Data and Surveillance

Public Health Surveillance Data

CDC defines public health surveillance as “the ongoing, systematic collection, analysis, and interpretation of health-related data”. This data is “essential to planning, implementation, and evaluation of public health practice”. There are three types of surveillance data:

1. Risk factor surveillance data provides information that helps to

• Identify populations at higher risk of chronic health conditions;
• Monitor changes in health risk behaviors and disease rates;
• Establish prevention strategies at local and state levels.[1]

Example: Behavioral Risk Factor Surveillance System (BRFSS)

2. Mortality surveillance data is a way to track characteristics of those who have died. It is most often used for:

• Monitoring and making decisions about public health challenges
• Monitoring trends in preventable deaths
• Raising awareness of fatal health conditions
• Identifying strategies for preventing additional deaths
• Comparing death trends with other countries
• Determining life expectance[2]^,[3]

Example: National Vital Statistics System

3. Syndromic surveillance data is a way to detect, understand, and monitor health events.

• When a person seeks treatment from an emergency department or urgent care, de-identified information is sent to state or local health departments.
• All the data is combined into a national database and analyzed for trends.
• After trends are identified, CDC and other public health organizations use this to share knowledge, build skills, and collaborate to respond to the problem.

Example: National Syndromic Surveillance Program

Learn more about surveillance in public health here.

Local Data

While surveillance data can be useful, it is not the only, or even the best, type of data to tell the story of your community. State and national level data does not always translate to your specific communities’ strengths or needs and is not always easily accessible at the local level. Consider the type of data you can collect through your partnerships, prevention and intervention efforts, and other local agencies. Most grants require some level of data collection, so consider asking funded agencies what type of information they are collecting. This information can assist you in better understanding the level of need and how big the gap is between the need and the services offered. For example, utilization, referral, and staffing reports at a local homeless shelter may be easily accessible and can help you better understand the demographics and needs of your population. Partnering with your local child advocacy center, who is required to provide monthly statistics if nationally accredited, will give you access to information that will help you better understand the incidence of sexual and physical abuse in your community.

Also consider utilizing previously completed assessments in your community. A Community Needs Assessment (CNA), Community Health Assessment (CHA), or Community Health Improvement Plan (CHIP), can be a great starting place to understanding the health status of your community and social determinants of health that may be at play.

NACCHO’s Public Health Infrastructure and Systems (PHIS) has compiled information and resources related to CHAs that may be useful.

PLACES provides health data at the county-, place-, census tract-, and zip code-level.

[1] Centers for Disease Control and Prevention. Behavioral risk factor surveillance system webpage. Retrieved July 7, 2022, from https://www.cdc.gov/chronicdis...

[2] Ramchand, R., Colpe, L., Claassen, C., Brinton, S., Carr, C., McKeon, R., & Schoenbaum, M. (2021). Prioritizing Improved Data and Surveillance for Suicide in the United States in Response to COVID-19. American journal of public health, 111(S2), S84–S88. https://doi.org/10.2105/AJPH.2...

[3] Centers for Disease Control and Prevention. Mortality statistics webpage. Retrieved July 7, 2022, from https://www.cdc.gov/nchs/nvss/...

Data tells stories that can be used internally to identify priority areas and areas of improvement, or externally raise awareness, gain community buy-in, communicate your programming, explore funding opportunities.

When telling the story of the intersection of suicide, overdose, and ACEs within your communities, try to collect data beyond general rates of suicide, overdose, and ACEs. Some examples include:

1. Social determinants of health (e.g., homelessness, discrimination, income inequality, access to health care). This data can be collected in several different ways. Several validated tools are available; a 2019 review can be found here.
2. Risk and protective factors (e.g., familial support, education, spirituality, stigma, social support, food insecurity, family history of trauma)

Once the data is compiled, consider key questions that can frame the story in your community and help you think critically about what questions remain unanswered or information remains unknown:

• What are the overall trends of suicide, overdose, and ACEs?
• What seems to be impacting these trends?
• Where are these trends overlapping or interconnected?
• Are there differences between demographics or social determinants of health?
• What other factors may be impacting the trends?

Allow the story to highlight areas that could be impacted by changes in funding, policy, programming, or public health education. Remember the data just are. They are not good or bad. Sometimes data tells us the story we want to be telling, and sometimes they help us see where we want to change the story.

Having the most up-to-date data will allow you to (1) gather useful information on your community for planning and (2) measure current impact of prevention and mitigation efforts, adjusting your plan as needed. Plan how your LHD will collect, review, analyze, and incorporate this information including.

Consider:

• The best ways to access the type of information you need to target suicide, overdose, and ACEs and their shared risk and protective factors in your community
• A plan for standardized data collection by your LHD, including who will be responsible for compiling and reviewing data
• An understanding of the data other agencies – local, state, and national – are collecting and how frequently new data is available
• How others in your community are using data
• What opportunities exist within current partnerships to collect, analyze, and plan using local data
• How the data lends itself to new funding, partnerships, and programming opportunities
• A plan for the analysis and dissemination of new data to both internal and external audiences

Look at the ways in which the risk and protective factors of suicide, overdose, and ACEs are intersecting in your community. See how these factors change over time. Consider:

• Which intersecting risk and protective factors are the most prevalent in your current population
• How targeting some of these risk factors may be impacting the presence of suicide, overdose, and adversity
• Which protective factors seem strongest and how this may be benefiting your community or could be leveraged to benefit your community in additional ways
• The partnerships that could be enhancing protective factors and minimizing risk factors for suicide, overdose, and ACEs