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The workplace is where 156 million working adults in the United States spend many waking hours, and it has a profound influence on health and well-being. Although some occupations and work-related activities are more hazardous than others and face higher rates of injuries, illness, disease, and fatalities, workers in all occupations face some form of work-related safety and health concerns. Understanding those risks to prevent injury, illness, or even fatal incidents is an important function of society. Occupational safety and health (OSH) surveillance provides the data and analyses needed to understand the relationships between work and injuries and illnesses in order to improve worker safety and health and prevent work-related injuries and illnesses. Information about the circumstances in which workers are injured or made ill on the job and how these patterns change over time is essential to develop effective prevention programs and target future research. The nation needs a robust OSH surveillance system to provide this critical information for informing policy development, guiding educational and regulatory activities, developing safer technologies, and enabling research and prevention strategies that serves and protects all workers. A Smarter National Surveillance System for Occupational Safety and Health in the 21st Century provides a comprehensive assessment of the state of OSH surveillance. This report is intended to be useful to federal and state agencies that have an interest in occupational safety and health, but may also be of interest broadly to employers, labor unions and other worker advocacy organizations, the workers' compensation insurance industry, as well as state epidemiologists, academic researchers, and the broader public health community. The recommendations address the strengths and weaknesses of the envisioned system relative to the status quo and both short- and long-term actions and strategies needed to bring about a progressive evolution of the current system.

The Transportation Security Administration requested a study by the National Research Council (NRC) to establish the Committee on Airport Passenger Screening: Millimeter Wave Machines to evaluate two models of active millimeter wave scanners: the L3 ProVision 1 and L3 ProVision 2. Airport Passenger Screening Using Millimeter Wave Machines provides findings and recommendations on compliance with applicable health and safety guidelines and appropriateness of system design and procedures for preventing over exposure. This study addresses the issue of whether millimeter wave machines used at airports comply with existing guidelines and whether it would be possible for anything to go wrong with the machines so that, by mistake, it exposes a person to more than 10 W/m2--Publisher's description.

A great number of diverse microorganisms inhabit the human body and are collectively referred to as the human microbiome. Until recently, the role of the human microbiome in maintaining human health was not fully appreciated. Today, however, research is beginning to elucidate associations between perturbations in the human microbiome and human disease and the factors that might be responsible for the perturbations. Studies have indicated that the human microbiome could be affected by environmental chemicals or could modulate exposure to environmental chemicals. Environmental Chemicals, the Human Microbiome, and Health Risk presents a research strategy to improve our understanding of the interactions between environmental chemicals and the human microbiome and the implications of those interactions for human health risk. This report identifies barriers to such research and opportunities for collaboration, highlights key aspects of the human microbiome and its relation to health, describes potential interactions between environmental chemicals and the human microbiome, reviews the risk-assessment framework and reasons for incorporating chemical-microbiome interactions.

The 2011 National Research Council decadal survey on biological and physical sciences in space, Recapturing a Future for Space Exploration: Life and Physical Sciences Research for a New Era, was written during a critical period in the evolution of science in support of space exploration. The research agenda in space life and physical sciences had been significantly descoped during the programmatic adjustments of the Vision for Space Exploration in 2005, and this occurred in the same era as the International Space Station (ISS) assembly was nearing completion in 2011. Out of that period of change, Recapturing a Future for Space Exploration presented a cogent argument for the critical need for space life and physical sciences, both for enabling and expanding the exploration capabilities of NASA as well as for contributing unique science in many fields that can be enabled by access to the spaceflight environment. Since the 2011 publication of the decadal survey, NASA has seen tremendous change, including the retirement of the Space Shuttle Program and the maturation of the ISS. NASA formation of the Division of Space Life and Physical Sciences Research and Applications provided renewed focus on the research of the decadal survey. NASA has modestly regrown some of the budget of space life and physical sciences within the agency and engaged the U.S. science community outside NASA to join in this research. In addition, NASA has collaborated with the international space science community. This midterm assessment reviews NASA's progress since the 2011 decadal survey in order to evaluate the high-priority research identified in the decadal survey in light of future human Mars exploration. It makes recommendations on science priorities, specifically those priorities that best enable deep space exploration.

The Roundtable on Obesity Solutions of the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, DC, on April 6, 2017, titled The Challenge of Treating Obesity and Overweight: A Workshop. The discussions covered treatments for obesity, overweight, and severe obesity in adults and children; emerging treatment opportunities; the development of a workforce for obesity treatments; payment and policy considerations; and promising paths to move forward. This publication summarizes the presentations and discussions from the workshop--

On June 21-22, 2017, the National Academies of Sciences, Engineering, and Medicine's Food and Nutrition Board convened a workshop in Washington, DC, to explore the range of policies and programs that exist at the federal, state, tribal, and local levels to limit sugar-sweetened beverage consumption in children birth to 5 years of age. Topics examined over the course of the 1.5-day workshop included prevalence and trends in beverage intake among young children; beverage intake guidelines applicable to the age range of interest; challenges and opportunities of influencing beverage consumption; the role of industry in beverage intake; and knowledge gaps and research needs. This publication summarizes the presentations and discussions from the workshop.

"The National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a public workshop, Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum, on February 13 and 14, 2017, in Washington, DC. The purpose of this workshop was to highlight the current evidence base, gaps in knowledge, and research needs on the associations among obesity, physical activity, weight management, and health outcomes for cancer survivors, as well as to examine the effectiveness of interventions for promoting physical activity and weight management among people living with or beyond cancer. Workshop sessions also reviewed the opportunities and challenges for providing weight management and physical activity interventions to cancer survivors. This publication summarizes the presentations and discussions from the workshop"--

The laser has revolutionized many areas of science and society, providing bright and versatile light sources that transform the ways we investigate science and enables trillions of dollars of commerce. Now a second laser revolution is underway with pulsed petawatt-class lasers (1 petawatt: 1 million billion watts) that deliver nearly 100 times the total world's power concentrated into a pulse that lasts less than one-trillionth of a second. Such light sources create unique, extreme laboratory conditions that can accelerate and collide intense beams of elementary particles, drive nuclear reactions, heat matter to conditions found in stars, or even create matter out of the empty vacuum. These powerful lasers came largely from U.S. engineering, and the science and technology opportunities they enable were discussed in several previous National Academies' reports. Based on these advances, the principal research funding agencies in Europe and Asia began in the last decade to invest heavily in new facilities that will employ these high-intensity lasers for fundamental and applied science. No similar programs exist in the United States. Opportunities in Intense Ultrafast Lasers assesses the opportunities and recommends a path forward for possible U.S. investments in this area of science.

The United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicines--and health care at large--more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugs--coupled with the broader trends in overall health care costs--is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.

The 1980 eruption of Mount St. Helens in southwest Washington State radically changed the physical and socio-economic landscapes of the region. The eruption destroyed the summit of the volcano, sending large amounts of debris into the North Fork Toutle River, and blocking the sole means of drainage from Spirit Lake 4 miles north of Mount St. Helens. As a result of the blockage, rising lake levels could cause failure of the debris blockage, putting the downstream population of approximately 50,000 at risk of catastrophic flooding and mud flows. Further, continued transport of sediment to the river from volcanic debris deposits surrounding the mountain reduces the flood carrying capacity of downstream river channels and leaves the population vulnerable to chronic flooding. The legacy of the 1980 eruption and the prospect of future volcanic, seismic, and flood events mean that risk management in the Spirit Lake Toutle River system will be challenging for decades to come. This report offers a decision framework to support the long-term management of risks related to the Spirit Lake and Toutle River system in light of the different regional economic, cultural, and social priorities, and the respective roles of federal, tribal, state, and local authorities, as well as other entities and groups in the region. It also considers the history and adequacy of characterization, monitoring, and management associated with the Spirit Lake debris blockage and outflow tunnel, other efforts to control transport of water and sediment from the 1980 and later eruptions, and suggests additional information needed to support implementation of the recommended decision framework.

"As of 2017, the emergence and spread of antimicrobial resistance continues unabated around the world, leaving devastating health and economic outcomes in its wake. Those consequences will multiply if collaborative global action is not taken to address the spread of resistance. Major drivers of antimicrobial resistance in humans have been accelerated by inappropriate antimicrobial prescribing in health care practices; the inappropriate use of antimicrobials in livestock; and the promulgation of antibiotic resistance genes in the environment. To explore the issue of antimicrobial resistance, the Forum of Microbial Threats planned a public workshop. Participants explored issues of antimicrobial resistance through the lens of One Health, which is a collaborative approach of multiple disciplines - working locally, nationally, and globally - for strengthening systems to counter infectious diseases and related issues that threaten human, animal, and environmental health, with an end point of improving global health and achieving gains in development. They also discussed immediate and short-term actions and research needs that will have the greatest effect on reducing antimicrobial resistance, while taking into account the complexities of bridging different sectors and disciplines to address this global threat. This publication summarizes the presentations and discussions from the workshop"--

To explore how the use of technology can facilitate progress toward globally recognized health priorities, the Forum on Public-Private Partnerships for Global Health and Safety organized a public workshop. Participants identified and explored the major challenges and opportunities for developing and implementing digital health strategies within the global, country, and local context, and framed the case for cross-sector and cross-industry collaboration, engagement, and investment in digital health strategies. This publication summarizes the presentations and discussions from the workshop.

The Intelligence Community Studies Board of the National Academies of Sciences, Engineering, and Medicine convened a workshop on August 9-10, 2017 to examine challenges in machine generation of analytic products from multi-source data. Workshop speakers and participants discussed research challenges related to machine-based methods for generating analytic products and for automating the evaluation of these products, with special attention to learning from small data, using multi-source data, adversarial learning, and understanding the human-machine relationship. This publication summarizes the presentations and discussions from the workshop.

Continuing education, continuing professional development, and high-value continuing professional development exist along a continuum. Continuing education (CE) often is associated with didactic learning methods, such as lectures and seminars, which take place in auditoriums and classrooms, and is often viewed by health professionals as merely a path to maintaining licensure and certification through the accumulation of credits. Continuing professional development (CPD), in contrast, embraces a wider array of learning formats and methods that are driven by learners. The Global Forum on Innovation in Health Professional Education hosted a workshop in April 2017 to explore the value proposition for CPD. Forum members and workshop participants gathered to learn about innovative CPD programs around the world, to consider the perspectives of those who invest in CPD, and to discuss the business case for CPD. This publication summarizes the presentations and discussions from the workshop.

The increasingly diverse ethnic composition of the United States population has created a profound and ongoing demographic shift, and public health and health care organizations face many challenges as they move to address and adapt to this change. To better understand how the public health and health care communities can meet the challenges of serving an increasingly diverse population, the Roundtable on Health Literacy conducted a public workshop on facilitating health communication with immigrant, refugee, and migrant populations through the use of health literate approaches. The goal of the workshop was to identify approaches that will enable organizations that serve these ethnically and culturally diverse populations in a manner that allows all members of these communities to obtain, process, and understand basic health information and the services needed to make appropriate health and personal decisions. This publication summarizes the presentations and discussions from the workshop--Publishers website.

"Following a series of natural disasters, including Hurricane Katrina, that revealed shortcomings in the nation's ability to effectively alert populations at risk, Congress passed the Warning, Alert, and Response Network (WARN) Act in 2006. Today, new technologies such as smart phones and social media platforms offer new ways to communicate with the public, and the information ecosystem is much broader, including additional official channels, such as government social media accounts, opt-in short message service (SMS)-based alerting systems, and reverse 911 systems; less official channels, such as main stream media outlets and weather applications on connected devices; and unofficial channels, such as first person reports via social media. Traditional media have also taken advantage of these new tools, including their own mobile applications to extend their reach of beyond broadcast radio, television, and cable. Furthermore, private companies have begun to take advantage of the large amounts of data about users they possess to detect events and provide alerts and warnings and other hazard-related information to their users. More than 60 years of research on the public response to alerts and warnings has yielded many insights about how people respond to information that they are at risk and the circumstances under which they are most likely to take appropriate protective action. Some, but not all, of these results have been used to inform the design and operation of alert and warning systems, and new insights continue to emerge. Emergency Alert and Warning Systems reviews the results of past research, considers new possibilities for realizing more effective alert and warning4 systems, explores how a more effective national alert and warning system might be created and some of the gaps in our present knowledge, and sets forth a research agenda to advance the nation's alert and warning capabilities"--Publisher's description.

"Our ability to observe and forecast severe weather events has improved markedly over the past few decades. Forecasts of snow and ice storms, hurricanes and storm surge, extreme heat, and other severe weather events are made with greater accuracy, geographic specificity, and lead time to allow people and communities to take appropriate protective measures. Yet hazardous weather continues to cause loss of life and result in other preventable social costs...There is growing recognition that a host of social and behavioral factors affect how we prepare for, observe, predict, respond to, and are impacted by weather hazards. For example, an individual's response to a severe weather event may depend on their understanding of the forecast, prior experience with severe weather, concerns about their other family members or property, their capacity to take the recommended protective actions, and numerous other factors. Indeed, it is these factors that can determine whether or not a potential hazard becomes an actual disaster. Thus, it is essential to bring to bear expertise in the social and behavioral sciences (SBS)--including disciplines such as anthropology, communication, demography, economics, geography, political science, psychology, and sociology--to understand how people's knowledge, experiences, perceptions, and attitudes shape their responses to weather risks and to understand how human cognitive and social dynamics affect the forecast process itself"--

During public health emergencies (PHEs) involving chemical, biological, radiological, or nuclear threats or emerging infectious diseases, medical countermeasures (MCMs) (e.g., drugs, vaccines, devices) may need to be dispensed or administered to affected populations to help mitigate the human health impact of the threat. The optimal MCMs determined for use during an emergency might be U.S. Food and Drug Administration (FDA) approved but used in unapproved ways (e.g., in a new age group or against a new agent); FDA approved using animal models because human efficacy testing is not ethical or feasible; or not yet FDA approved for any indication. As part of the United States' scientific and research preparedness enterprise, there is an imperative to go "beyond the last mile" of MCM dispensing and administration to build and maintain a national capability to monitor and assess the use of MCMs (e.g., safety, compliance, clinical benefit) after they have been dispensed during PHEs. To further the discussion on this need, the Board on Health Sciences Policy of the National Academies of Sciences, Engineering, and Medicine hosted a 2-day public workshop, Building a National Capability to Monitor and Assess Medical Countermeasure Use in Response to Public Health Emergencies. The workshop, sponsored by FDA, was held on June 6-7, 2017, in Washington, DC. Workshop participants discussed the roles and efforts of the federal government and of relevant stakeholders with an interest in building and maintaining a national PHE MCM active monitoring and assessment capability. This publication summarizes the presentations and discussions from the workshop.

On June 26, 2017, the Forum on Regenerative Medicine hosted a public workshop in Washington, DC, titled Navigating the Manufacturing Process and Ensuring the Quality of Regenerative Medicine Therapies in order to examine and discuss the challenges, opportunities, and best practices associated with defining and measuring the quality of cell and tissue products and raw materials in the research and manufacturing of regenerative medicine therapies. The goal of the workshop was to learn from existing examples of the manufacturing of early-generation regenerative medicine products and to address how progress could be made in identifying and measuring critical quality attributes. The workshop also addressed the challenges of designing and adhering to standards as a way of helping those who are working to scale up processes and techniques from a research laboratory to the manufacturing environment. This publication summarizes the presentations and discussions from the workshop.

"The field of computer science (CS) is currently experiencing a surge in undergraduate degree production and course enrollments, which is straining program resources at many institutions and causing concern among faculty and administrators about how best to respond to the rapidly growing demand. There is also significant interest about what this growth will mean for the future of CS programs, the role of computer science in academic institutions, the field as a whole, and U.S. society more broadly. Assessing and Responding to the Growth of Computer Science Undergraduate Enrollments seeks to provide a better understanding of the current trends in computing enrollments in the context of past trends. It examines drivers of the current enrollment surge, relationships between the surge and current and potential gains in diversity in the field, and the potential impacts of responses to the increased demand for computing in higher education, and it considers the likely effects of those responses on students, faculty, and institutions. This report provides recommendations for what institutions of higher education, government agencies, and the private sector can do to respond to the surge and plan for a strong and sustainable future for the field of CS in general, the health of the institutions of higher education, and the prosperity of the nation" -- Publisher's description

"Palliative care is the interdisciplinary specialty focused on improving quality of life for people with serious illness and their families. This interdisciplinary care is provided by doctors, nurses, social workers, chaplains and others who work together with the patient's other doctors to provide an extra layer of support. Such care is appropriate for people at any age and at any stage in a serious illness, and can be provided together with curative treatment to address clinical, emotional, psychosocial and spiritual concerns of the patient and their family. To better understand how the principles of palliative care can be integrated into the overall provision of care and services to those facing serious illness, the Roundtable on Quality Care for People with Serious Illness held a public workshop in April 2017. This publication summarizes the presentations and discussions from the workshop"--

As the United States continues to adapt to a more digital, mobile, and interconnected world, health care and public health professionals have sought to better prepare for and respond to long-standing and emerging threats to the nation's health security. Health security is the collective effort to prevent, protect against, mitigate, respond to, and recover from the health consequences of natural, man-made, and technological disasters. Although substantial progress has been made in the past 15 years toward improving health care and public health systems and capacities for health security threats, many complex challenges persist, and often the nation's preparedness efforts are not sufficient. On March 8-9, 2017, the National Academies of Sciences, Engineering, and Medicine's Forum on Medical and Public Health Preparedness for Disasters and Emergencies hosted a two-day public workshop to acknowledge these persistent issues; to evaluate past, and perhaps inadequate, approaches to addressing them; and to discuss intentional and innovative new solutions. This publication summarizes the presentations and discussions from the workshop--

The Planning Committee on Connector Reliability for Offshore Oil and Natural Gas Operations held the Workshop on Bolting Reliability for Offshore Oil and Natural Gas Operations in Washington, D.C., on April 10-11, 2017. The workshop was designed to advance and develop a comprehensive awareness of the outstanding issues associated with fastener material failures and equipment reliability issues. Speakers and participants were also encouraged to discuss possible paths for ameliorating risks associated with fasteners used for subsea critical equipment in oil and gas operations. This publication summarizes the presentations and discussions from the workshop.

The ocean is an integral component of the Earth's climate system. It covers about 70% of the Earth's surface and acts as its primary reservoir of heat and carbon, absorbing over 90% of the surplus heat and about 30% of the carbon dioxide associated with human activities, and receiving close to 100% of fresh water lost from land ice. With the accumulation of greenhouse gases in the atmosphere, notably carbon dioxide from fossil fuel combustion, the Earth's climate is now changing more rapidly than at any time since the advent of human societies. Society will increasingly face complex decisions about how to mitigate the adverse impacts of climate change such as droughts, sea-level rise, ocean acidification, species loss, changes to growing seasons, and stronger and possibly more frequent storms. Observations play a foundational role in documenting the state and variability of components of the climate system and facilitating climate prediction and scenario development. Regular and consistent collection of ocean observations over decades to centuries would monitor the Earth's main reservoirs of heat, carbon dioxide, and water and provides a critical record of long-term change and variability over multiple time scales. Sustained high-quality observations are also needed to test and improve climate models, which provide insights into the future climate system. Sustaining Ocean Observations to Understand Future Changes in Earth's Climate considers processes for identifying priority ocean observations that will improve understanding of the Earth's climate processes, and the challenges associated with sustaining these observations over long timeframes--Publishers website.

The Superfund program of the US Environmental Protection Agency (EPA) was created in the 1980s to address human-health and environmental risks posed by abandoned or uncontrolled hazardous-waste sites. Identification of Superfund sites and their remediation is an expensive multistep process. As part of this process, EPA attempts to identify parties that are responsible for the contamination and thus financially responsible for remediation. Identification of potentially responsible parties is complicated because Superfund sites can have a long history of use and involve contaminants that can have many sources. Such is often the case for mining sites that involve metal contamination; metals occur naturally in the environment, they can be contaminants in the wastes generated at or released from the sites, and they can be used in consumer products, which can degrade and release the metals back to the environment. This report examines the extent to which various sources contribute to environmental lead contamination at Superfund sites that are near lead-mining areas and focuses on sources that contribute to lead contamination at sites near the Southeast Missouri Lead Mining District. It recommends potential improvements in approaches used for assessing sources of lead contamination at or near Superfund sites.

The Manufacturing USA initiative seeks to reinforce U.S.-based advanced manufacturing through partnerships among industry, academia, and government. Started in 2012 and established with bipartisan support by the Revitalize American Manufacturing and Innovation Act of 2014, the initiative envisages a nationwide network of research centers for manufacturing innovation. As of May 2017, 14 manufacturing innovation institutes had been established to facilitate the movement of early-stage research into proven capabilities ready for adoption by U.S. manufacturers. To better understand the role and experiences of the Manufacturing USA institutes to date, a committee of the Innovation Policy Forum of the National Academies of Sciences, Engineering, and Medicine convened a workshop on May 23, 2017 drawing together institute directors and manufacturing policy experts along with leaders from industry, academia, and government. Participants addressed the role of the manufacturing institutes in increasing advanced manufacturing in the United States, examined selected foreign programs designed to support advanced manufacturing, and reviewed recent assessments of existing institutes. This publication summarizes the presentations and discussions from the workshop.

Opportunities for Organ Donor Intervention Research focuses on the ethical, legal, regulatory, policy, and organizational issues relevant to the conduct of research in the United States involving deceased organ donors. This report provides recommendations for how to conduct organ donor intervention research in a manner that maintains high ethical standards, that ensures dignity and respect for deceased organ donors and their families, that provides transparency and information for transplant candidates who might receive a research organ, and that supports and sustains the public's trust in the process of organ donation and transplantation--

In 2010, the National Research Council published the report U.S-Iran Engagement in Science, Engineering, and Medicine (2000-2009). The review of the program described in detail the National Academies' science, technology, and health cooperation program carried out jointly with partners in Iran (otherwise known as science-engagement). The purpose of this new publication is to document the history and details of the National Academies' program of science-engagement from 2010 through 2016, while providing a perspective in considering future science-engagement. A variety of cooperative activities, and particularly workshops that dominated science-engagement during that period, are highlighted.

The National Agricultural Statistics Service (NASS) is the primary statistical data collection agency within the U.S. Department of Agriculture (USDA). NASS conducts hundreds of surveys each year and prepares reports covering virtually every aspect of U.S. agriculture. Among the small-area estimates produced by NASS are county-level estimates for crops (planted acres, harvested acres, production, and yield by commodity) and for cash rental rates for irrigated cropland, nonirrigated cropland, and permanent pastureland. Key users of these county-level estimates include USDA's Farm Services Agency (FSA) and Risk Management Agency (RMA), which use the estimates as part of their processes for distributing farm subsidies and providing farm insurance, respectively. Improving Crop Estimates by Integrating Multiple Data Sources assesses county-level crop and cash rents estimates, and offers recommendations on methods for integrating data sources to provide more precise county-level estimates of acreage and yield for major crops and of cash rents by land use. This report considers technical issues involved in using the available data sources, such as methods for integrating the data, the assumptions underpinning the use of each source, the robustness of the resulting estimates, and the properties of desirable estimates of uncertainty.

"This is the second Consensus Study Report of the Panel on Improving Federal Statistics for Policy and Social Science Research Using Multiple Data Sources and State-of-the-Art Estimation Methods. Our first report, Innovations in Federal Statistics: Combining Data Sources While Protecting Privacy, was released in January 2017. In that report, the panel noted that there has been increasing attention in recent years to using data already collected by government entities for statistical purposes, such as evaluation of government programs. These data include such records as employment and earnings information on state unemployment insurance, income reported on federal tax forms, Social Security earnings and benefits, medical conditions and payments made for services from Medicare and Medicaid records, and food assistance program benefits"--Page ix.