Bernard Choi Canada

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Enhancing Global Capacity in the Surveillance of
Chronic Diseases Seven Themes to Consider
Bernard Choi (Canada) David McQueen (USA) Pekka
Puska (Finland)
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Authors (N23)
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Authors
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To enhance capacity SCIENCE as an acronym

• S trategy
• C ollaboration
• I nformation
• E ducation
• N ovelty
• C ommunication
• E valuation

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S trategy

• Develop a strategy to promote and market
  surveillance and prevention of NCD
• Create a sense of urgency
• Marketing should be based on solid facts
• Show how incremental steps can contribute to long
  term outcome
• Use economic arguments

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Use of projections and economic modeling to make
the case
The Business Case British Columbia
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C ollaboration

• Involve multiple stakeholders in devising a
  comprehensive approach to surveillance
• Involve all stakeholders from the beginning
  including data providers ,collectors and users
• Responsive to needs at different levels
• Link data with broader policy agenda and respond
  to increasingly complex policy questions
• Develop integrated information platforms and
  alliances to improve planning and evaluation

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Data needed from many different sectors
INTERNATIONAL
WORK/
COMMUNITY LOCALITY
NATIONAL/
SCHOOL/HOME
FACTORS
REGIONAL
Leisure Activity/ Facilities
Public Transport
Transport
INDIVIDUAL
POPULATION
Globalization of markets
Energy Expenditure
Urbanization
Public Safety
Labour
OBESE OR UNDERWT
Infections
Health Care
Health
Development
Worksite Food Activity
Social Security
Sanitation
Food intake Nutrient density
Media Culture
Media programs advertising
System
Family Home
Manufactured/ Imported Food
Education
School Food Activity
Food Nutrition
Agriculture/ Gardens/ Local markets
National perspective
Source see Kumanyika Ann Rev Pub Health 2001
22293-308
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I nformation

• Improve accuracy, timeliness, and comparability
  of surveillance information
• WHO STEPwise surveillance approach WHO Global
  InfoBase to facilitate cross country comparison
• Link different data sources to add sociological
  and ecological perspectives Behavioral Risk
  Factor Surveillance System (BRFSS) data is
  merged with data on environmental pollutants
• Data should be collected on a continuous basis
• shortage of influenza vaccine in 2004, 17
  questions were added to BRFSS to estimate vaccine
  coverage

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E ducation

• Enhance capacity and raise awareness
• Partnering of low and high income countries to
  provide training courses such as with Amnet
• Training of public health workforce
• Joint courses offered by university and
  government

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N ovelty

• Develop novel ways of thinking about traditional
  and emerging data collection challenges
• New problems cellular phones, privacy in
  information acts
• Beyond questionnaires pedometers, photometers,
  personal air sampling, biological monitoring

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C ommunication

• Develop effective ways to convey public health
  messages to key audiences
• New breed of scientists knowledge brokers,
  translational scientists, chief knowledge
  officer, Science integrators
• Use of celebrities and spokespersons
• Synthetic indices for health may be helpful in
  summarising data
• Canadas chronic disease clock 170,000 deaths
  per year, or 1 death every 3 minutes

Chronic Disease deaths so far this year
8 810 Chronic Disease
deaths so far today (as of 1200 midnight)
252 http//www.phac-aspc.gc.ca/ccdpc-cpcmc/index_e
.html
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Use technology
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Tell the story

• Targeted to user
• Politicians and policy makers key points,
  implications, policy direction needed
• Informed user access to data for manipulation
  e.g. Chronic Disease Infobase on Web
• General public packaged information

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NCD surveillanceFrom Information to Action
Public, Professional Stakeholder Input
Basic Research
Information Management
O U T C O M E S
Data Collection
H E A L T H

• Actions
• Programs
• Interventions
• Policy

R E Q U I R E M E N T S
Knowledge Synthesis And Decision Making
Health Surveillance
Integration
Analysis
Interpretation
Applied Research Epidemiological Studies
Surveillance Products
Social Economic Considerations
Other Considerations
Dissemination
Management
Coordination
LEGISLATION REGULATION
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E valuation

• The process of evaluation should measure how well
  knowledge is put into action
• Surveillance valuable tool for evaluating the
  effectiveness of policies and programs
• City of Bogota (Colombia) built a 300 km bicycle
  route, new mass transit system, 120 km Sunday
  street closure car users dropped from 17 to
  12, pedestrians increased from 7 to 12
• Evaluation must be a built-in component of any
  public health initiatives

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The Art of SCIENCE to enhance capacity

• S trategy
• C ollaboration
• I nformation
• E ducation
• N ovelty
• C ommunication
• E valuation

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Conclusion

• The acronym SCIENCE makes a relatively easy
  mnemonic to help us remember the 7 ways to
  enhance the global capacity in public health
  surveillance
• It may be useful for public health practitioners
  to test our ideas and examples in their own time
  frame, situation and locale, and use them to
  stimulate more ideas