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Epidemiology concerns disease control and entails analyzing disease and health condition determinants in specific populations. It is the core of public health since it molds decisions on policy and practices through risk factor identification in preventive healthcare targets. Freeman et al. (2010) defined public health surveillance as continuous scientific research in regard to events that are health-related to serve the public in taking actions directed toward mortality reduction and health improvement. Governments should uphold the surveillance culture for the betterment of public health.
Rosenkötter (2017) conducted research to determine relevant conditions for public health surveillance advancement in Europe. Several weaknesses surfaced as the study was in motion. Firstly, Europe had several actions, networks, and funded projects for developing public health surveillance capacities; however, the influence and prominence of respective elements fell short, indicating a weak status quo. Secondly, surveillance for public health can use various sources to generate knowledge and information. Data retrieval, analysis, and learning from other countries are all technologically triggered considering the advancements, and this is why approaches and new data sources for public health surveillance emerged. The surveillance systems depend mainly on monitoring methods for surveillance and continuous monitoring of potential new sources of data as well as assessing their significance. Thirdly, the health information system of Europe does not support all information system aspects; hence, experts in public health anticipate sustainable and comprehensible systems covering all elements.
Rosenkötter (2017) identified conditions supportive of the implementation and development of Europe's public health surveillance. The requirements included infrastructure preparation via networks. The second condition entailed improved data collection formalization and routine data collection mechanisms implementation and information-based maintenance approaches. The other condition concerned policy actions where actions were because of crisis occurrence, convincing narratives establishment, and influences from different policy sectors.
Freeman et al. (2010) described public health systems to have relied on surveillance for the planning of health programs explaining that surveillance systems are there because of chronic diseases. One of the chronic diseases affecting the public and in need of surveillance is mental illnesses. The data collection system for mental health emphasizes disease prevalence measurement and healthcare use. Freeman et al. (2010) stated that in America, approximately 26% of the adult population have mental disorders diagnosed in any given year. Public health surveillance operated independently from mental health traditionally, but that changed with the first surgeon's mental health report in 1999 (Freeman et al., 2010). The government has since then built infrastructure to establish a continuous mental health surveillance system. It is crucial to comprehend the bond between chronic disease and mental health for the assessment of public health and care delivery. In surveillance, the primary tool used is BRFSS, which mostly deals with the estimation of chronic disease preventive services, access to healthcare, and behaviors risking health. The BRFSS is for adults who are not institutionalized, and to widen its reach; systems are in place. The BRFSS systems entail special oversampling of population, callback surveys, and mobile and telephone numbers, not forgetting paper surveys. What makes BRFSS unique is the fact that there is the production of data at all levels, including micro and metropolitan, state, and county. US government agencies in the health and human services department are coming together to make new while expanding old systems for monitoring mental diseases. The monitoring of mental illness is through the incorporation of standard measures of mental health in continuous surveys. These surveys include federal, extensive benchmarks for psychiatric epidemiology with the facilitation of surveillance of health risk factors. The surveillance surveys comprise variables of mental health at local and state levels (Freeman et al., 2010).
The surveillance systems put in place by the US Health department exhibit strengths in the fact that they exist and function at different levels, such as county and state. The systems are, however, meant for only mental health; hence in the case of other chronic diseases, the US government would have to create new systems all together with a move that is impractical due to its complexity. Considering that chronic diseases are many, the US government should place orders that can cover a broad spectrum of diseases. It is upon researchers and scholars to expound knowledge on how governments can create and develop surveillance systems to cover all chronic diseases, i.e., the creation of multi-disease surveillance systems. The issue of multi persistent disease surveillance also concerns Europe's public health advancement of surveillance systems considering the information system available does not support all elements. Europe's public health surveillance is not only less widespread but also requires enormous investments considering data collection relies heavily on advanced technology. If Europe were to comply with the conditions identified for supporting public health surveillance, it would seem impractical since government policymakers have to consider other sectors apart from health when it comes to resource allocation.
In conclusion, for better public health, surveillance should be maintained. Although, in theory, the culture of public health surveillance is responsible for effective preventive measures of chronic diseases, practically, monitoring may prove difficult. What makes surveillance impractical is the fact that system development not only needs significant investments but also policymakers need to balance all sectors, not just health. Since monitoring should be continuous and not by event for effective management of public health, it is upon scholars and researchers to venture into studies for balancing the scale between the health sector and other policy sectors while providing solutions to the funding aspect.
Rosenkötter, N. (2017). Advancing public health surveillance in Europe. [ Doctoral Thesis, Maastricht University]. Maastricht University. https://doi.org/10.26481/dis.20170212nr
Freeman, E.J., Colpe, L.J., Strine, T.W., Dhingra, S., McGuire, L.C., Elam-Evans, L.D., & Geraldine, S. P. (2010). Public health surveillance for mental health. Prev Chronic Disease,7(1), 1-7. http://www.cdc.gov/pcd/issues/2010/jan/09_ 0126.htm
Cultural Factors in Epidemiology
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