Public Health Data Authority

How data currently come to public health

• Data used by public health come from a wide variety of places within our communities: hospitals, laboratories, doctors' offices, clinics, pharmacies, restaurants, and other community locations.
• Data come to public health agencies in a variety of formats, and the types of data reported can vary by state or jurisdiction.
• State and local laws define what data is reportable to them and how the data can be used.
• Data that come to public health then need to be assembled, reviewed, and analyzed before the data can be used to inform action.
• After receiving data, state and local public health agencies often have to follow up to collect missing information, which can delay detection of and response to health threats.
• At the federal level, CDC receives deidentified data (i.e., data that has had personally identifiable information removed to protect anonymity) from a variety of sources, such as state and local public health agencies, laboratories, and healthcare facilities.
  • These data provide a national picture of health problems and an early warning of emerging threats.
  • CDC operates under strict guidelines to ensure that all data collected and used complies fully with privacy and security regulations.

What is data authority?

Public health data authority refers to the legal rights and frameworks that enable a federal, state, tribal, territorial or local government entity to require the collection, management and sharing of information for public health purposes.

• Authority to require the reporting of public health data in the United States resides largely with state and local governments. Jurisdictions' laws define what data is reportable to them and how the data can be used.
• CDC relies almost entirely on voluntary reporting of public health data. CDC may receive and request data, but the agency has no general legal authority to require states, US territories, counties, cities or healthcare organizations to report data to CDC or to any other public health agency.
• This has led to a de-centralized and fragmented public health data environment, with varying levels of data sharing among federal, state and local agencies, resulting in gaps in information needed for public health situational awareness, emergency preparedness and outbreak response.
• Such gaps could make it harder for our nation to detect and respond effectively to the next health threat.

Why public health needs federal level data authority

CDC needs data authority at the federal level to help identify and respond to health threats.

• While some data authorities exist at state and local level, federal authority will result in more efficient and effective information sharing before and during emergencies to inform timely decisions at the federal, state and local levels.
• Public health must be able to answer critical questions, such as—
  • Where are cases occurring?
  • How many hospital beds are available?
  • Are there outbreaks in nursing homes?
  • Are certain racial or ethnic groups more impacted?
  • Are vaccines or treatments working?
• Public health must be ready to identify and respond to emerging health threats, and data authority at CDC will help the entire public health field be ready.
  • When the COVID-19 pandemic first hit, it took too long for public health to access important data.
  • Data authorities will ensure that public health has the right data, in the right place at the right time to inform decision-making and act quickly.

What would data authority do?

Data authority at CDC would modernize public health's legal ability to support public health activities in a timely and coordinated way across the public health system.

• Modernized CDC data authority will help standardize how data are reported, which means better data for federal, state, local, territorial, and tribal partners—and less burden on data providers. Without standardized data reporting, public health can receive data that is slow, incomplete, lower quality, and more challenging to put together for decision-making.
• Data authority at the federal level would also ensure that data is shared securely across public health.

Who benefits from CDC having data authority?

The public: Faster, more complete, coordinated data will enable public health authorities to alert the public more quickly about health threats, empowering them to make informed decisions about their health and safety.

Healthcare providers: Hospitals, doctors, and laboratories often face multiple reporting requirements that vary by jurisdiction. Healthcare providers also need timely information about health concerns and outbreaks in their community so they can better serve their patients.

Federal authority to coordinate health data reporting would reduce this burden and make it easier for providers to report to multiple jurisdictions and receive timely data in return. Better, faster data will help healthcare providers make better decisions to protect their patients.

State and local jurisdictions: A state or local health department's authority ends at its borders, but health threats don't. Outbreaks often cross state and county lines.

A nationally led and coordinated approach to data reporting would allow neighboring jurisdictions to be aware of and prepare for threats as they emerge. Data authority would facilitate communication and collaboration between healthcare and public health, especially when healthcare providers see patients from multiple jurisdictions. It would also streamline, simplify, and harmonize reporting requirements across jurisdictions and enable state and local health departments to share data more easily with one another.

CDC and national partners: Data authority would enable CDC to set consistent standards for reporting public health data while strictly adhering to privacy standards and laws. It would help streamline the use and implementation of data use agreements across multiple state and local jurisdictions.

In turn, these improvements would make it much easier for public health agencies and decision-makers at all levels—federal, state or local—to

• Develop a clear picture of what is happening during an emergency and respond more swiftly and effectively
• Monitor and prevent the health problems we see every day—such as workplace injuries, sexually transmitted diseases or drug overdoses
• Identify and address health disparities affecting certain groups