The Rising Public Health Leviathan: Health Information Gets Social
With social determinants of health, everything about you can be coded, tracked, and stored as health information - and directly accessed by the government for public health purposes.
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What’s in your medical records?
When you think of the information your health care providers collect and store, it’s probably things about your body that spring to mind: height and weight, blood test and screening results, information about surgeries, vaccinations, medications, and allergies.
If you’re on a medication for a psychological issue, like an SSRI or anti-anxiety drugs, there’s probably some information about your state of mind in your records. Maybe you’ve told a doctor you’re depressed or feeling stressed out, and that’s in there too.
If that’s your idea of the kind of information your health care providers track, you’re probably about right. For now. But soon, there could be a lot more information in your records. If you’re on Medicaid in the state of New York, soon probably means this year.
The kinds of information being added will be about aspects of your life that aren’t strictly medical but can affect your health—what you eat, what transportation you use, what kind of place you live in, what your family and social life is like, and more.
Because all of those things can affect people’s health, information about them will be integrated into our health records in the coming years. Health care programs and organizations will increasingly address those factors with social services and financial assistance. And the information will be stored in health information databases that are created by and accessible to government health departments.
The information collected will be basic at first, but the infrastructure for tracking an extremely granular data set on each individual is being created right now. As I mentioned in my last article, the health information system already has ways to track personal details like whether you get along with your neighbors. That’s just one of tens of thousands of details that specific codes exist for, and the code sets are continuously expanding.
Of course, there’s a significant upside to collecting lots of health information and making it easily accessible: Massive medical data sets could be analyzed by artificial intelligence tools to discover causes and cures for disease. AI could create customized health plans and treatments for each individual. The underlying causes for ill health in vulnerable populations could be identified and addressed more effectively than ever.
The downside? We’re building a health information infrastructure that lays the foundation for a system of totalitarian control. It will create an extensive file on every individual that is available to government authorities. That’s because when it comes to protecting personal health information, our privacy laws and regulations make a huge exception for public health uses.
Health information is the one area in which government authorities have the legal right to access your personal information without your consent and without any judicial approval process such as obtaining a warrant or subpoena. All that is required is for public health authorities to assert that they are acquiring your information for legitimate public health purposes.
The Social Determinants of Health
All of those non-medical aspects of life that can affect your health fall under the rubric of what public health policy experts call “social determinants of health” (SDH or SDOH).
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