Toolkit Development and Organization

Purpose

This toolkit aims to advance the integration of syndromic surveillance in health equity-centered solutions in public health practice.

Development

This toolkit is a starting point for introducing a health equity-centered focus to syndromic surveillance data and analyses. The Centers for Disease Control's (CDC) National Syndromic Surveillance Program (NSSP), Office of Health Equity (OHE) staff and the Council of State and Territorial Epidemiologists' (CSTE) Community of Practice (CoP) members contributed to toolkit development through key informant interviews and guided discussion sessions. This document was developed from a scientific perspective based on the current best practices, published literature and syndromic surveillance practitioners' experience and knowledge. Data equity is an evolving science. The intent is for this document to grow and evolve with the field.

Input was sought from the listed sources, including the CSTE Community of Practice, which includes representatives from TECs. Direct input from Tribes was not sought. This language will not be updated.

Organization

This toolkit includes an overview of health equity, a description of data equity and how to apply equitable principles across the data life cycle, and considerations for establishing equity-centered systems. Each section includes actions analysts can take to further health equity work.

The toolkit also includes several practical examples from the field using syndromic surveillance data for health equity. The additional resources section provides relevant articles, data sources and data equity guidance supporting integrating syndromic surveillance practice in health equity work.

Key Terms

To search within these definitions by using the "ctrl+f" feature within your web browser, please expand the list first by clicking "Expand All +" in the top-right corner.

The process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, culture, demographics, social status, or similar factors. It involves partnerships and coalitions that mobilize resources, influence systems, and serve as a catalyst for changing policies, programs, and practices.1

The application of equity-centered approaches to the entire data equity lifecycle including considerations for how to visualize data, interpret representativeness, involve communities, disseminate data, and limit harm and reinforcement of biases. The CDC Foundation defines five data equity principles: recognize and define systemic factors, use equity-mindedness for language and action, allow for cultural modifications, create shared data agreements, and facilitate data sovereignty.2

Communicating data collection strategies, use, analytic methods (including definitions of health conditions), limitations, and interpretations to individuals and groups that supply, collect, and consume the data and analyses.

A health difference that is closely linked with health inequities. Health disparities adversely affect groups of people who experience social or economic obstacles to health or a healthy environment based on their racial and ethnic group; religion; socioeconomic status; gender; age; mental health condition; cognitive, sensory, or physical disability; sexual orientation; geographic location; or other characteristics.3

Differences in health determinants and health outcomes that are in large part the result of systematic social and structural barriers and are avoidable and preventable

The attainment of the highest level of health for all people and a state in which every person has the opportunity to attain their full health potential.45 Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and social determinants of health—and to eliminate disparities in health and health care. 6

Conditions in the places where people live, learn, work, play, and age that affect a wide range of health risks and outcomes.7 "Upstream" factors, such as living conditions and social inequities, also contribute to health risks and outcomes.

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Content Source:
Office of Public Health Data, Surveillance, and Technology
  1. What is Community Engagement? Agency for Toxic Substances and Disease Registry. Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. Updated on June 25, 2015. Accessed on September 12, 2022. Available at: https://www.atsdr.cdc.gov/communityengagement/pce_what.html
  2. Data Equity Principles | CDC Foundation. (n.d.). Retrieved November 9, 2023, from https://www.cdcfoundation.org/HealthEquity/data-equity-principles
  3. Disparities. Office of Disease Prevention and Health Promotion (ODPHP). Available at https://health.gov/healthypeople/objectives-and-data/about-disparities-data Accessed on September 1, 2022.
  4. What is Health Equity? National Center for HIV, Viral Hepatitis, STD, and TB Prevention. Centers for Disease Control and Prevention. U.S. Department of Health & Human Services. Last reviewed May 11, 2022. Accessed on August 24, 2022. Available at: https://www.cdc.gov/nchhstp/healthequity/index.html
  5. Braveman P, Arkin E, Orleans T, Proctor D, and Plough A. What is Health Equity? And What Difference Does a Definition Make? Princeton, NJ: Robert Wood Johnson Foundation, 2017.
  6. Office of Disease Prevention and Health Promotion. (2022, August 30). Healthy People 2030: Health Equity in Healthy People 2030. U.S. Department of Health and Human Services. Retrieved August 30, 2022, from https://health.gov/healthypeople/priority-areas/health-equity-healthy-people-2030
  7. Social Determinants of Health: Know What Affect Health. Centers for Disease Control and Prevention. U.S. Department of Health & Human Services. Last reviewed March 10, 2021. Accessed on August 26, 2022. Available at: https://www.cdc.gov/socialdeterminants/about.html