Rapid changes to the United States public health system challenge the current strategic approach to surveillance. During 2011, the Council of State and Territorial Epidemiologists convened national experts to reassess public health surveillance in the United States and update surveillance strategies that were published in a 1996 report and endorsed by the Council of State and Territorial Epidemiologists. Although surveillance goals, historical influences, and most methods have not changed, surveillance is being transformed by 3 influences: public health information and preparedness as national security issues; new information technologies; and health care reform. Each offers opportunities for surveillance, but each also presents challenges that public health epidemiologists can best meet by rigorously applying surveillance evaluation concepts, engaging in national standardization activities driven by electronic technologies and health care reform, and ensuring an adequately trained epidemiology workforce.
This article discusses the Council of State and Territorial Epidemiologists' Blueprint Version 2.0 for updating public health surveillance for the 21st century. It also reviews surveillance goals, history, methods, and practice at different levels of government, describes current influences affecting surveillance, and updates strategies for surveillance.
School of Public Health, State University of New York at Albany, New York (Dr Smith); Yale School of Public Health, Yale University, New Haven, Connecticut (Dr Hadler); Michigan Department of Community Health, Lansing (Ms Stanbury); Utah Department of Health, Salt Lake City (Dr Rolfs); and Florida Department of Health, Tallahassee (Dr Hopkins).
Correspondence: Perry F. Smith, MD, School of Public Health, State University of New York at Albany, One University Place, Rensselaer, New York 12144 (firstname.lastname@example.org).
The CSTE (Council of State and Territorial Epidemiologists) Surveillance Strategy Group: Christopher Braden, Peter Briss, May Chu, Letitia Davis, Alfred DeMaria, Lisa Ferland, Seth Foldy, Karen Foster, Julia Gunn, Janet Hamilton, Katrina Hedberg, Khosrow Heidari, Lesliann Helmus, Monica Huang, Sara Huston, Tim Jones, James Kirkwood, William Lober, Cortland Lohff, Steven Macdonald, Laurene Mascola, Patrick McConnon, Joseph McLaughlin, Pamela Meyer, Stephen Ostroff, Robert Pinner, Judith Qualters, Lakesha Robinson, David Ross, Tom Safranek, Hillard Weinstock, and Paula Yoon.
This publication, including Dr Smith's contribution, was supported by Cooperative Agreement no. 5U38HM000414 from the Centers for Disease Control and Prevention (CDC) to the Council of State and Territorial Epidemiologists. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC. No other conflicts of interest were declared.