Sufficient quality data is a key to any dramatic improvements in outcomes in public health.  And yet, fifty-state comparisons have been difficult – if  not impossible to find. Enter the Pew Charitable Trusts, which, supported with research from Mathematica issued an important December 2024 report appropriately titled “State Public Health Data Reporting Policies and Practices Vary Widely”.

Lilly Kan recently joined the Centers for Disease Control and Prevention and led Pew’s work. In a December 18th podcast from Mathematica, “On the Evidence,” hosted by J.B. Wogan, she said that, “Data enable public health agencies to do everything from spotting emerging threats, tracking how and where they spread, to determining which communities and populations need the most support, to informing interventions and assessing how effective they are. Both policies and practices affect the flow of data from providers to public health, so it's important to understand how states govern public health data reporting from both aspects.”

As Kathy Talkington, director of public health at Pew Charitable Trusts told Barrett and Greene. “‘Quality in’ equals ‘quality out’. If we’re going to focus on the best use of this data to improve community care we need to improve the speed and quality of the data.”

At its heart, the report shows that even though reporting of patient case data advanced dramatically during the COVID-19 pandemic, there’s still pressing need for improvement. The effort is worthwhile, according to Margaret Arnesen, senior officer for state policy and research, because “we saw during COVID the impact that automated electronic case reporting can make for public health and now we see the opportunity to expand on that particularly for communicable diseases.”

For example, despite the strides that have been made in electronic communications, many patient case reports are still shared by phone, fax or even old-fashioned snail mail. As you might expect, among the providers who don’t have the resources to invest in automated electronic reporting systems, “officials are concerned that requiring them to do so, may discourage reporting altogether,” according to the report.

What’s more, in about half of the jurisdictions covered (which included all fifty states and Washington D.C.), officials who were interviewed indicated that they’re frequently unable to feed the data they receive directly into surveillance systems thanks to “staffing shortages, outdated IT infrastructure, and inadequate funding limitations of technology and resources,” according to the report.

This doesn’t mean that the states aren’t requiring some form of reporting. In fact, according to Pew, every state requires case and lab reporting, though not one requires automated electronic case reporting. 

The absence of timely data has real ramifications according to Pew, which points out that this information is critical in: 

• Detecting and investigating infectious and environmental health threats.

• Monitoring the health of the population.

• Identifying health inequities

• Designing and implementing evidence-based policies and practices to prevent and manage illness, improve health, and reduce inequities. 

• Allocating funds and workforce more efficiently and effectively. 

• Evaluating the impact of their interventions and adjusting as needed.

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