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Overview of Public Health Surveillance

Overview of Public Health Surveillance. Denise Koo , MD, MPH Epidemiology Program Office Centers for Disease Control and Prevention. Risk Factor Identification: What is the cause?. Surveillance: What is the problem?. Public Health Approach. Implementation: How do you do it?.

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Overview of Public Health Surveillance

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  1. Overview of Public Health Surveillance Denise Koo, MD, MPH Epidemiology Program Office Centers for Disease Control and Prevention

  2. Risk Factor Identification: What is the cause? Surveillance: What is the problem? Public Health Approach Implementation: How do you do it? Intervention Evaluation: What works? Problem Response

  3. Public Health Surveillance • Ongoing, systematic collection, analysis, and interpretation of health-related data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control.

  4. Public Health Surveillance Systematic, ongoing • Collection • Analysis • Interpretation • Dissemination • Link to public health practice

  5. Purposes of Public Health Surveillance • Assess public health status • Define public health priorities • Evaluate programs • Stimulate research

  6. Surveillance Information for Action

  7. Uses of Public Health Surveillance • Estimate magnitude of the problem • Determine geographic distribution of illness • Portray the natural history of a disease • Detect epidemics/define a problem • Generate hypotheses, stimulate research • Evaluate control measures • Monitor changes in infectious agents • Detect changes in health practices • Facilitate planning

  8. Uses of Public Health Surveillance • Estimate magnitude of the problem • Determine geographic distribution of illness • Portray the natural history of a disease • Detect epidemics/define a problem • Generate hypotheses, stimulate research • Evaluate control measures • Monitor changes in infectious agents • Detect changes in health practices • Facilitate planning

  9. 15 10 Reported Cases per 100,000 Population 5 0 1968 1973 1978 1983 1988 1993 1998 Year ShigellosisUnited States, 1968-1998 Source: CDC. Summary of notifiable diseases. 1998.

  10. Uses of Public Health Surveillance • Estimate magnitude of the problem • Determine geographic distribution of illness • Portray the natural history of a disease • Detect epidemics/define a problem • Generate hypotheses, stimulate research • Evaluate control measures • Monitor changes in infectious agents • Detect changes in health practices • Facilitate planning

  11. Rate of Hepatitis AUnited States, 1998 NYC DC PR NA VI GUAM AM SAMOA NA NA CNMI < 5.0 5.0–9.9 10.0–19.9 >20.0 Source: CDC. Summary of notifiable diseases. 1998.

  12. Uses of Public Health Surveillance • Estimate magnitude of the problem • Determine geographic distribution of illness • Portray the natural history of a disease • Detect epidemics/define a problem • Generate hypotheses, stimulate research • Evaluate control measures • Monitor changes in infectious agents • Detect changes in health practices • Facilitate planning

  13. 160 National Center for Infectious Diseases (NCID) data* 140 TOXIC SHOCK SYNDROME (TSS) United States, 1983-1998 National Electronic Telecommunications System for Surveillance (NETSS) data 120 Reported Cases 100 80 60 40 20 Year (Quarter) 1984 0 1997 1992 1986 1990 1988 1994 1998 1996 1983 1989 1995 1993 1991 1985 1987

  14. Uses of Public Health Surveillance • Estimate magnitude of the problem • Determine geographic distribution of illness • Portray the natural history of a disease • Detect epidemics/define a problem • Generate hypotheses, stimulate research • Evaluate control measures • Monitor changes in infectious agents • Detect changes in health practices • Facilitate planning

  15. 110 100 90 80 70 60 50 40 30 20 10 0 Botulism (Foodborne)United States, 1978-1998 Laboratory-confirmed cases* Outbreak caused by sautéed onions, IL NETSS data Outbreak caused by potato salad, NM Outbreak caused bybaked potatoes, TX Outbreak caused by fermented fish/sea products, AK Reported Cases 1983 1988 1993 1998 1978 Year Source: CDC. Summary of notifiable diseases. 1998.

  16. Uses of Public Health Surveillance • Estimate magnitude of the problem • Determine geographic distribution of illness • Portray the natural history of a disease • Detect epidemics/define a problem • Generate hypotheses, stimulate research • Evaluate control measures • Monitor changes in infectious agents • Detect changes in health practices • Facilitate planning

  17. MEASLES (Rubeola) United States, 1963-1998 500 MEASLES — by year, United States, 1983–1998 450 30 25 400 20 Reported Cases (Thousands) 15 350 10 300 5 0 250 1983 1988 1993 1998 200 Year 150 100 50 0 1963 1968 1973 1978 1983 1988 1993 1998 Vaccine licensed Reported Cases (Thousands) 20 10 Year

  18. 2,400 2,100 1,800 1,500 1,200 900 600 300 0 >60 <1 1–4 5–9 10–14 15–19 20–29 30–39 40–49 50–59 Pertussis (Whooping Cough) United States, 1998 Reported Cases Age Group (Years)

  19. Uses of Public Health Surveillance • Estimate magnitude of the problem • Determine geographic distribution of illness • Portray the natural history of a disease • Detect epidemics/define a problem • Generate hypotheses, stimulate research • Evaluate control measures • Monitor changes in infectious agents • Detect changes in health practices • Facilitate planning

  20. 60 55 50 1000 45 100 40 10 1 35 0.1 30 0.01 0.001 25 1951 1956 1961 1966 1971 1976 1981 1986 1991 1996 20 15 10 5 0 1968 1973 1978 1983 1988 1993 1998 Poliomyelitis (Paralytic) United States, 1968-1998 Inactivated Vaccine Oral Vaccine Rate/100,000 Population Reported Cases Year Year Source: CDC. Summary of notifiable diseases. 1998.

  21. Uses of Public Health Surveillance • Estimate magnitude of the problem • Determine geographic distribution of illness • Portray the natural history of a disease • Detect epidemics/define a problem • Generate hypotheses, stimulate research • Evaluate control measures • Monitor changes in infectious agents • Detect changes in health practices • Facilitate planning

  22. PPNG 12 TRNG 10 PPNG & TRNG 8 6 4 2 0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 Trends in Plasmid-Mediated Resistance to Penicillin and Tetracycline United States, 1988-1997 Percent Source: Gonococcal Isolate Surveillance Project (GISP) Year

  23. Uses of Public Health Surveillance • Estimate magnitude of the problem • Determine geographic distribution of illness • Portray the natural history of a disease • Detect epidemics/define a problem • Generate hypotheses, stimulate research • Evaluate control measures • Monitor changes in infectious agents • Detect changes in health practices • Facilitate planning

  24. Breast Cancer Screening

  25. Uses of Public Health Surveillance • Estimate magnitude of the problem • Determine geographic distribution of illness • Portray the natural history of a disease • Detect epidemics/define a problem • Generate hypotheses, stimulate research • Evaluate control measures • Monitor changes in infectious agents • Detect changes in health practices • Facilitate planning

  26. 20,000 U.S.-born 16,000 Reported Cases 12,000 8,000 4,000 Year 0 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 Tuberculosis United States, 1986-1998 (U.S.- and foreign-born persons) Foreign-born

  27. Obesity United States, 1987-1998 Not available < 10 % ……. ……. …… 10%-15% >15%

  28. Physical Activity Georgia 1998 PER CENT Responses NO YES Less than 15,000$ 15,000- 24,999$ 25,000- 34,999$ 35,000- 49,999$ $50,000> Source: BRFSS 1998

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