“From TB to HIV/AIDS to cancer, disease tracking has always had a political dimension, but it’s the foundation of public health,” co-authored by University Professor Amy Fairchild, was published in The Conversation.

The article talks about the history and ethics of surveillance, the three major controversies in the history of public health that underscore what is at stake with the collection and maintenance of this information, and the key lessons that have emerged.

Following is an excerpt:

In the broader history of surveillance, two key lessons have emerged.

First, despite some pitched battles, communities have more often viewed surveillance as serving their interests.

Second, the system of public health surveillance in the U.S. remains an underfunded patchwork. The Pew Environmental Health Commission called birth defects surveillance “woefully inadequate.” In 1972, the U.S. House Committee on Government Operations described occupational disease surveillance as “70 years behind infectious disease surveillance and counting.” In 2010, we ourselves observed that it was now “a century behind and counting.”

The scope of the changes that the Trump administration has planned for federal data systems and datasets is unclear. Per a federal court order, key public health surveillance systems and datasets are back online. But the landing pages for both the Social Vulnerability Index and the Youth Risk Behavior Survey display a caveat based in politics rather than science that “any information on this page promoting gender ideology is extremely inaccurate and disconnected from the immutable biological reality that there are two sexes, male and female.”

Systems can be compromised if datasets are scrubbed of key variables that enable public health action with populations at highest risk, are halted, or are removed from the public eye. Communities cannot act on what they cannot count.