Public health monitoring and reporting (PHMR); what is it and why do we need it?
Public or population health monitoring is the regular collection of data on relevant components of health and its determinants in the population or in samples thereof, aimed at informing the public health policy process. Health components are considered to be relevant if they cover issues of major public health importance, in terms of numbers and trends, geographic spread, costs and health impact. There should also be coherence between the components, i.e. health issues and their determinants, in terms of our understanding of the mechanisms of health and disease. Next, there should be possibilities to take action to improve the population health. The scope of monitoring may differ from ‘comprehensive’ to ‘topical’. A comprehensive approach attempts to provide an overview of the entire public health field, whereas a topical approach may, for example, focus on children’s health, environmental health, diabetes, or health care quality. Population health monitoring can be expanded to include methods such as modelling and forecasting, and the integration of a multitude of epidemiological, psycho-social, (bio)medical and other evidence.
Public health monitoring is useless without public health reporting. The major aims of public health reporting are to communicate the state of health of a population to ‘all who need to know’ and to support the preparatory as well as evaluative phases of health policy making and health care planning. Therefore, without reporting, public health monitoring cannot adequately influence the policy process. The reporting function of public health monitoring can take many forms, e.g. reports, brochures and articles. More recently also websites and presentations in various other media, such as dedicated newspapers or films on the internet. Policy briefs and policy dialogues are other important instruments for health reporting. Ideally these information products do not only contain data, but also explanatory texts and links to research results, sources of expertise and policy documents.
In the development of public health knowledge three phases can be discerned; creation, translation and propagation. Creation is the generation of knowledge, i.e. exploration and analysis of data, investigation and evaluation of evidence in other to understand what drives population health (epidemiology). Translation is the phase where created knowledge is taken, combined, analysed and processed for different audiences (e.g. policy makers and public health professionals); public health reporting. Propagation is what the target audiences of reporting do with the processed knowledge; policy and practice. So, public health reporting fills the role joining epidemiology and policy & practice together. When the focus of activities is on a set of policy relevant public health elements, for which data are being collected and reported on a regular basis, we speak of public health monitoring. It is noted that data for public health monitoring generally are routinely collected data from existing sources, such as disease registries (e.g. cancer registries), health care registries (e.g. hospital discharge registries) and administrative sources (e.g. health insurers data). For the creation phase generally other types of data are needed, e.g. research cohorts.
When looking at another well-known model for knowledge generation, the 'data-information-knowledge-wisdom'-pyramid, which has data at the base and wisdom (knowing what to do) at the top, PHMR is situated mainly at the knowledge level; information from focused monitoring activities and additional sources is integrated and placed in a policy relevant context. In this way an effort is made to bridge the information and wisdom levels in the pyramid.
The envisaged EUPHA section on Public Health Monitoring and Reporting (PHMR) will apply a comprehensive and integrative approach towards PHMR. That means that its focus will be on the broad public health field (health status and health determinants, including prevention and care aspects), and on generating public health knowledge using multiple sources of information coming from several sectors (next to public health e.g. (bio)medicine and social sciences). Its main fields of interest are related to the main –subsequent– components of PHMR;
- Monitoring models (what elements of public health do we monitor and why);
- Indicators for public health monitoring and the underlying data;
- Reporting of outcomes of public health monitoring (content, reporting formats/tools, process (interaction with user/commissioner)), including forecasts and evaluation of impact of reporting.
The mission of the envisaged EUPHA section on PHMR is to establish a platform that will exchange experiences with and good practice examples of PHMR. This should lead to improvement of the interaction between research and policy/practice, i.e. to better support for decision making and more efficient influencing of the political agenda setting.
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