Moulton Anthony Drummond, Schramm Paul John
Climate and Health Program, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia (Mr Schramm). Dr Moulton was with the Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, during research for this study.
J Public Health Manag Pract. 2017 Nov/Dec;23(6):618-626. doi: 10.1097/PHH.0000000000000550.
Climate change poses a host of serious threats to human health that robust public health surveillance systems can help address. It is unknown, however, whether existing surveillance systems in the United States have adequate capacity to serve that role, nor what actions may be needed to develop adequate capacity.
Our goals were to review efforts to assess and strengthen the capacity of public health surveillance systems to support health-related adaptation to climate change in the United States and to determine whether additional efforts are warranted.
Building on frameworks issued by the Intergovernmental Panel on Climate Change and the Centers for Disease Control and Prevention, we specified 4 core components of public health surveillance capacity relevant to climate change health threats. Using standard methods, we next identified and analyzed multiple assessments of the existing, relevant capacity of public health surveillance systems as well as attempts to improve that capacity. We also received information from selected national public health associations.
Multiple federal, state, and local public health agencies, professional associations, and researchers have made valuable, initial efforts to assess and strengthen surveillance capacity. These efforts, however, have been made by entities working independently and without the benefit of a shared conceptual framework or strategy. Their principal focus has been on identifying suitable indicators and data sources largely to the exclusion of other core components of surveillance capacity.
A more comprehensive and strategic approach is needed to build the public health surveillance capacity required to protect the health of Americans in a world of rapidly evolving climate change. Public health practitioners and policy makers at all levels can use the findings and issues reviewed in this article as they lead design and execution of a coordinated, multisector strategic plan to create and sustain that capacity.
气候变化对人类健康构成了一系列严重威胁，强大的公共卫生监测系统有助于应对这些威胁。然而，美国现有的监测系统是否有足够能力发挥这一作用尚不清楚，也不清楚需要采取哪些行动来发展足够的能力。
我们的目标是审查评估和加强公共卫生监测系统能力的努力，以支持美国在与健康相关的气候变化适应方面的工作，并确定是否需要进一步努力。
基于政府间气候变化专门委员会和疾病控制与预防中心发布的框架，我们确定了与气候变化健康威胁相关的公共卫生监测能力的4个核心组成部分。接下来，我们使用标准方法，识别并分析了对公共卫生监测系统现有相关能力的多项评估以及提高该能力的尝试。我们还从选定的全国性公共卫生协会获取了信息。
多个联邦、州和地方公共卫生机构、专业协会及研究人员已做出了有价值的初步努力，以评估和加强监测能力。然而，这些努力是由各自独立工作的实体做出的，没有共享的概念框架或战略的支持。它们的主要重点一直是确定合适的指标和数据来源，很大程度上忽略了监测能力的其他核心组成部分。
需要一种更全面、更具战略性的方法来建设公共卫生监测能力；在气候变化迅速演变的世界中，这一能力对于保护美国人的健康至关重要。各级公共卫生从业者和政策制定者在领导设计和实施协调一致的多部门战略计划以创建和维持该能力时，可以利用本文中审查的结果和问题。
