An Enhanced Approach to Distinguishing Public Health Practice and Human Subjects Research
What are the Differences between Public Health Practice and Research? This perplexing question constantly arises in the planning and performance of public health activities involving the acquisition and use of identifiable health information. Public health agencies collect and analyze significant id...
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Published in | The Journal of law, medicine & ethics Vol. 33; no. 1; pp. 125 - 141 |
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Main Author | |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Publishing Ltd
22.03.2005
SAGE Publications Sage Publications, Inc Cambridge University Press |
Subjects | |
Online Access | Get full text |
ISSN | 1073-1105 1748-720X |
DOI | 10.1111/j.1748-720X.2005.tb00215.x |
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Abstract | What are the Differences between Public Health Practice and Research?
This perplexing question constantly arises in the planning and performance of public health activities involving the acquisition and use of identifiable health information. Public health agencies collect and analyze significant identifiable health data from health care providers, insurers, other agencies, or individuals to perform an array of public health activities. These activities include surveillance (e.g., reporting requirements, disease registries, sentinel networks), epidemiological investigations (e.g., to investigate disease outbreaks), and evaluation and monitoring (e.g., public health program development and analysis, oversight functions). Few debate that these essential public health activities, often specifically authorized by law, are classifiable as public health practice.
Other public health activities in which identifiable health data are acquired or used, however, can resemble, include, or constitute human subjects research. “Human subjects research” is legally defined as “a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalizable knowledge” that involves living human subjects (or their identifiable, private data). |
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AbstractList | What are the Differences between Public Health Practice and Research?
This perplexing question constantly arises in the planning and performance of public health activities involving the acquisition and use of identifiable health information. Public health agencies collect and analyze significant identifiable health data from health care providers, insurers, other agencies, or individuals to perform an array of public health activities. These activities include surveillance (e.g., reporting requirements, disease registries, sentinel networks), epidemiological investigations (e.g., to investigate disease outbreaks), and evaluation and monitoring (e.g., public health program development and analysis, oversight functions). Few debate that these essential public health activities, often specifically authorized by law, are classifiable as public health practice.
Other public health activities in which identifiable health data are acquired or used, however, can resemble, include, or constitute human subjects research. “Human subjects research” is legally defined as “a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalizable knowledge” that involves living human subjects (or their identifiable, private data). [...]the public health agency must adhere to a series of protections (e.g., individual informed consent absent a waiver) and procedures (e.g., review by an institutional review board [IRB]) designed to protect the health and safety of human subjects. Human subjects research is not limited to any particular actor (e.g., public or private sector individual) or a specific setting (e.g., institution, agency, or corporation). [...]a public health agency and its representatives may conduct human subjects research even in the pursuit of public health goals and objectives.20 NBAC and others question whether the common definition of research can or should be applied to public health.21 Many public health practice activities, such as disease surveillance, are (like research) routinely and systematically carried out, but are not considered research. [...]public health practitioners at every level of government find it difficult to properly assess their own activities; * Public health practice activities that are misclassified as research require public health authorities to engage in time-consuming reviews through governmental or private sector IRBs. [...]depending on how a public health activity is classified, various health information privacy protections, including an IRB or Privacy Board review, may be required. |
Audience | Professional |
Author | Hodge, James G. |
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This perplexing question constantly arises in the planning and performance of public... [...]the public health agency must adhere to a series of protections (e.g., individual informed consent absent a waiver) and procedures (e.g., review by an... |
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