Public health surveillance of low-frequency populations

Public health agencies often require data that address the needs of special populations, such as minority groups. Sources of surveillance data often contain insufficient numbers of subjects to fully inform health agencies. In this review, we address the problems of and potential approaches for situations with insufficient surveillance data. We use the examples of race and ethnic minority groups throughout our discussion. However, many of the broad issues are applicable to other special groups with low frequency or who are especially hard to reach. Our recommendations are based, in part, on a symposium held in Missouri with the collaboration of state health agency, community, and academic research participants. We review problems in using existing data and collecting new data, especially from nonprobability samples. We also describe fieldwork issues for reaching and collecting information from special populations. Decisions among methods and solutions may require seeking additional resources for surveillance.