Report Publish Date: January 1, 2023
This journal article explores the relationship between public health surveillance and the policing of communities of color. It presents a scoring system that evaluates whether surveillance systems meant to improve health have the potential for harm, such as increased policing.
Of the 44 surveillance systems scored, half had the potential for harm. The researchers found evidence of harm made by 12% of the systems and no risk of harm for 30% of the systems.
In the context of the COVID-19 pandemic, the authors wanted to know whether public health surveillance systems might contribute to increased policing and other types of harm in communities of color. For example, causing people to be at risk of detention, incarceration, or deportation or preventing them from accessing services and resources.
The authors reviewed literature on surveillance systems and surveyed an expert panel. Based on that research, they developed a scoring system and used it to score 44 COVID-19, health services, and racism related surveillance systems.
“As the COVID-19 pandemic is not the last disaster of its type, the concerns raised here will continue to be relevant in future public health emergencies and beyond.”
— Bita Amani, Breann McAndrew, Mienah Z. Sharif, Jamie Garcia, Ezinne Nwankwo, Alejandra Cabral, Consuela Abotsi-Kowu, Hamid Khan, Cindy Le, Monica L. Ponder, and Chandra L. Ford, UCLA–CDU COVID-19 Task Force
The authors say public health practitioners must face the tension between public health surveillance’s role in identifying and finding solutions to health disparities and the potential for surveillance to harm the people most affected by health emergencies.
Background: Although surveillance systems used to mitigate disasters serve essential public health functions, communities of color have experienced disproportionate harms (eg, criminalization) as a result of historic and enhanced surveillance.
Methods: To address this, we developed and piloted a novel, equity-based scoring system to evaluate surveillance systems regarding their potential and actual risk of adverse effects on communities made vulnerable through in- creased exposure to policing, detention/incarceration, deportation, and disruption of access to social services or public resources. To develop the scoring system, we reviewed the literature and surveyed an expert panel on surveillance to identify specific harms (eg, increased policing) that occur through surveillance approaches.
Results: Scores were based on type of information collected (individual and/or neighborhood level) and evidence of sharing information with law enforcement. Scores were 0 (no risk of harm identified), 1 (potential for risk), 2 (evidence of risk), and U (data not publicly accessible). To pilot the scoring system, 44 surveillance systems were identified between June 2020 and October 2020 through an environmental scan of systems directly related to COVID-19 (n1⁄421), behavioral and health-related services (n1⁄411), and racism and racism-related factors (n1⁄412). A score of 0-2 was assigned to 91% (n1⁄440) of the systems; 9% were scored U; 30% (n1⁄413) scored a 0. Half scored a 1 (n1⁄422), indicating a “potential for the types of harm of concern in this analysis.” “Evidence of harm,” a score of 2, was found for 12% (n1⁄45).
Conclusions: The potential for surveillance systems to compromise the health and well-being of racialized and/or vulnerable populations has been understudied. This project developed and piloted a scoring system to accomplish this equity-based imperative. The nobler pursuits of public health to improve the health for all must be reconciled with these potential harms.
Ethn Dis. 2023;33(1):63–75; doi:10.18865/ed.33.1.63
Figure 1. Information-sharing environment: the Stalker State
This study and report was conducted and created by the following people.
