Linking health and social data in Brazil: challenges and potentials for public health research
Abstract Health research using linked routine population-based data collected for non-research purposes has increased in recent years. In Brazil, the Centre for Data and Knowledge Integration for Health (CIDACS-Fiocruz) was created in 2016 in Salvador with the objective of integrating data to answer research questions related to public health. In CIDACS, efforts are made to obtain high-quality linked data while adhering to security, ethical use and privacy issues. Efforts have been made to conduct operations with respect to implementing the appropriate structures, processes and controls over the original and integrated datasets in order to provide relevant data for research purposes. Two different cohorts have been constructed. The “100 Million Brazilian Cohort” comprises of individuals registered in a National Social Register from 2001 linked to data from different social protection programs ('exposures') and outcomes from various health-related Brazilian National databases (deaths, births, infectious diseases). The main aim is to explore the impact of social protection programs on health using natural experiment approaches. By studying the effect of social policies, they increase our possibilities to explore links between the social and economic determinants and health. The CIDACS Birth Cohort is also a population-based cohort derived from linked data, developed to investigate the relationships between prenatal and early life events on health-related outcomes for infants and children, in the context of social inequalities. The overall objective is to research the effect of obstetric and prenatal conditions on birth, growth, morbidity, and survival in a dynamic cohort. CIDACS is expected to be an important resource for researchers and policymakers interested in enhancing the evidence base pertaining to different aspects of health, as well as investigating the role of social determinants of health and the potential effects of social and environmental policies on health.