of healthcare professionals (doctors, nurses) in Massachusetts found that over one third never talked about environmental hazards with their patients during routine care. This is despite environmental exposures having a 4/5 importance ranking for health impacts (Mass, 2021). This difference is often led by the perceived lack of proven interventions against environmental risks that clinicians can utilize to inform their patients as well as a lack of knowledge on the specific environmental risks that may be driving health outcomes in an individual patient. Better research utilizing integrated resources can directly address both issues.
What ASCENT is trying to build
The gap between the known importance of the environment and its integration into clinical research – and by extension clinical care - is the gap ASCENT Research exists to study. Our mission is to research, validate, and communicate best practices for integrating the environment into healthcare and research, so that researchers, clinicians, policymakers, and the public are all better equipped to act on the environmental drivers of health (ASCENT Research).
We organize that research around the ASCENT Framework, which breaks this problem into five specific, answerable conditions — because no single fix (better data, better policy, better systems, better awareness, or a better rollout plan) is enough on its own. That means working across all four groups, because no single one can solve this alone:
Researchers are refining how environmental exposure data can be linked to clinical outcomes at scale, and identifying where current integration methods break down.
Clinicians can describe what environmental information, delivered at the point of care, would actually change a treatment plan or a conversation with a patient.
Policymakers can help determine what regulatory or funding priorities would make environment-EHR integration a reality rather than a research curiosity — including addressing the reimbursement gap identified above.
The public can tell us what environmental information they wish their own medical record already contained.
None of this is solved yet, but the direction is clear: the environmental data that already shapes your health shouldn't remain invisible to the people trying to help you stay healthy.
If you're a researcher, clinician, policymaker, or simply someone who has wondered why your medical chart doesn't reflect the air you breathe or the water you drink, we want to hear from you.
Sources
· JMIR: "Integration of Environmental Data Into Electronic Health Records," 2025
· Hikma Health: "Our New Research on Linking Environmental Data to Health Records," 2025
· World Health Organization: "Climate Change and Health" fact sheet
· Annals of Global Health: "Taking a Climate and Health History," 2026