American Journal of Epidemiology Vol. 140, No. 5: 383-397
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
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Future Directions for Comprehensive Public Health Surveillance and Health Information Systems in the United States
1National Center for Environmental Health, Centers for Disease Control and Prevention Atlanta, GA.
2Epidemiology Program Office, Centers for Disease Control and Prevention Atlanta, GA.
Reprint requests to Dr. Donna F. Stroup, Epidemiology Program Office, Mail Stop C08, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Atlanta, GA 30333
The authors describe a comprehensive system for public health surveillance for the United States based on a network of data systems ranging from population surveys and physician-based records to electronically linked laboratory and administrative data. They also discuss traditional uses of surveillance data, legal and ethical issues associated with using data from any surveillance system (particularly the tension between individual privacy and the public right to a healthful environment), and factors impeding the development of a comprehensive system. Just as provisional data on notifiable diseases are critical in protecting communities from disease, data from other information systems should be applied to prevention practice with the same urgency. The major barriers to a successful comprehensive, nationwide, integrated public health surveillance and information system are a lack of appreciation for the value of high-quality provisional surveillance data and a weak societal commitment to public health.
data collection; epidemiologic methods; ethics; medical record linkage; medical records systems; computerized; population surveillance; public health; public policy
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