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        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
        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

        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.
 Published July 27, 2001.
        4  Hamilton, J. FY20 LHHS Testimony Hamilton. Oral. CSTE. Published April 24, 2019.

        The Public Health Enterprise                                                                           12
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