Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA.
Center for the Study of Racism, Social Justice & Health, Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA.
Ethn Dis. 2023 Mar 31;33(1):63-75. doi: 10.18865/2022-2022. eCollection 2023 Jan.
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.
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 increased 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.
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 (n=21), behavioral and health-related services (n=11), and racism and racism-related factors (n=12). A score of 0-2 was assigned to 91% (n=40) of the systems; 9% were scored U; 30% (n=13) scored a 0. Half scored a 1 (n=22), indicating a "potential for the types of harm of concern in this analysis." "Evidence of harm," a score of 2, was found for 12% (n=5).
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.
尽管用于减轻灾害的监测系统履行着至关重要的公共卫生职能，但由于历史上和加强监测而导致的过度监测，有色人种社区遭受了不成比例的伤害（例如被定罪）。
为了解决这个问题，我们开发并试行一种新颖的、基于公平的评分系统，以评估监测系统在增加对警察、拘留/监禁、驱逐出境的接触、以及对获取社会服务或公共资源的干扰的情况下，对弱势群体产生潜在和实际负面影响的风险。为了开发评分系统，我们回顾了文献并对监测专家小组进行了调查，以确定通过监测方法发生的具体危害（例如，增加警察干预）。
分数基于收集的信息类型（个人和/或社区层面）以及与执法部门共享信息的证据。分数为 0（未识别到伤害风险）、1（存在风险潜力）、2（存在风险证据）和 U（数据不可公开获取）。为了试行评分系统，我们通过对直接与 COVID-19 相关的系统（n=21）、行为和健康相关服务（n=11）以及种族主义和与种族主义相关因素（n=12）进行环境扫描，于 2020 年 6 月至 10 月期间确定了 44 个监测系统。91%（n=40）的系统得分为 0-2；9%的系统得分为 U；30%（n=13）的系统得分为 0。有一半系统（n=22）得分为 1，这表示“在本分析中关注的伤害类型存在潜在风险”。12%（n=5）的系统得分 2，表明“存在伤害证据”。
监测系统对种族化和/或弱势群体的健康和福祉构成威胁的可能性尚未得到充分研究。该项目开发并试行评分系统以实现这一公平目标。公共卫生的崇高追求是改善所有人的健康，必须与这些潜在危害相协调。
