Lesson 5: Public Health Surveillance

Summary, References, Further Reading, and Websites

Surveillance has a long history of value to the health of populations and continues to evolve as new health-related problems arise. In this lesson, we have defined public health surveillance as continued watchfulness over health-related problems through systematic collection, consolidation, and evaluation of relevant data.2 Data and interpretations derived from surveillance activities are useful in setting priorities, planning and conducting disease control programs, and assessing the effectiveness of control efforts. We have reviewed the identification and prioritization of health problems for surveillance; the need for a clear, functional definition of a health problem to facilitate surveillance for it; and various approaches for gathering data about health problems, including environmental monitoring, surveys, notifications, and registries. Sources of data are often available and used for surveillance at the national, state, and local levels.

We have described and illustrated basic methods for analyzing and interpreting data and have focused on time, place, and person as the foundation for characterizing a health-related problem through surveillance. Potential problems with surveillance data that can lead to errors in their analysis or interpretation have been presented. We have emphasized the importance of the timely, regular dissemination of basic data and their interpretation as a critical component of surveillance. These data and surveillance reports must be shared with those who supplied the data and those responsible for the control of health problems.

Critical to maintaining useful, cost-effective surveillance is periodic evaluation and implementation of recommended improvements. Stakeholders should be identified and included in evaluation processes; a clear description and diagram of surveillance activities should be developed; and the usefulness, resource requirements, and characteristics of optimal surveillance should be individually assessed. This lesson ends with examples of surveillance and recommendations for further reading.


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Further Reading

Buehler JW. Surveillance. In: Rothman KJ, Greenland S, editors. Modern Epidemiology, 2nd ed. Philadelphia: Williams and Wilkins; 1988, pp. 435–57.

Eylenbosch WJ, Noah ND, editors. Surveillance in health and disease. Oxford: Oxford University Press; 1988.

Langmuir AD. Evolution of the concept of surveillance in the United States. Proc R Soc Med. 1971;64:681–4.

Langmuir AD. William Farr: founder of modern concepts of surveillance. Int J Epidemiol 1976;5(1):13–8.

Orenstein WA, Bernier RH. Surveillance: information for action. Pediatr Clin N Amer 1990;37:709–734.

Rothman KJ. Lessons from John Graunt. Lancet. 1996;347(8993):37–9.

Sandiford P, Annett H, Cibulskis R. What can information systems do for primary health care? An international perspective. Soc Sci Med 1992:34(10):1077–87.

Teutsch SM, Churchill RE, editors. Principles and practice of public health surveillance, 2nd ed. New York: Oxford University Press; 2000.


For more information on: Visit the following websites:
CDC Case Definitions https://www.cdc.gov/ncphi/disss/nndss/casedef/case_definitions.htm
CPSC National Electronic Injury Surveillance System (NEISS)On-line http://www.cpsc.gov/library/neiss.html
Emergency Preparedness and Response: A-Z Index http://emergency.cdc.gov/az/a.asp
FDA Adverse Event Reporting System (AERS) http://www.fda.gov/Drugs/ GuidanceComplianceRegulatoryInformation/ Surveillance/AdverseDrugEffects/default.htm
Healthy People 2010: Tracking Healthy People 2010: Part C. MajorData Sources for Healthy People 2010 http://www.healthypeople.gov/Document/html/ tracking/THP_PartC.htm
MedWatch, The FDA Safety Information and Adverse Event ReportingProgram http://www.fda.gov/Safety/MedWatch/default.htm
National Health and Nutrition Examination Survey https://www.cdc.gov/nchs/nhanes.htm
Nationally Notifiable Infectious Diseases https://www.cdc.gov/ncphi/disss/nndss/phs/infdis.htm
NCI CancerMortality Maps & Graphs http://www3.cancer.gov/atlasplus/index.html
NCI SEER http://seer.cancer.gov/faststats/
NIDA DAWN http://www.drugabuse.gov/pubs/assessing/
NIDA Monitoring the Future Survey http://www.drugabuse.gov/DrugPages/MTF.html
SAMHSA Officeof Applied Studies http://www.drugabusestatistics.samhsa.gov/
Summary of notifiable diseases — United States, 2004 https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5353a1.htm
World Health Organization International Classification of Diseases, 10th revision http://www.who.int/classifications/icd/en/
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