Identifiable Health Information and the Public's Health: Practice, Research, and Policy

This chapter examines some of the difficult issues at the intersection of public health, data uses, and individual interests. It describes some of the fundamental uses and disclosures of identifiable health data for public health practice and public health research, and presents legal structures and challenges that underlie public health data uses and disclosures. It briefly explores relevant constitutional sources of public health powers and privacy. Core statutory and regulatory legal protections for data uses related to public health research (i.e., federal, state, and local human subjects research protections) and public health privacy (i.e., privacy laws at the federal, state, and local levels) are examined. This includes a core analysis of the public health implications of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule. The chapter concludes by addressing one of the key questions critical to each of these legal approaches: What are the distinctions between public health practice and research activities? It sets forth enhanced methodology on the basis of a 2004 report of the Council of State and Territorial Epidemiologists (CSTE) for distinguishing these activities.