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Expert Testimonial




                                                     Data are truly the engine of public health. Without appropriate
                                                     data, we don’t know how to chart the course ahead, how to
                                                     know if we are headed in the right direction, or when and
                                          where we may have made a wrong turn. As data grow bigger, we need
                                          better systems and strategies to manage the flow of information and
                                          ensure access to the most timely content. There are so many fast-moving,
                                          complex public health challenges that require real-time or even predictive
                                          data for public health to fully comprehend and address them. So where are
            Anne Schuchat,                we now? Are we still puttering along the data superhighway in our Model
                                          T Ford, or are we speeding along in the latest electric car? Spoiler alert:
     MD (RADM, USPHS, RET)                we are likely closer to the former than the latter. What that means for the
           Principal Deputy Director      system’s ability to address these complex challenges is that we are woefully
                           CDC            behind. Yesterday’s data systems must evolve to meet future public health
                                          challenges.


                                          The opioid epidemic is one example where the factors driving the epidemic
                                          are changing over time. So far there have been three waves: The first wave
                                          of the epidemic began in 1999, caused by a rise in prescription drug use due
                                          to overprescribing by physicians who were under the misguided belief of
                                          no harm. The second wave of the epidemic came from increases in heroin
                                          use beginning in 2010. The third wave, a rise in synthetic opioids including
                                          illicitly manufactured fentanyl, began in 2013 and has increased rapidly.
                                          Without access to reliable data, we have been slow in recognizing changes
                                          and were also not able to get ahead of these shifts as quickly. It also means
                                          we may not see the next threats to our health coming until they are closer
                                          than we think. We know that 30 million American adults have diabetes but
                                          another 84 million have prediabetes, which can lead to development of
                                          the disease. Nine out of 10 adults don’t know they have prediabetes. This
                                          is a major public health problem – what else is there in our blind spots?
                                          Old diseases are making a comeback and challenging our public health
                                          data systems to keep up. Measles was declared eliminated from the United
                                          States in 2000, yet in 2019 we saw 880 cases in the first five months of the
                                          year. Tracking this resurgence was more difficult than it would have been if
                                          our systems were ready.

                                          Don’t despair—the news isn’t all bad and there are opportunities to
                                          strengthen and improve our data systems. We need a few things to do this:
                                          Deep, growing data sets that drive new analytics; the ability to predict,
                                          model, and address diseases based on data quality and currency; and
                                          modernizing the public health data platform, adding data resources that
                                          are well-governed, fast, and flexible. We may not be ready for self-driving
                                          cars in our public health data world yet, but there are an awful lot of ‘driver-
                                          assist’ features that public health really needs to make standard options in
                                          the immediate future.









        Driving Public Health in the Fast Lane                                                                 8
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