Public Health Monitoring: An Active Phrase for Vigilance, Warning, Guidance, and Accountability

In 2023, Kassler and Bowman cogently argued in their essay "Overcoming Public Health 'Surveillance': When Words Matter" that the field of public health needs to drop the phrase "surveillance," given its deep links to state and corporate efforts to collect data to control people as political subjects and as consumers 2 Reminding readers of the etymology of "surveillance"-as "derived from the French roots sur (over) and veiller (to watch)"2(p1102)- they called for a reframing of "public health surveillance" so that it prioritizes "protecting data privacy and restoring public trust as foremost objectives. "4 For people, examples of those who are monitors include "a person who oversees or observes; one who observes or comments on a process or activity, esp. in an official capacity to ensure that correct procedure is followed" (e.g., human rights monitor) and "a person who uses monitoring equipment to check levels, standards, etc. [...]it is an active word and makes clear that someone or something is doing the monitoring-and this monitoring can be implemented by individuals and by communities for themselves to advance their health and thus is not reducible to surveillance conducted by government agencies or corporations to control populations and behaviors. "4 Stated bluntly, data are never simply a "given" but instead are a social product whose content and cost reflect societal priorities and intellectual frameworks-with the work and resources required to obtain the data necessarily involving human labor, technology, and concepts regarding the phenomena to be measured3,5 Additionally, "monitoring," unlike "surveillance," provides a sense of purpose that is in accord with a public health focus on prevention: monitors warn to guide action to prevent harm.