Case Synopsis

The case outlines the challenges that the National Institute for Health and Welfare in Helsinki, Finland is facing in light of an ongoing national health care reform. The health care reform has taken precedence over other research activities, and the Institute is anticipating changes to population health surveillance methods. The Institute elected a new Director General in the fall of 2018 who will influence decisions about which population surveillance data collection methods are used. The Health Monitoring Unit at the Institute fears that the Director General will decide that all surveillance data will be collected using administrative patient registries with the consequent elimination of population health surveys. The team responsible for the 2017 National FinHealth population health survey must determine how they can advocate for the continued use of survey data in population health surveillance.

Case Objectives

1. Compare alternative methods for collecting population health data using knowledge of study designs to analyze strengths and inherent sources of bias for each method.

2. Discuss the importance of, but challenges associated with, evidence-informed decision making in public health and practice making decisions with limited or insufficient evidence.

3. Recognize foundational epidemiological concepts such as risk factors, prevalence, simple random sampling, surveillance, study designs, secondary data, and levels of prevention.

4. Illustrate how descriptive epidemiology can be used to quantify population disease burden and support surveillance.

Case Study Questions

1. Explain the stages of the epidemiological research cycle.

2. What is the design of the FinHealth 2017 Study? What are the strengths and weaknesses of different observational study designs?

3. What are the advantages and disadvantages associated with alternative sources of population health data?


Cross-sectional study; epidemiology; evidence-informed decision-making; population health; prevalence; registry data; surveillance; survey data

Additional Author Information

Kristia Maatta, BSc, MPH

Katja Borodulin, PhD

Ava John-Baptiste, PhD, Assistant Professor



Recommended Citation

Maatta, K., Borodulin, K. & John-Baptiste, A. (2019). Population Health Surveillance in Finland: Threats to Historically Dependable Surveillance Methodology. In: Sibbald, S.L. & McKinley, G. [eds] Western Public Health Casebook 2019. London, ON: Public Health Casebook Publishing.