Innovation, Engagement, and Equity: How Harris County Public Health’s Values Shape its Technology

Harris County Public Health (HCPH) is the local health department serving the third most populous community in United States (4.7mil. people). It spans over 4,600 km2 – one of the most diverse and geopolitically complex in the U.S. – and home to 4th largest city (Houston). For public health activities including disease surveillance, the HCPH jurisdiction includes
approx. 2.5 million people within large unincorporated areas and over 30 small municipalities (not including the city of Houston). For other activities such as mosquito & vector control, it includes the entire 4.7mil. population. HCPH embraces cornerstone values of Innovation, Engagement, and Equity for both planning and public health implementation.

With over 22 sites across the system, there was no central source for vetted data. A federation of processes existed for data acquisition, sharing, and analysis. Across each site, each data owner utilized data differently, while strategic public health visibility and value-based decision-making were not centralized. Data issues within HCPH were emblematic of national issues within the United States, where data are usually owned at the State level with little or no federal standards. Access to timely and accurate data across multiple datasets is critical to fight emerging infectious diseases such as Zika, measles outbreaks, or yearly influenza and other public health threats such as industrial fires, flooding, and the opioid epidemic.

These data need to be put in the context of social determinants of health to ensure that response is performed in an equitable fashion. HCPH embarked on a journey to create a nationally recognized, state-of-art Data Warehouse that quickly identifies, observes, and responds to community surveillance trends. By utilizing data in this capacity, HCPH has gained unique ability to target specific geographic areas of need and tailor interventions based on the social vulnerability indicators for that community.