在大流行和政治动荡中改变美国对公共卫生数据使用的支持。

IF 4.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Milbank Quarterly Pub Date : 2024-06-01 Epub Date: 2024-05-13 DOI:10.1111/1468-0009.12700
Cason D Schmit, Brian N Larson, Thomas Tanabe, Mahin Ramezani, Q I Zheng, Hye-Chung Kum
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引用次数: 0

摘要

政策要点 本研究探讨了 2020 年几件改变世界的事件(如大流行病和广泛的种族主义抗议)对美国民众在公共卫生方面使用可识别数据的舒适度的影响。在 2020 年大选之前,民主党人和共和党人之间没有明显差异。然而,非裔美国人的舒适度有所下降,这与其他亚群有所不同。我们的研究结果表明,相对于其他数据的使用,公众在大流行病和 2020 年选举周期的动荡中仍然支持公共卫生数据活动。然而,与其他人口群体相比,非裔美国人对公共卫生数据使用的支持率出现了独特的下降:近期的隐私立法工作并未包含针对公共卫生数据使用的特别规定。尽管过去的研究记录了对公共卫生数据使用的支持,但 2020 年发生的几起全球性事件提高了人们对隐私和数据使用的认识和关注。本研究旨在了解 2020 年发生的事件是否影响了美国对可识别数据二次使用的隐私偏好,重点关注公共卫生和研究用途:我们在 2020 年 2 月和 11 月使用基于选择的联合分析方法对数据隐私的态度和偏好进行了两次在线调查。参与者收到了不同的数据使用场景配对--根据数据类型、用户和目的而有所不同--并根据他们的舒适度选择场景。分层贝叶斯回归模型模拟了人群偏好:共收到 1,373 份回复。在二月和十一月之间,人们对数据的偏好没有明显的统计学差异,每个人对人口健康和研究数据活动的舒适度最高,而对利润驱动型活动的舒适度最低。除非洲裔美国人对人口健康和研究数据活动的舒适度明显下降外,大多数亚群的数据偏好与人口偏好相当:尽管发生了包括大流行病在内的改变世界的事件,但我们发现两党公众都支持将可识别数据用于公共卫生和研究。非裔美国人的支持率下降可能与他们对系统性种族主义、其危害和持续存在的差异的认识提高有关。美国民众的偏好支持在美国法律中纳入允许使用公共卫生和研究数据的法律条款,而美国法律目前还缺乏具体的公共卫生使用许可。
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Changing US Support for Public Health Data Use Through Pandemic and Political Turmoil.

Policy Points This study examines the impact of several world-changing events in 2020, such as the pandemic and widespread racism protests, on the US population's comfort with the use of identifiable data for public health. Before the 2020 election, there was no significant difference between Democrats and Republicans. However, African Americans exhibited a decrease in comfort that was different from other subgroups. Our findings suggest that the public remained supportive of public health data activities through the pandemic and the turmoil of 2020 election cycle relative to other data use. However, support among African Americans for public health data use experienced a unique decline compared to other demographic groups.

Context: Recent legislative privacy efforts have not included special provisions for public health data use. Although past studies documented support for public health data use, several global events in 2020 have raised awareness and concern about privacy and data use. This study aims to understand whether the events of 2020 affected US privacy preferences on secondary uses of identifiable data, focusing on public health and research uses.

Methods: We deployed two online surveys-in February and November 2020-on data privacy attitudes and preferences using a choice-based-conjoint analysis. Participants received different data-use scenario pairs-varied by the type of data, user, and purpose-and selected scenarios based on their comfort. A hierarchical Bayes regression model simulated population preferences.

Findings: There were 1,373 responses. There was no statistically significant difference in the population's data preferences between February and November, each showing the highest comfort with population health and research data activities and the lowest with profit-driven activities. Most subgroups' data preferences were comparable with the population's preferences, except African Americans who showed significant decreases in comfort with population health and research.

Conclusions: Despite world-changing events, including a pandemic, we found bipartisan public support for using identifiable data for public health and research. The decreasing support among African Americans could relate to the increased awareness of systemic racism, its harms, and persistent disparities. The US population's preferences support including legal provisions that permit public health and research data use in US laws, which are currently lacking specific public health use permissions.

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来源期刊
Milbank Quarterly
Milbank Quarterly 医学-卫生保健
CiteScore
9.60
自引率
3.00%
发文量
37
审稿时长
>12 weeks
期刊介绍: The Milbank Quarterly is devoted to scholarly analysis of significant issues in health and health care policy. It presents original research, policy analysis, and commentary from academics, clinicians, and policymakers. The in-depth, multidisciplinary approach of the journal permits contributors to explore fully the social origins of health in our society and to examine in detail the implications of different health policies. Topics addressed in The Milbank Quarterly include the impact of social factors on health, prevention, allocation of health care resources, legal and ethical issues in health policy, health and health care administration, and the organization and financing of health care.
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