Axis ES · E — Environment
Your environment is part of your chart.
You can do everything right and still be poisoned by your zip code. We pull air quality, water quality, ambient light, sound, and toxin data from public APIs and your own home sensors (optional), then weight it against where you actually spend your time. The score follows you home.
Environmental quality. Air, water, light, toxin exposure — the floor everything else stands on.
Sixteen environmental signals, time-weighted to where you actually are. A patient who works in a clean office and sleeps in a polluted bedroom gets a score that reflects both.
From signals to a single value.
Each signal contributes a weighted partial score. The axis aggregates them and clamps to 0–100. Here's a worked example for a real (anonymized) patient on this axis today:
Sample contribution
Where it lands in CH
ES contributes E in (T + E)p. With T=82 and E=79 and p=1.5, this term contributes ~1,419 points in raw weight before normalization. It's the largest single multiplier in the equation.
E — Environment
A typical week, on the axis.
No single day defines you. A consistent week does. Here's what consistent looks like — and the HCR you'd earn for it.
The pay ladder.
ES pays both for behavior (time outdoors) and for context (your air quality). Patients in polluted zip codes get a small contextual boost — they're fighting harder for the same score. Always free to receive — patients never pay to earn HCR, and clinics never see a bill for hosting it.
All payouts settle to the patient's HCR wallet within 24 hours of verification. HCR is redeemable for care, contributions to a Conceptual Health pharmacy account, or held as a long-term reserve.
For providers ordering on this axis.
For Conceptual Health-credentialed clinicians: this is the recommended order-of-operations on this axis. Free to use, no certification required, no software to install — the protocol lives inside the EHR you already use through us.
Environmental Symbiosis · clinical sequence
- Open the ES panel for any patient with respiratory, cardiac, or sleep complaints.
- Look at the home dwell-time air quality — often worse than outdoor.
- For chronic patients in high-PM zip codes, prescribe an in-home air filter and document the order. The patient can apply HCR earnings toward it.
- For sleep-onset complaints, check LAN before adding sedatives.
- Refer environmental concerns to the local public health partner — Conceptual Health relays the data automatically when authorized.
The peer-reviewed evidence base.
Every signal we score has a literature trail. These are the foundational papers we cite in our scoring model documentation. Our full bibliography (404 references) is available in the methodology appendix.
One real (anonymized) trajectory.
Names changed. Numbers verified. A composite from three patients with similar starting conditions — the chart, the intervention, and the outcome.
Lena T., 41, Phoenix
"My PCP was treating my asthma; my ES chart was treating my house. We added a filter, fixed the bedroom dark hours, and I haven't had an ER visit in 11 months."
What you can study, and how.
Environmental data is the largest single contribution to public-health research from the platform. Most fields are public-API derived; patient location is hashed to a 1km grid by default. Research access is available to credentialed institutions through the HCC research portal — pay-per-query, patient revenue-shared.
All fields below are time-aligned and de-identified to NIST 800-53 standards.
Standards we conform to.
No new yardsticks. We map every signal on this axis to existing peer-reviewed instruments and regulatory norms — the same instruments your clinician learned in residency.
EPA AQI
Air quality index breaks match EPA categories.
WHO Air Quality Guidelines
Long-term exposure targets follow 2021 WHO update.
EPA SDWIS
Drinking water compliance pulled from EPA Safe Drinking Water Information System.
NLCD
Land cover classification per USGS National Land Cover Database.
IES Lighting
Light-at-night reference per Illuminating Engineering Society.
The other seven axes
Eight axes. One score. Each pulls.
Health is multi-dimensional. ES is one of eight. The Master Equation weights them, multiplies them, and gives you and your clinician a single number — and the ability to see exactly which axis is moving it.