Public Health Surveillance Systems Research Articles

Enhancing Public Health Surveillance: Outbreak Detection Algorithms Deployed for Syndromic Surveillance During Arbaeenia Mass Gatherings in Iraq.

Large gatherings often involve extended and intimate contact among individuals, creating environments conducive to the spread of infectious diseases. Despite this, there is limited research utilizing outbreak detection algorithms to analyze real syndrome data from such events. This study sought to address this gap by examining the implementation and efficacy of outbreak detection algorithms for syndromic surveillance during mass gatherings in Iraq. For the study, 10 data collectors conducted field data collection over 10 days from August 25, 2023, to September 3, 2023. Data were gathered from 10 healthcare clinics situated along Ya Hussein Road, a major route from Najaf to Karbala in Iraq. Various outbreak detection algorithms, such as moving average, cumulative sum, and exponentially weighted moving average, were applied to analyze the reported syndromes. During the 10 days from August 25, 2023, to September 3, 2023, 12202 pilgrims visited 10 health clinics along a route in Iraq. Most pilgrims were between 20 and 59 years old (77.4%, n=9444), with more than half being foreigners (58.1%, n=7092). Among the pilgrims, 40.5% (n=4938) exhibited syndromes, with influenza-like illness (ILI) being the most common (48.8%, n=2411). Other prevalent syndromes included food poisoning (21.2%, n=1048), heatstroke (17.7%, n=875), febrile rash (9.0%, n=446), and gastroenteritis (3.2%, n=158). The cumulative sum (CUSUM) algorithm was more effective than exponentially weighted moving average (EWMA) and moving average (MA) algorithms for detecting small shifts. Effective public health surveillance systems are crucial during mass gatherings to swiftly identify and address emerging health risks. Utilizing advanced algorithms and real-time data analysis can empower authorities to improve their readiness and response capacity, thereby ensuring the protection of public health during these gatherings.

How do we understand the value of drug checking as a component of harm reduction services? A qualitative exploration of client and provider perspectives

BackgroundMortality related to opioid overdose in the U.S. has risen sharply in the past decade. In California, opioid overdose death rates more than tripled from 2018 to 2021, and deaths from synthetic opioids such as fentanyl increased more than seven times in those three years alone. Heightened attention to this crisis has attracted funding and programming opportunities for prevention and harm reduction interventions. Drug checking services offer people who use drugs the opportunity to test the chemical content of their own supply, but are not widely used in North America. We report on qualitative data from providers and clients of harm reduction and drug checking services, to explore how these services are used, experienced, and considered.MethodsWe conducted in-depth semi-structured key informant interviews across two samples of drug checking stakeholders: “clients” (individuals who use drugs and receive harm reduction services) and “providers” (subject matter experts and those providing clinical and harm reduction services to people who use drugs). Provider interviews were conducted via Zoom from June-November, 2022. Client interviews were conducted in person in San Francisco over a one-week period in November 2022. Data were analyzed following the tenets of thematic analysis.ResultsWe found that the value of drug checking includes but extends well beyond overdose prevention. Participants discussed ways that drug checking can fill a regulatory vacuum, serve as a tool of informal market regulation at the community level, and empower public health surveillance systems and clinical response. We present our findings within three key themes: (1) the role of drug checking in overdose prevention; (2) benefits to the overall agency, health, and wellbeing of people who use drugs; and (3) impacts of drug checking services at the community and systems levels.ConclusionThis study contributes to growing evidence of the effectiveness of drug checking services in mitigating risks associated with substance use, including overdose, through enabling people who use and sell drugs to test their own supply. It further contributes to discussions around the utility of drug checking and harm reduction, in order to inform legislation and funding allocation.

Editorial: Public health surveillance systems and outbreak response: evidence from the field

Editorial: Public health surveillance systems and outbreak response: evidence from the field

Strengthening event-based surveillance (EBS): a case study from Afghanistan

SummaryThe sustained instability in Afghanistan, along with ongoing disease outbreaks and the impact of the COVID-19 pandemic, has significantly affected the country.During the COVID-19 pandemic, the country’s detection and response capacities faced challenges. Case identification was done in all health facilities from primary to tertiary levels but neglected cases at the community level, resulting in undetected and uncontrolled transmission from communities. This emphasizes a missed opportunity for early detection that Event-Based Surveillance (EBS) could have facilitated.Therefore, Afghanistan planned to strengthen the EBS component of the national public health surveillance system to enhance the capacity for the rapid detection and response to infectious disease outbreaks, including COVID-19 and other emerging diseases. This effort was undertaken to promptly mitigate the impact of such outbreaks.We conducted a landscape assessment of Afghanistan’s public health surveillance system to identify the best way to enhance EBS, and then we crafted an implementation work plan. The work plan included the following steps: establishing an EBS multisectoral coordination and working group, identifying EBS information sources, prioritizing public health events of importance, defining signals, establishing reporting mechanisms, and developing standard operating procedures and training guides.EBS is currently being piloted in seven provinces in Afghanistan. The lessons learned from the pilot phase will support its overall expansion throughout the country.

Awareness and Knowledge of Chikungunya Virus Infection Among Healthcare Workers in Hulu Langat District.

As Chikungunya virus (CHIKV) infection continues to rise globally, including in Malaysia, it is essential for healthcare workers (HCWs) to have adequate knowledge about the disease for diagnostic accuracy and to improve public health surveillance systems. This study aimed to assess awareness and measure the level of knowledge of CHIKV infection among HCWs in the Hulu Langat district and explore associated sociodemographic and skill-related factors. This was a cross-sectional study in which the questionnaire was physically distributed to participants using the universal sampling method. All participants (100%) were aware of CHIKV infection, and most (80.1%) had knowledge of the disease. Furthermore, networks such as professional members, family, and friends (27.8%), followed by professional development programs (23.1%), were identified as the common platforms utilized by HCWs to access information regarding CHIKV infection. Ordinal logistic regression analysis further demonstrated that the level of education (odds ratio [OR] = 2.23, 95% confidence interval [CI] [1.14, 4.35]) and HCWs who attended Continuing Medical Education (CME)/courses on CHIKV infection (OR = 1.73, 95% CI [1.00, 3.01]) and had experience in handling the case (OR = 3.23, 95% CI [1.44, 7.28]) were significantly associated with awareness and knowledge of the disease. Implementing continuous education and training can enhance HCWs' understanding of CHIKV infection.

Community-based surveillance programme evaluation using the platform Nyss implemented by the Somali Red Crescent Society—a mixed methods approach

BackgroundSomali Red Crescent Society (SRCS), supported by Norwegian Red Cross, has implemented community-based surveillance (CBS) in Somaliland. This methodology aims to reduce the high risk of epidemics by strengthening early warning and response from and at community level, particularly where there is a weak public health surveillance system. CBS is implemented through SRCS community volunteers, who report signals from the community via SMS to the software platform Nyss. This paper presents key findings from the CBS programme evaluation.MethodsA retrospective observational mixed-methods approach to evaluate the CBS programme was conducted, using routine CBS data from 2021 for Awdal and Togdheer regions and qualitative interviews with stakeholders’ representatives.ResultsThe usefulness of the CBS programme in preventing, detecting, and responding to disease outbreaks was acknowledged by the stakeholders’ representatives. 83% of the signals in Awdal region matched a Community Case Definition (CCD) and were escalated to the Ministry of Health and Development (MoHD)). For Togdheer region, 97% were escalated. Verification of signals by supervisors and escalation to the authorities was done timely.Alert outcome and response action was not well recorded, therefore there is limited evidence on sensitivity. The programme was shown to be simple and can be flexibly adjusted for new diseases and changing CCDs.Stakeholders appreciated being engaged, the good collaboration, their participation throughout the implementation and expressed high acceptance of the programme.ConclusionCBS can support early warning and response for a variety of public health risks. Improved documentation for alert outcomes could help to better evaluate the sensitivity of CBS. A participatory approach is vital to achieve successful community volunteer engagement. Software tools, such as the Nyss platform, can be useful to support effective and efficient CBS implementation.

Algorithmic Approach to Determination of Epidemic Thresholds in Infectious Disease Surveillance Systems

Introduction: This review is devoted to the algorithmic approach to establishing epidemic thresholds for a wide range of diseases, including influenza and acute respiratory infections. Objective: To compare Russian and foreign approaches to the determination of epidemic thresholds within public health surveillance systems. Materials and methods: To reveal the algorithmic approach to establishing epidemic thresholds in the epidemiological surveillance system, we summarized the results of 14 foreign scientific works and two domestic method guidelines published before December 31, 2023. The literature search was conducted in the eLibrary, CyberLeninka, PubMed, and Google Scholar databases using the keywords “epidemic threshold” and “epidemic”. We compared domestic and foreign algorithms for establishing epidemic thresholds by various characteristics, including the statistical method used, determination of a numerical value of the epidemic threshold, complexity of the algorithm, and the possibility of automating calculations. Results: Here we discuss the classification and comparative characteristics of the basic algorithms for determining epidemic thresholds used in various countries of the world when carrying out epidemiological surveillance (including the syndromic one). We describe the existing methods for establishing and presenting epidemic thresholds, as well as the sequence of steps for performing the Farrington algorithms, the Early Aberration Detection System C1–C3, the Method of Moving Epidemics, the Method of Moving Percentiles, Multi-level identification of increasing activity by indicators taking into account mixed effects, as well as algorithms provided in Russian Method Guidelines MR 3.1.2.0118–17 and MR 3.1.2.0303–22. We also dwell on the problems of development, accuracy assessment and prospects for the implementation of existing and developed algorithms. Conclusions: Current algorithms for establishing epidemic thresholds in epidemiological surveillance systems around the world are diverse; they rely on different statistical methods and vary in complexity. To date, there is no convincing evidence of higher efficiency of any algorithm.

Brief Commentary: Using a Logic Model to Integrate Public Health Informatics Into Refinements of Public Health Surveillance System

The COVID-19 pandemic has been a watershed moment in public health surveillance, highlighting the crucial role of data-driven insights in informing health actions and policies. Revisiting key concepts— public health, epidemiology in public health practice, public health surveillance, and public health informatics—lays the foundation for understanding how these elements converge to create a robust public health surveillance system framework. Especially during the COVID-19 pandemic, this integration was exemplified by the WHO efforts in data dissemination and the subsequent global response. The role of public health informatics emerged as instrumental in this context, enhancing data collection, management, analysis, interpretation, and dissemination processes. A logic model for public health surveillance systems encapsulates the integration of these concepts. It outlines the inputs and outcomes and emphasizes the crucial actions and resources for effective system operation, including the imperative of training and capacity development.

Rethinking the World Health Organization's leadership of global health governance and the global health surveillance systems.

Global health governance is a strategic priority for the World Health Organization (WHO), and the public health surveillance system (PHSS) is a fundamental element of the global health governance structure to timely identify emerging diseases and guide global public health decisions and actions. This analysis explores the overall landscape of global health governance, with a specific focus on the PHSS to understand whether the existing governance landscape facilitates or undermines the WHO's ability to formulate and implement global health policies and initiatives. To achieve this, the existing evidence was reviewed, and synthesized with the experts' perspectives. It is reported that fragmentation is the main drawback of the global health governance landscape, necessitating reorganization and restructuring. The disintegration of PHSS at the global, regional and local levels is associated with a lack of leadership, misalignment with global health priorities, imbalance in coverage of surveillance systems, inadequate innovative technology and digitalization, and fragmented data and information systems. The fragmentation and disintegration of global health governance undermine the effectiveness of the WHO's global health strategic directions and programmes and hinder its ability to govern and guide the global, regional and national public health emergency response. Strategic rethinking of the WHO's governance is essential because strong governance and leadership lead to a robust, aligned and effective PHSS.

Effect of environmental variables on the incidence of Visceral Leishmaniasis in Brazil and Colombia

Visceral Leishmaniasis (VL) is the most severe of the three forms of Leishmaniasis. In the Americas, Brazil and Colombia present more than 90 % of the cases in the region. Our aim in this research was to estimate the association of the incidence rate of Visceral Leishmaniasis with the following environmental variables: the percentage of area suitable for the vector Lutzomyia longipalpis, the episodes of La Niña and El Niño, the Brazilian and Colombian biomes. Epidemiological data were obtained from the Brazilian Notifiable Diseases Information System and the Colombian National Public Health Surveillance System. Environmental data were downloaded from the NASA Giovanni web app, the Modis Sensor database, and the meteorological agencies of Australia, Japan, and the United States of America. Records of the presence of Lu. longipalpis were obtained from public databases and previous studies. As a result, the incidence per 10,000 inhabitants with LEBS for each El Niño-Southern Oscillation (ENSO) episode showed the largest values during El Niño 2015–2016, mainly in Brazil's Northeast and Central regions and the Northeast region of Colombia. Compared with the Neutral 2012–2014 episode, the episodes of El Niño 2015–2016 and La Niña 2010–2011 showed an average increase in the monthly incidence rate of VL, and the average increase was higher during El Niño 2015–2016 (aIRR = 2.304 vs.1.453) We found a positive association between the incidence rate of VL and the El Niño 2015–2016 episode and an impressive% of area suitable for the vector Lu. longipalpis in the Amazon region.An increase of 1 % in the area suitable for the vector Lu. longipalpis leads to an average rise of 0.8 % in the monthly incidence rate of VL. Our study shows a possible association between VL incidence and ENSO, with the most considerable incidence rates observed during El Niño 2015–2016 in Brazil's Northeast and Central regions and the Northeast region of Colombia. The present study is very important to better understand the Visceral Leishmaniasis transmission dynamics.

Evaluation of an Infection surveillance program in residential aged care facilities in Victoria, Australia.

Infection surveillance is a key element of infection prevention and control activities in the aged care sector. In 2017, a standardised infection surveillance program was established for public residential aged care services in Victoria, Australia. This program will soon be expanded to a national level for all Australian residential aged care facilities. It has not been evaluated since its inception. The current study aimed to evaluate the Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre Aged Care Infection Indicator Program (ACIIP), to understand its performance and functionality. A mixed methods evaluation was performed using the Updated Guidelines for Evaluating Public Health Surveillance Systems developed by the United States Centers for Disease Control and Prevention as a framework. VICNISS staff who coordinate and manage the ACIIP were invited to participate in interviews. Residential aged care staff who use the program were invited to participate in a survey. Document analysis was also performed. Four VICNISS staff participated in the interviews and 38 aged care staff participated in the survey. The ACIIP is stable and able to be adapted quickly to changing definitions for infections. Users found the system relatively easy to use but have difficulties after the long intervals between data entry year on year. VICNISS staff provide expert guidance which benefits users. Users appreciated the benefit of participating and many use the data for improving local practice. The ACIIP is a usessful state-wide infection surveillance program for aged care. Further development of data validation, IT system capacity and models for education and user support will be required to support future scalability.

Concepts, objectives and analysis of public health surveillance systems

Public health surveillance (PHS) systems are an important tool to map the distribution and burden of disease as well as enable efficient distribution of resources to fight a disease. The surveillance systems are used to detect, report, track a disease as well as assess the response to the disease and people's attitudes. PHS systems are changing with the rapid change in technology and are becoming more real-time responsive with availability of new type of data such as online content and social media data. This review presents the basics of surveillance systems and develop from it to show the evolution of surveillance systems. The different forms of data available, surveillance methods and surveillance types are also reviewed such as social media based, web-based and clinical data based PHS maps. This review provide comprehensive details of the surveillance systems in terms of data types used, source of data and purpose of the surveillance system.

Studying usability of public health surveillance maps through framework based heuristic evaluation

Public health surveillance systems play a crucial role in detecting and responding to disease outbreaks. Visualizations of surveillance data are important for decision-making, but little attention has been paid to the usability and interaction of such systems. In this paper, we developed a set of 10 heuristics to assess the visualization and usability of public health surveillance systems. The heuristics cover aspects of perception, cognition, and interaction. The perception deals with how the system looks in the first glance and whether it has pleasant effect on the user or otherwise. Cognition deals with the question of whether enough information is provided to use the system, while usability and interaction deal with whether the system is user-friendly in terms of the tools provided for interaction and use. We recruited a panel of experts to evaluate a set of systems using our heuristics. Results showed that there was variation in the scores of the experts' assessments, indicating the importance of multiple expert evaluations. Our heuristics provide a practical and comprehensive tool for assessing the visualization and usability of public health surveillance systems, which can lead to improved decision-making and ultimately better public health outcomes. The results suggest that the heuristic based evaluation through a panel of experts can provide meaningful results and insights into the usability aspects of public health systems. The results suggest that for some systems there can be agreement in terms of evaluation while for some other systems the experts’ opinions can vary based on the weightage and importance each expert gives to a particular aspect.

The Zika virus emergency in Brazil and the federal response of the National Public Health Surveillance and Brazilian Health Regulatory Systems

Resumo O artigo analisa a resposta federal dos Sistemas Nacionais de Vigilância em Saúde e de Vigilância Sanitária frente à epidemia do Zika vírus no Brasil, de 2015 a 2018, com foco nos contextos político-institucionais e no conteúdo das medidas governamentais desenvolvidas no período. O estudo ancorou-se na abordagem institucionalista histórica, compreendendo análise documental e entrevistas com atores-chave. A resposta se caracterizou pela priorização inicial da emergência sanitária na agenda política do governo federal, reduzindo-se ao longo do período, influenciada pelas crises financeira e política. Verificou-se multiplicidade de atores e instâncias voltadas à contingência, com certa articulação entre os dois sistemas, a partir de experiências pré-emergência próprias. O controle vetorial teve centralidade, valorizando ações intersetoriais e comunitárias, induzidas sobretudo pela Secretaria de Vigilância em Saúde do Ministério da Saúde e complementarmente pela Agência Nacional de Vigilância Sanitária. Observaram-se expressivas limitações alocativas de recursos financeiros novos e mudanças no aparato organizativo de resposta, com efeitos para a continuidade das políticas no pós-emergência, incluindo o desenvolvimento de medicamentos, vacinas e testes. A Emergência em Saúde Pública do Zika Vírus no Brasil foi marcada por limitada institucionalização de aprendizados e estratégias estruturantes, reduzindo oportunidades para a (re)organização das vigilâncias no Sistema Único de Saúde.

A emergência do Zika vírus no Brasil e a resposta federal dos Sistemas Nacionais de Vigilância em Saúde e de Vigilância Sanitária

Abstract The article analyzes the federal response of the National Public Health Surveillance and Brazilian Health Regulatory Systems to the Zika virus epidemic in Brazil, from 2015 to 2018, focusing on the political-institutional contexts and the content of government measures developed during the period. The study was anchored in the historical institutionalist approach, comprising documentary analysis and interviews with key actors. The response was characterized by the initial prioritization of the health emergency on the federal government's political agenda, which was reduced over the period, influenced by the financial and political crises. There was a multiplicity of actors and instances focused on contingency, with a certain articulation between the two systems, based on their own pre-emergency experiences. Vector control had centrality, valuing intersectoral and community actions, induced mainly by the Health Surveillance Secretariat of the Ministry of Health and additionally by the National Health Surveillance Agency. Significant allocation limitations of new financial resources and changes in the organizational response apparatus were observed, with effects on the continuity of post-emergency policies, including the development of medicines, vaccines and tests. The Zika Virus Public Health Emergency in Brazil was marked by limited institutionalization of learning and structuring strategies, reducing opportunities for the (re)organization of surveillance in the Unified Health System.

Evaluation of the Universal Salt Iodization (USI) surveillance system in Tanzania, 2022.

The evaluation of surveillance systems has been recommended by the World Health Organization (WHO) to identify the performance and areas for improvement. Universal salt iodization (USI) as one of the surveillance systems in Tanzania needs periodic evaluation for its optimal function. This study aimed at evaluating the universal salt iodization (USI) surveillance system in Tanzania from January to December 2021 to find out if the system meets its intended objectives by evaluating its attributes as this was the first evaluation of the USI surveillance system since its establishment in 2010. The USI surveillance system is key for monitoring the performance towards the attainment of universal salt iodization (90%). This evaluation was guided by the Center for Disease Control Guidelines for Evaluating Public Health Surveillance Systems, (MMWR) to evaluate USI 2021 data. The study was conducted in Kigoma region in March 2022. Both Purposive and Convenient sampling was used to select the region, district, and ward for the study. The study involved reviewing documents used in the USI system and interviewing the key informants in the USI program. Data analysis was done by Microsoft Excel and presented in tables and graphs. A total of 1715 salt samples were collected in the year 2021 with 279 (16%) of non-iodized salt identified. The majority of the system attributes 66.7% had a good performance with a score of three, 22.2% had a moderate performance with a score of two and one attribute with poor performance with a score of one. Data quality, completeness and sensitivity were 100%, acceptability 91.6%, simplicity 83% were able to collect data on a single sample in < 2 minutes, the system stability in terms of performance was >75% and the usefulness of the system had poor performance. Although the system attributes were found to be working overall well, for proper surveillance of the USI system, the core attributes need to be strengthened. Key variables that measure the system performance must be included from the primary data source and well-integrated with the Local Government (district and regions) to Ministry of Health information systems.

Developing and Establishing Attribute-based Surveillance System: A Review

Abstract This review was conducted by analysing the nine attributes of the surveillance system according to Updated Guidelines for Evaluating Public Health Surveillance Systems. Information was collected using various databases by setting keywords and the inclusion and exclusion criteria. The results showed that 67% of surveillance system implementations used sentinel surveillance and 33% used epidemiological studies. Surveillance system activities: 83% used active and passive surveillance, whereas 17% used only passive surveillance. The adequacy assessment found that 50% met the attributes of surveillance systems in Nigeria, Indonesia and Pakistan, whereas 50% did not meet the attributes of surveillance systems in Ghana, Australia and Ethiopia. This variability was due to geographical differences, the number of informants and experts, the level of collaboration and the health policies of each country. It is recommended that surveillance systems should aim to meet these nine attributes from the design to implementation stage.

Artificial intelligence in environmental health and public safety: A comprehensive review of USA strategies

This study explores the transformative role of artificial intelligence (AI) in environmental health and public safety within the USA, focusing on pollution monitoring, emergency response, and sustainable practices for public. With the growing challenges posed by climate change, pollution, and emerging public health threats, the integration of Artificial Intelligence (AI) in environmental health and public safety strategies has become imperative. This comprehensive review explores the diverse array of AI applications implemented in the United States to address environmental issues and enhance public safety measures. The paper analyzes the multifaceted role of AI across various domains, including air and water quality monitoring, disease surveillance, disaster response, and infrastructure resilience. The advancements in AI technologies that have revolutionized data collection, analysis, and prediction in environmental health are examined. Machine learning algorithms, sensor networks, and satellite imagery are examined as tools for real-time monitoring and early detection of environmental hazards. Additionally, the paper investigates the integration of AI in public health surveillance systems, showcasing how predictive analytics and data-driven models contribute to the identification and containment of infectious diseases. Furthermore, the study sheds light on the incorporation of AI in disaster management, emphasizing the role of predictive modeling and risk assessment in optimizing emergency response strategies. The implementation of smart city technologies and intelligent infrastructure systems is discussed, highlighting how AI contributes to enhancing public safety and minimizing the impact of natural disasters. The review also critically evaluates the ethical, legal, and privacy considerations associated with the widespread adoption of AI in environmental health and public safety initiatives. It addresses concerns related to data security, algorithmic biases, and the need for transparent and accountable governance frameworks. Through an in-depth analysis of case studies, policies, and initiatives, this review provides insights into the successes and challenges of AI implementation in the USA. It concludes with recommendations for future research directions and policy considerations to ensure the responsible and effective integration of AI technologies in safeguarding environmental health and public safety. The findings presented in this review contribute to the broader discourse on leveraging AI for sustainable and resilient communities in the face of evolving environmental and public health challenges.

Conception on Public Health Surveillance System Based on Big Data in Health and Medical Care

In recent years, public health events in varying degrees have occurred in different parts of China, these public health emergencies are characterized by volatility and complexity. To effectively respond to major challenges, we must establish a comprehensive public health surveillance system capable of efficiently collecting, analyzing, and processing data, while providing effective and timely information support. This paper focuses on how big data technologies can be used to achieve this goal. The theoretical basis is first introduced, including the definition, characteristics and application methods of big data; then the existing public health surveillance system is analyzed and summarized, its shortcomings are pointed out; finally, a design scheme for a public health monitoring system based on health care big data is proposed, detailing the design ideas, functional modules and database structure of the scheme. The scheme can help the authorities to monitor and manage information in real time so as to provide the basis for scientific-decision making. Through testing and verification, the scheme is found to have good performance and can meet the needs of large-scale public health surveillance. The findings of this project hold significant relevance in advancing the development of the public health surveillance system in China.

Assessing the role of social determinants of health in health disparities: The need for data on work.

Work is a key social determinant of health. Without the collection of work-related information in public health data systems, the role of social determinants in creating and reinforcing health disparities cannot be fully assessed. The Centers for Disease Control and Prevention (CDC) maintains or supports a number of public health surveillance and health monitoring systems, including surveys, case-based disease and exposure systems, vital status records, and administrative data systems. We evaluated a convenience sample of these systems for inclusion of information in three work-related domains: employment status, industry and occupation, and working conditions. While 12 of 39 data systems were identified as collecting work-related data, this information was often minimal (e.g., only employment status), restricted to a subset of respondents, or only gathered periodically. Information on working conditions was particularly sparse. Historically, the limited and inconsistent collection of work-related information in public health data systems has hindered understanding of the role work plays in health disparities. Current CDC data modernization efforts present opportunities to enhance the identification and mitigation of health disparities by prioritizing inclusion of an expanded set of work-related data elements.