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An Equity-Based Scoring System for Evaluating Surveillance-Related Harm in Public Health Crises
Bita Amani1,2, Breann McAndrew1, Mienah Z Sharif2,3
1Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA.
Ethnicity & Disease
|June 7, 2024
Summary
Public health surveillance systems can harm communities of color. An equity-based scoring system was developed to evaluate these risks, finding potential harm in half of systems studied.
Area of Science:
- Public Health
- Health Equity
- Surveillance Studies
Background:
- Surveillance systems, while crucial for public health, have historically disproportionately harmed communities of color through mechanisms like criminalization.
- Existing surveillance practices can exacerbate vulnerabilities related to policing, detention, deportation, and access to social services.
Purpose of the Study:
- To develop and pilot a novel, equity-based scoring system to assess the potential and actual risks of surveillance systems.
- To identify specific harms associated with surveillance and evaluate their impact on vulnerable populations.
Main Methods:
- Literature review and expert panel survey to identify surveillance-related harms.
- Development of a scoring system (0-2, U) based on data type and law enforcement sharing.
- Pilot testing on 44 surveillance systems related to COVID-19, behavioral health, and racism.
Main Results:
- 91% of systems received a risk score (0-2), with 9% unassessable (U).
- Half of systems (50%) scored a 1, indicating potential for harm.
- 12% of systems (n=5) scored a 2, showing evidence of actual harm.
Conclusions:
- The potential for surveillance systems to negatively impact racialized and vulnerable populations is significant and understudied.
- The developed scoring system provides a tool to evaluate and mitigate these risks.
- Reconciling public health goals with the imperative to prevent harm to vulnerable communities is essential.
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