SSG Blog

Public Health Surveillance vs. Research: What’s the Difference?

Posted on October 4th, 2022   |   SSG

Improving public health requires a mix of public health surveillance and research into ongoing health trends. Both are part of the government’s authority to protect the public from the spread or onset of diseases and illnesses, but they represent two different aspects of the process. Public health surveillance focuses on the collection, analysis, and interpretation of public health data, while public health research is about identifying potential determinants that affect the public’s health to help patients and healthcare providers prevent these diseases from affecting more of the population. 

There are many differences between the two, but their work can overlap. They are also dependent on one another. Public health research depends on the quality of data received from the surveillance program. Without public health surveillance and research, providers and officials would have little to no insight into the health of the general population, which limits their ability to keep the public safe. 

What is Public Health Surveillance?

Public health surveillance refers to the activities that allow public health agencies to identify, track, and investigate potential public health hazards, such as the onset of chronic disease, exposure to environmental contamination, or the outbreak of an infectious or communicable disease. The work involves collecting public and private health data related to these potential hazards. This includes patient medical records, lab test results, physician notes, vaccine information, and other data about the affected patient or population that may give researchers a clue into what is causing the disease or illness. 

Public health surveillance is carried out by various public health agencies at the state, local, and federal levels. State agencies collect this information before reporting their findings to various agencies in the federal government. Federal agencies do not contain detailed personalized health records. Instead, they use these reports to track the overall health of the nation or a subset of the population. 

However, there are strict guidelines for public health surveillance, as patient privacy laws protect medical records. The scope of the agency’s work must be limited to what is necessary for the agency to identify, track, and investigate these health trends. The work must be conducted and/or authorized by a public health authority, which is defined as an agency of authority of the United States, including all states, territories, Indian tribes, and any of its employees, contractors, or entities that are acting on its behalf. A public health authority is a public agency organized at the state, local, or federal level. This doesn’t include healthcare organizations, non-profits, and public universities. 

Public health surveillance includes the collection and analysis of vast quantities of data related to potential health hazards or trends of concern. Various types of medical surveillance can include:

  • The detection of potential health signs or signals that may indicate a change in public health, such as the spread of an infectious virus, the number of reported cases or diagnoses within the population;
  • Identifying and monitoring potential hazards that have not yet been recognized by the healthcare community;
  • Adding context to the nature of the outbreak or health trend to assess whether additional public health action is needed;
  • Evaluating the characteristics and lifestyle factors that may contribute to the population’s risk of being affected by these trends;
  • Investigating the scope of the potential trend or problem and how it will likely evolve over time, so that public health officials can implement the appropriate control measures. 

Why is Surveillance Important for Public Health?

Public health surveillance is important for public health because it gives these agencies the information they need to understand the nature of the disease or illness and how it spreads. This data includes important details about the health of the population that may alert officials to potential hazards affecting the population, so they can take action to prevent the illness from affecting more people or recommend action to the appropriate public health authority.

Outbreaks happen unexpectedly and often catch public agencies off guard. New diseases and viruses are also being discovered all the time. If an outbreak should occur, public health surveillance systems will often be the government’s first line of defense. The agency will report on the first cases to learn as much about the disease as possible before it spreads to other parts of the population. 

The medical community’s understanding of various diseases and illnesses is also evolving as researchers learn more about these conditions and what causes them. The knowledge acquired from this information can then be used to further develop treatments, vaccines, and control measures that prevent more cases of the disease or illness from occurring in the population. 

What is Public Health Research?

Public health research seeks to examine the environmental, genetic, and social determinants that affect a person’s health. Researchers incorporate a wide range of data into their work to investigate what is causing the onset or spread of disease within the population. The research can be carried out in various ways, such as case studies, cause-of-death investigations, and reviewing a patient’s medical history and diagnostic information. 

The National Institute of Health is the leading public health research organization in the United States. It aided in the development of numerous treatments for diseases and illnesses, such as cancer, diabetes, and communicable diseases like COVID-19. The NIH works with various health agencies to obtain data on the latest health trends. It oversees both the collection and interpretation of this data as it relates to specific diseases and conditions affecting the public.

Why is Research Important for Public Health?

Research gives public health agencies insight into the data they collect from various providers and organizations. When faced with an emerging health trend or an infectious disease outbreak, researchers look for links and factors that may increase a person’s risk of becoming infected or severely ill. With the help of disease surveillance software, they help to explain causality to give the public a better understanding of how to prevent these conditions.

The culmination of this work is used to gain a better understanding of the factors that make individuals more susceptible to disease, such as access to healthcare, geographic location, and eating and lifestyle habits. For example, researchers discovered older individuals and those with preexisting health conditions like diabetes, heart disease, and cancer were more likely to become ill during the COVID-19 pandemic. 

Once the researchers have made their conclusions, they share their findings with various public health agencies and care coordinators that distribute this information to the public. The researchers may also include recommendations and specific actions the public can take to protect themselves from disease. 

Their findings will also influence public health policy, such as the implementation of restrictions and vaccine requirements designed to limit the spread or onset of disease. For example, once researchers discovered that COVID-19 spreads through respiratory droplets, state and local governments began implementing social distancing requirements to limit in-person gatherings in indoor settings.

The collection of public health data via public health surveillance marks the beginning of the research process. Only after the data has been collected and organized can the researchers start looking for relationships between these data. They will examine the context in which a person was diagnosed with a condition or disease and look for similarities across patients with the same diagnosis. 

Researchers often examine and investigate health conditions and diseases that have not yet been formally recognized by the medical community, in addition to furthering the community’s understanding of previously identified conditions and diseases. Their work focuses on developing effective treatment and prevention methods when no treatment is available. They conduct numerous clinical trials to assess the efficacy of new drugs and treatments to protect the public from disease. 

What is the Difference between Public Health Research and Surveillance?

Public health surveillance and research have a lot in common. Both depend on the collection and interpretation of data, but research depends on the data collected by the surveillance team. Researchers often rely on public health surveys to expand their knowledge of a particular disease or condition. Surveillance falls under the category of research when it involves the collection and analysis of public health data used to generate knowledge that may apply to populations and settings other than the ones in which this data was collected. It may also fall under this category if used to further the medical community’s understanding of a new disease or health condition.

Public health surveillance can also qualify research if data collection includes longitudinal data that examines trends and health conditions over time and makes room for hypothesis and testing. Public health research is not subject to the same guidelines and requirements as surveillance, so it is important to review these activities separately. 

For example, the NIH is funding a study designed to examine how smoking affects a person’s health and its impact on the wider healthcare system. The agency may conduct surveys with individuals that smoke or check cause-of-death records to see if smoking played a role. It would then publish its findings to give patients and providers more information about the health effects of smoking. This would qualify under the public health research definition.

In another example, a public health agency concerned with the health effects of smoking will request data on a specific population with high smoking rates to keep these individuals informed of their health risks. This qualifies under the public health surveillance definition. 

Public health research and surveillance are subject to unique requirements and focus on different aspects of public health. They both involve the collection and interpretation of data, but research applies this information to the wider population, not just the population where this data was collected. Research helps to explain the root causes of infection and identify the factors that can affect a person’s health, while surveillance focuses more on the collection and distribution of public health data to give public health agencies the knowledge they need to keep the public safe.