Center for Disease Control (CDC):
An Overview of the Organization’s History, Related Publications, and Compliance with Government Regulations
February 28, 2006
From modest beginnings in 1946 battling malarial outbreaks in the American South, the Center for Disease Control (CDC) has expanded into one of the foremost authorities on the subject of infectious and chronic disease prevention and control, as well as injuries, workplace hazards, disabilities and environmental health issues. (http://www.cdc.gov/about/default.htm
). In light of recent news developments pertaining to avian flu and the fairly recent outbreak of diabetes in certain segments of the American population, the core focus of the CDC is alive and well. Simply put, the core mission of the CDC is “to promote health and quality of life by preventing and controlling disease, injury, and disability” (http://www.cdc.gov/about/mission.htm
). With a host of information developed in coordination with major medical authorities throughout the United States and related agencies within the United Nations (U.N.), the CDC is poised to further develop the medical infrastructure of the United States and beyond.
The Center for Disease Control exists as an agency under the auspices of the Department of Health and Human Services. The Department of Health and Human Services was originally mandated as the Department of Health, Education, and Welfare on April 11, 1953 through the establishment of 5 U.S.C. app. (http://frwebgate4/
.access.gpo.gov/cgi bin/waisgate.cgi?WAISdocID =17975711525+0+ 0+0&WAISaction=retrieve). At this point, the Center for Disease Control was brought under the control of the Department of Health and Human Services, after having existed as a converted war-time agency for seven years, charged with the express purpose of malarial prevention in the American South. Hence, the headquarters of the CDC is located in Atlanta, Georgia. However, the CDC has expanded considerably since then.
The website for the Center for Disease Control and Prevention (http://www.cdc.gov/
) acts as a clearinghouse of sorts for all medical information of use to the general public. The website is designed to parallel this clearinghouse structure; all information is arranged by topics and a search function is also provided. The topics of consistent access, such as birth defects, disabilities, environmental health, and vaccines & immunizations, are presented vertically on the left hand column, offering the greatest visibility possible. Immediately below that, information related to the publications and products of the CDC are listed, according to broad category. One of the first publications of merit produced by the CDC is the journal entitled “Emerging Infectious Diseases.” This journal is published in both print and electronic form with a readership of 23,000 subscribers for the print version and 24,000 for the electronic version (http://www.cdc.gov/ncidod/EID/about/about.htm
). In this regard, the CDC is fully committed to providing timely and pertinent information in an equitably accessible manner.
The most recent edition of “Emerging Infectious Diseases” demonstrates the CDC’s focus on emerging diseases with articles focused on avian flu pathogens, the west Nile virus, salmonella variations, and hygiene and related health matters (http://www.cdc.gov/ncidod/EID/index.htm
). A testament to the authority and high standards of the “Emerging Infectious Diseases” journal is the manuscript acceptance rate; only 1/3 of the more than 1300 papers submitted yearly are accepted, although more might be accepted with considerable revision (http://www.cdc.gov/ncidod/EID/about/about.htm
). Furthermore, the journal does not solely represent an American localism; these papers are researched and written by medical professionals throughout the world, representing a diversity of medical methodology that assists in finding global solutions to global epidemics, like the current focus on Avian Flu.
Another consistent publication of merit is the “Morbidity and Mortality Weekly Report” (MMWR), which has a focus on emerging public health issues and their prevention. Articles presented in MMWR must be based on appropriate medical research and statistical information provided by credible sources, such as information presented to the CDC by state and local health departments. Current topics of interest as illustrated by the most recent edition are renewed efforts to obtain tetanus and diphtheria vaccinations, a mumps epidemic raging in Great Britain, and influenza vaccinations for health care professionals (http://www.cdc.gov/mmwr/
). Furthermore, MMWR distributes statistical information related to current health issues as provided in the illustration in Figure 1, which relates to asthmatic children under age 18 ranked according to race, ethnicity, and gender (http://www.cdc.gov/mmwr/preview/mmwrhtml/%20mm5507a7.htm
). The Morbidity and Mortality Weekly Report is available in both electronic and print format. However, while the electronic subscription is free, the print publication requires a considerable yearly fee ($149). This fee mandates the necessity of an electronic mode of access for the average patron for the timely and pertinent information presented in this journal.
A third publication of merit is the journal entitled “Preventing Chronic Disease”, which is published in electronic format only, is a format for health care practitioners and researchers to publish their related studies and findings. This journal is published by a subdivision of the CDC, namely the National Center for Chronic Disease Prevention and Health Promotion, one of eight centers contained within the CDC (http://www.cdc.gov/pcd/about_the_journal/index.htm
). The mission of the journal, according to the website, is to “address the interface between applied prevention research and public health practice in chronic disease prevention” (http://www.cdc.gov/pcd/about_the_journal/index.htm
). Since the demographic for this type of information is primarily health care practitioners and medical policymakers, there exists a lessened need to provide this information in print format for the general public. In essence, matters of equitable access are justified by the exclusiveness of the demographic. Evidence of this exclusiveness is contained in topics for the current issue; there are discussions of program evaluation management, the use of concept mapping as a program design tool, and manipulating the Office of Management and Budget (OMB)’s clearance program for program development (http://www.cdc.gov/pcd/issues/2006/%20jan/toc.htm
). The need for both print and electronic access is abated somewhat when the topics are so particular to those professionals in the field itself. The CDC places any information of direct pertinence to the individual citizen directly on the CDC website, or through some of the journal mentioned above.
Furthermore, the Center for Disease Control (CDC) maintains a variety of other publications and resources designed to address the related realms of disease control and prevention. For example, the CDC operates an image library entitled, appropriately enough, the Public Health Image Library (PHIL) (http://phil.cdc.gov/phil/home.asp
). This multimedia library serves as a clearinghouse for non-textual information, such as images and video clips that can be especially useful for medical professionals developing visual presentations or for educational purposes. As an example, a sample illustration has been provided on the title page of this paper, which presents a microscopic image of the avian flu. A further publication that addresses a related industry is the CDC Public Health Law News, which is a weekly electronic digest with current and topical information related to public health law and legislation. The information contained in this digest ranges from profiles of key individuals within the medical legal profession to relevant court rulings and their subsequent applications.
A further publication that existed for years in print form only is “Health Information for International Travel”, which stands as one of the CDC’s oldest publications. However, this publication has made the transition to electronic format being categorized under the general “Traveler’s health” heading. Many of the older issues, as well as the current issue can be found online (http://www.cdc.gov/travel/yb/index.htm
). “Health Information for International Travel” is published every two years by the CDC and the primary focus of the publication is for health care providers. The individual citizen with specific international travel concerns would be best served by the “Traveler’s health” portion of the CDC website. “Basic Housing Inspection” is another publication that has generated considerable interest, although it originally existed in print format only. “Basic Housing Inspection” offers practical health related advice for those people wanting to develop training programs for housing inspectors, a need that has increased substantially since the publication was originally distributed. Due to the need for such a publication, the CDC wisely felt it necessary to disseminate the information in electronic format (http://www.cdc.gov/
nceh/publications/books/housing/housing.htm#ackpg). In summation, it is difficult to locate many flaws in the CDC’s policy of equitable electronic access, with print sources available electronically. This reflects the growing trend of the Government Printing Office (GPO) to switch their focus from print to electronic formats, a trend exacerbated by the popularity and convenience of electronic format sources with the general public.
All information of importance to the individual concerned citizen is available electronically, whether it be through the Center for Disease Control (CDC) website (http://www.cdc.gov/
) or through a variety of related health information websites available through the Department of Health and Human Services (http://www.hhs.gov/
). Therefore, it is difficult to fault the CDC with a failure to limit access to viable information by maintaining their information in a print only format.
In order to establish the consistency and the validity of the information disseminated through various government, the Office of Management and Budget (OMB) has established guidelines entitled “Guidelines for ensuring and maximizing the quality, objectivity, utility, and integrity of information disseminated by federal agencies (67 FR 8451, 2002). The Center for Disease Control (CDC) has taken obvious care in establishing their compliance with these guidelines. This is especially important concerning the validity of the information being presented; since CDC is concerned with medical information, it is especially critical that this information is produced using scientifically acceptable procedures so as to minimize any negative health effects that could result from faulty procedures. In order to do this, it is necessary for agencies to have their methods be transparent so that they can be peer reviewed and subjected to additional testing. The OMB is aware of this when it explicitly states that “transparency is important for peer review and these guidelines set minimum standards for the transparency of agency-sponsored peer review“(67 FR 8254, 2002). Furthermore, the OMB states that if this data has been “subjected to formal, independent, external peer review, the information may generally be presumed to be of acceptable objectivity” (67 FR 8254, 2002).
The CDC abides by this strict measure of transparency by subjecting all research reports and journal articles to strict peer review standards. For example, Emerging Infectious Diseases Journal employed peer reviewers from over 61 countries last year alone to ensure that the information presented in their journal was accurate (http://www.cdc.gov/ncidod/EID/about/reviewers.htm)
. Likewise, the Morbidity and Mortality Weekly Report establishes that scientific data presented in their journal must reflect that issued by the Center for Disease Control itself or must be verifiable through the CDC (http://www.cdc.gov/od/foia/policies/author.htm
). This additional layer of peer review helps to establish the transparency as requested by the OMB guidelines.
Scientifically, aside from error detection, the OMB guidelines help to establish whether the result is overtly based on the analytic choices made by the agency itself (67 FR 8456, 2002). In the case of the CDC, this clause opens up their research findings to outside agencies or non-governmental organizations, allowing them to reproduce the results or deviate from the agency’s research path to produce new methods or results. Since the information disseminated by the Center for Disease Control is transparent, abiding by the guidelines of the OMB, it serves to stimulate the common good by producing platforms on which to conduct future experiments. Furthermore, it establishes the CDC is not proprietary in nature; it facilitates the use of agency information by posting it to the website without any undue restrictions. Overall, though, the OMB guidelines assure the public and medical professionals that the information disseminated through the CDC is valid.
The information provided on the Center for Disease Control (CDC) website is accurate and authoritative. The articles presented in their related publications are peer-reviewed in an attempt to maintain this desire for authenticity and authority by way of transparency. Since the information is presented scientifically, with some publications forcing submissions to establish their scientific credibility, the CDC is establishing objectivity by allowing scientific and medical realities to dictate policy. Furthermore, the information presented is both pertinent and timely, as made evident by the recent focus on avian flu and other topical illnesses and diseases. The coverage of the CDC publications is vast; incorporating a variety of topics related to the prevention and nature of communicable and chronic diseases, with a variety of supporting statistical data and multimedia supporting information. Furthermore, the umbrella organization of the CDC, namely the many centers and organizations that comprise the Department of Health and Human Services, establishes further topic coverage of medical information related to the specific focus of the CDC to disease control and prevention. The Center for Disease Control (CDC) fulfills its mission by providing information related to promoting the health and quality of life by preventing and controlling disease, injury, and disability.
Center for Disease Control. Retrieved February 2, 2006, from http://www.cdc.gov/
“Colorized transmission electron micrograph of Avian influenza A H5N1 viruses grown in MDCK cells “(n.d.). Department of Health and Human Services, Center for Disease Control, Public Health Image Library (PHIL). Retrieved February 28, 2006, from http://phil.cdc.gov/phil/quicksearch.asp
Department of Health and Human Services. Retrieved February 8, 2006, fromhttp://www.hhs.gov/
Dowell, S.F. & Levitt, A.M. (2002). Protecting the nation’s health in an era of
globalization: CDC’s global infectious disease strategy. Department of Health and Human Services, Center for Disease Control, Atlanta, 2002.
Emerging Infectious Diseases (2006, March). Department of Health and Human
Services, Center for Disease Control, 12 (3), March, 2006. Retrieved March 8, 2006, from http://www.cdc.gov/ncidod/EID/index.htm
Guidelines for ensuring and maximizing the quality, objectivity, utility, and
integrity of information disseminated by Federal Agencies; Notice; Republication. 67 FR 8451 (February 22, 2002). Retrieved March 9, 2006, from http://www.gpoaccess.gov/.
Morbidity and Mortality Weekly Report (2006, March 3).
Department of Health and Human Services, Center for Disease Control, 55 (8), March 3, 2006. Retrieved March 5, 2006, from http://www.cdc.gov/mmwr/
Preventing Chronic Diseases (2006). Department of Health and Human Services,
Center for Disease Control, 3 (1), January, 2006. Retrieved February 28, 2006, from http://www.cdc.gov/pcd/
Public Health Law News (n.d.). Department of Health and Human Services,
Center for Disease Control. Retrieved February 28, 2006, fromhttp://www2a.cdc.gov/phlp/cphln.asp