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June 26, 1996

The Public Health Information Infrastructure: A National Review of the Law on Health Information Privacy

JAMA. 1996;275(24):1921-1927. doi:10.1001/jama.1996.03530480063042

Our objectives were to review and analyze the laws in the 50 states, the District of Columbia, and Puerto Rico that regulate the acquisition, storage, and use of public health data and to offer proposals for reform of the laws on public health information privacy. Virtually all states reported some statutory protection for governmentally maintained health data for public health information in general (49 states), communicable diseases (42 states), and sexually transmitted diseases (43 states). State statutes permitted disclosure of data for statistical purposes (42 states), contact tracing (39 states), epidemiologic investigations (22 states), and subpoena or court order (14 states). The survey revealed significant problems that affect both the development of fair and effective public health information systems and the protection of privacy. Statutes may be silent about the degree of privacy protection afforded, confer weaker privacy protection to certain kinds of information, or grant health officials broad discretion