Page 12 - Driving Public Health in the Fast Lane

Introduction

The Public Health Enterprise

Today, it is common for consequential public health threats to dominate news headlines: a record-
breaking number of measles cases in the first four months of 2019; the deadly, drug-resistant superbug
Candida auris becoming an untreatable health threat; steep rises in fentanyl-linked overdose deaths; and
lead contamination in public water systems. While diverse in their origins and public health impact, these
public health threats have one thing in common: effective response and prevention efforts rely on a
strong, timely public health surveillance system.

Public Health Surveillance: Moving Data to Action

CDC defines public health surveillance as the ongoing systematic collection, analysis, and interpretation
of health data, closely integrated with the timely dissemination of these data to those responsible for
3
preventing and controlling disease (or condition), exposure, and injury. It enables population-level
measurements of disease burden and allows for evaluation of broad interventions and prevention
measures.

Gathering and exchanging data defines the foundation of public health surveillance. Starting at the point
of patient care, health-related information is collected and sent to the territorial, tribal, state, and/or local
health department so epidemiologists—also known as disease detectives—can measure the health status
of the population and evaluate and implement control measures. To provide a nationwide perspective of
disease burden, health departments share de-identified data with CDC, which ultimately informs national
public health responses, prevention initiatives, and policy. The value and quality of the nation’s public
health surveillance system relies on efficient and accurate data flow from source to the agencies to make
evidence-based decisions.

“My colleague in Pennsylvania, working in concert with CDC and the Agency for Toxic Substances and
Disease Registry, is responding to a manufacturing plant ‘bad actor’ that has released lead into the
air. The community understandably wants answers about their health: What are our blood levels? How
many people and children have been tested? How do they compare to other communities? Does my child
need to be tested? Unfortunately, those questions can’t be answered with today’s data, because while
health care facilities have data stored in electronic medical records, data are sent on paper to the health
department and the stacks take time to enter and process.” 4

Janet Hamilton, MPH
Council of State and Territorial Epidemiologists

3 German RR, Lee LM, Horan JM, et al. Updated guidelines for evaluating public health surveillance systems: Recommendations from the guidelines working group. MMWR. 2001;50(13):1-35.
https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5013a1.htm. Published July 27, 2001.
4 Hamilton, J. FY20 LHHS Testimony Hamilton. Oral. CSTE. https://cste.sharefile.com/share/view/sc5e20318a5a49a1a. Published April 24, 2019.

The Public Health Enterprise 12