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Health and safety refers to the study of various aspects of maintaining health and securing the safety of the people. Health and safety are crucial duties of the state. Doctors keep people healthy and soldiers provide security. Research in this field is important for people's well-being. Thus, students must choose quality health and safety dissertation topics for their research modules.

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Research Topics & Ideas: Healthcare

F inding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. If you’ve landed on this post, chances are you’re looking for a healthcare-related research topic , but aren’t sure where to start. Here, we’ll explore a variety of healthcare-related research ideas and topic thought-starters across a range of healthcare fields, including allopathic and alternative medicine, dentistry, physical therapy, optometry, pharmacology and public health.

NB – This is just the start…

The topic ideation and evaluation process has multiple steps . In this post, we’ll kickstart the process by sharing some research topic ideas within the healthcare domain. This is the starting point, but to develop a well-defined research topic, you’ll need to identify a clear and convincing research gap , along with a well-justified plan of action to fill that gap.

If you’re new to the oftentimes perplexing world of research, or if this is your first time undertaking a formal academic research project, be sure to check out our free dissertation mini-course. In it, we cover the process of writing a dissertation or thesis from start to end. Be sure to also sign up for our free webinar that explores how to find a high-quality research topic.

Overview: Healthcare Research Topics

• Allopathic medicine
• Alternative /complementary medicine
• Veterinary medicine
• Physical therapy/ rehab
• Optometry and ophthalmology
• Pharmacy and pharmacology
• Public health
• Examples of healthcare-related dissertations

Allopathic (Conventional) Medicine

• The effectiveness of telemedicine in remote elderly patient care
• The impact of stress on the immune system of cancer patients
• The effects of a plant-based diet on chronic diseases such as diabetes
• The use of AI in early cancer diagnosis and treatment
• The role of the gut microbiome in mental health conditions such as depression and anxiety
• The efficacy of mindfulness meditation in reducing chronic pain: A systematic review
• The benefits and drawbacks of electronic health records in a developing country
• The effects of environmental pollution on breast milk quality
• The use of personalized medicine in treating genetic disorders
• The impact of social determinants of health on chronic diseases in Asia
• The role of high-intensity interval training in improving cardiovascular health
• The efficacy of using probiotics for gut health in pregnant women
• The impact of poor sleep on the treatment of chronic illnesses
• The role of inflammation in the development of chronic diseases such as lupus
• The effectiveness of physiotherapy in pain control post-surgery

Topics & Ideas: Alternative Medicine

• The benefits of herbal medicine in treating young asthma patients
• The use of acupuncture in treating infertility in women over 40 years of age
• The effectiveness of homoeopathy in treating mental health disorders: A systematic review
• The role of aromatherapy in reducing stress and anxiety post-surgery
• The impact of mindfulness meditation on reducing high blood pressure
• The use of chiropractic therapy in treating back pain of pregnant women
• The efficacy of traditional Chinese medicine such as Shun-Qi-Tong-Xie (SQTX) in treating digestive disorders in China
• The impact of yoga on physical and mental health in adolescents
• The benefits of hydrotherapy in treating musculoskeletal disorders such as tendinitis
• The role of Reiki in promoting healing and relaxation post birth
• The effectiveness of naturopathy in treating skin conditions such as eczema
• The use of deep tissue massage therapy in reducing chronic pain in amputees
• The impact of tai chi on the treatment of anxiety and depression
• The benefits of reflexology in treating stress, anxiety and chronic fatigue
• The role of acupuncture in the prophylactic management of headaches and migraines

Topics & Ideas: Dentistry

• The impact of sugar consumption on the oral health of infants
• The use of digital dentistry in improving patient care: A systematic review
• The efficacy of orthodontic treatments in correcting bite problems in adults
• The role of dental hygiene in preventing gum disease in patients with dental bridges
• The impact of smoking on oral health and tobacco cessation support from UK dentists
• The benefits of dental implants in restoring missing teeth in adolescents
• The use of lasers in dental procedures such as root canals
• The efficacy of root canal treatment using high-frequency electric pulses in saving infected teeth
• The role of fluoride in promoting remineralization and slowing down demineralization
• The impact of stress-induced reflux on oral health
• The benefits of dental crowns in restoring damaged teeth in elderly patients
• The use of sedation dentistry in managing dental anxiety in children
• The efficacy of teeth whitening treatments in improving dental aesthetics in patients with braces
• The role of orthodontic appliances in improving well-being
• The impact of periodontal disease on overall health and chronic illnesses

Topics & Ideas: Veterinary Medicine

• The impact of nutrition on broiler chicken production
• The role of vaccines in disease prevention in horses
• The importance of parasite control in animal health in piggeries
• The impact of animal behaviour on welfare in the dairy industry
• The effects of environmental pollution on the health of cattle
• The role of veterinary technology such as MRI in animal care
• The importance of pain management in post-surgery health outcomes
• The impact of genetics on animal health and disease in layer chickens
• The effectiveness of alternative therapies in veterinary medicine: A systematic review
• The role of veterinary medicine in public health: A case study of the COVID-19 pandemic
• The impact of climate change on animal health and infectious diseases in animals
• The importance of animal welfare in veterinary medicine and sustainable agriculture
• The effects of the human-animal bond on canine health
• The role of veterinary medicine in conservation efforts: A case study of Rhinoceros poaching in Africa
• The impact of veterinary research of new vaccines on animal health

Topics & Ideas: Physical Therapy/Rehab

• The efficacy of aquatic therapy in improving joint mobility and strength in polio patients
• The impact of telerehabilitation on patient outcomes in Germany
• The effect of kinesiotaping on reducing knee pain and improving function in individuals with chronic pain
• A comparison of manual therapy and yoga exercise therapy in the management of low back pain
• The use of wearable technology in physical rehabilitation and the impact on patient adherence to a rehabilitation plan
• The impact of mindfulness-based interventions in physical therapy in adolescents
• The effects of resistance training on individuals with Parkinson’s disease
• The role of hydrotherapy in the management of fibromyalgia
• The impact of cognitive-behavioural therapy in physical rehabilitation for individuals with chronic pain
• The use of virtual reality in physical rehabilitation of sports injuries
• The effects of electrical stimulation on muscle function and strength in athletes
• The role of physical therapy in the management of stroke recovery: A systematic review
• The impact of pilates on mental health in individuals with depression
• The use of thermal modalities in physical therapy and its effectiveness in reducing pain and inflammation
• The effect of strength training on balance and gait in elderly patients

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Topics & Ideas: Optometry & Opthalmology

• The impact of screen time on the vision and ocular health of children under the age of 5
• The effects of blue light exposure from digital devices on ocular health
• The role of dietary interventions, such as the intake of whole grains, in the management of age-related macular degeneration
• The use of telemedicine in optometry and ophthalmology in the UK
• The impact of myopia control interventions on African American children’s vision
• The use of contact lenses in the management of dry eye syndrome: different treatment options
• The effects of visual rehabilitation in individuals with traumatic brain injury
• The role of low vision rehabilitation in individuals with age-related vision loss: challenges and solutions
• The impact of environmental air pollution on ocular health
• The effectiveness of orthokeratology in myopia control compared to contact lenses
• The role of dietary supplements, such as omega-3 fatty acids, in ocular health
• The effects of ultraviolet radiation exposure from tanning beds on ocular health
• The impact of computer vision syndrome on long-term visual function
• The use of novel diagnostic tools in optometry and ophthalmology in developing countries
• The effects of virtual reality on visual perception and ocular health: an examination of dry eye syndrome and neurologic symptoms

Topics & Ideas: Pharmacy & Pharmacology

• The impact of medication adherence on patient outcomes in cystic fibrosis
• The use of personalized medicine in the management of chronic diseases such as Alzheimer’s disease
• The effects of pharmacogenomics on drug response and toxicity in cancer patients
• The role of pharmacists in the management of chronic pain in primary care
• The impact of drug-drug interactions on patient mental health outcomes
• The use of telepharmacy in healthcare: Present status and future potential
• The effects of herbal and dietary supplements on drug efficacy and toxicity
• The role of pharmacists in the management of type 1 diabetes
• The impact of medication errors on patient outcomes and satisfaction
• The use of technology in medication management in the USA
• The effects of smoking on drug metabolism and pharmacokinetics: A case study of clozapine
• Leveraging the role of pharmacists in preventing and managing opioid use disorder
• The impact of the opioid epidemic on public health in a developing country
• The use of biosimilars in the management of the skin condition psoriasis
• The effects of the Affordable Care Act on medication utilization and patient outcomes in African Americans

Topics & Ideas: Public Health

• The impact of the built environment and urbanisation on physical activity and obesity
• The effects of food insecurity on health outcomes in Zimbabwe
• The role of community-based participatory research in addressing health disparities
• The impact of social determinants of health, such as racism, on population health
• The effects of heat waves on public health
• The role of telehealth in addressing healthcare access and equity in South America
• The impact of gun violence on public health in South Africa
• The effects of chlorofluorocarbons air pollution on respiratory health
• The role of public health interventions in reducing health disparities in the USA
• The impact of the United States Affordable Care Act on access to healthcare and health outcomes
• The effects of water insecurity on health outcomes in the Middle East
• The role of community health workers in addressing healthcare access and equity in low-income countries
• The impact of mass incarceration on public health and behavioural health of a community
• The effects of floods on public health and healthcare systems
• The role of social media in public health communication and behaviour change in adolescents

Examples: Healthcare Dissertation & Theses

While the ideas we’ve presented above are a decent starting point for finding a healthcare-related research topic, they are fairly generic and non-specific. So, it helps to look at actual dissertations and theses to see how this all comes together.

Below, we’ve included a selection of research projects from various healthcare-related degree programs to help refine your thinking. These are actual dissertations and theses, written as part of Master’s and PhD-level programs, so they can provide some useful insight as to what a research topic looks like in practice.

• Improving Follow-Up Care for Homeless Populations in North County San Diego (Sanchez, 2021)
• On the Incentives of Medicare’s Hospital Reimbursement and an Examination of Exchangeability (Elzinga, 2016)
• Managing the healthcare crisis: the career narratives of nurses (Krueger, 2021)
• Methods for preventing central line-associated bloodstream infection in pediatric haematology-oncology patients: A systematic literature review (Balkan, 2020)
• Farms in Healthcare: Enhancing Knowledge, Sharing, and Collaboration (Garramone, 2019)
• When machine learning meets healthcare: towards knowledge incorporation in multimodal healthcare analytics (Yuan, 2020)
• Integrated behavioural healthcare: The future of rural mental health (Fox, 2019)
• Healthcare service use patterns among autistic adults: A systematic review with narrative synthesis (Gilmore, 2021)
• Mindfulness-Based Interventions: Combatting Burnout and Compassionate Fatigue among Mental Health Caregivers (Lundquist, 2022)
• Transgender and gender-diverse people’s perceptions of gender-inclusive healthcare access and associated hope for the future (Wille, 2021)
• Efficient Neural Network Synthesis and Its Application in Smart Healthcare (Hassantabar, 2022)
• The Experience of Female Veterans and Health-Seeking Behaviors (Switzer, 2022)
• Machine learning applications towards risk prediction and cost forecasting in healthcare (Singh, 2022)
• Does Variation in the Nursing Home Inspection Process Explain Disparity in Regulatory Outcomes? (Fox, 2020)

Looking at these titles, you can probably pick up that the research topics here are quite specific and narrowly-focused , compared to the generic ones presented earlier. This is an important thing to keep in mind as you develop your own research topic. That is to say, to create a top-notch research topic, you must be precise and target a specific context with specific variables of interest . In other words, you need to identify a clear, well-justified research gap.

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18 Comments

I need topics that will match the Msc program am running in healthcare research please

Hello Mabel,

I can help you with a good topic, kindly provide your email let’s have a good discussion on this.

Can you provide some research topics and ideas on Immunology?

Thank you to create new knowledge on research problem verse research topic

Help on problem statement on teen pregnancy

This post might be useful: https://gradcoach.com/research-problem-statement/

can you give me research titles that i can conduct as a school nurse

can you provide me with a research topic on healthcare related topics to a qqi level 5 student

Please can someone help me with research topics in public health ?

Hello I have requirement of Health related latest research issue/topics for my social media speeches. If possible pls share health issues , diagnosis, treatment.

I would like a topic thought around first-line support for Gender-Based Violence for survivors or one related to prevention of Gender-Based Violence

Please can I be helped with a master’s research topic in either chemical pathology or hematology or immunology? thanks

Can u please provide me with a research topic on occupational health and safety at the health sector

Good day kindly help provide me with Ph.D. Public health topics on Reproductive and Maternal Health, interventional studies on Health Education

may you assist me with a good easy healthcare administration study topic

May you assist me in finding a research topic on nutrition,physical activity and obesity. On the impact on children

I have been racking my brain for a while on what topic will be suitable for my PhD in health informatics. I want a qualitative topic as this is my strong area.

Hi, may I please be assisted with research topics in the medical laboratory sciences

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🏆 best safety essay examples, 👍 unique safety research topics, ❓ research questions about safety, 🌶️ catchy safety essay examples, 🎓 interesting safety topics to research, 📌 easy safety topics for a project, 💡 simple safety topics ideas.

• New Zealand Cultural Safety in Nursing Practice
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• Drug Errors: Enhancing Care Quality and Safety Though numerous new technologies have been developed to improve healthcare delivery, drug errors continue to be an issue in the United States.
• Risk Management and Patient Safety: Health Services Management The Patient Safety and Quality Improvement Act designates a voluntary reporting system to expand the available data to evaluate and address patient safety.
• Food Safety Sanitation Requirements for a Child’s Health To maintain optimal diet and nutrition for a child’s health and welfare, emphasis must be made on sanitary criteria for food safety, storage, preparation, and food presentation.
• Human Development and the Security and Safety Index The objective of this research was to look at the connection between human development and the security and safety index.
• Safety Considerations of a Commercial Airport The realization of improved safety in our airports therefore warrants a renewed focus on how we perceive airport security threats.
• Irish Aviation Safety and Its Strategic Position This report discusses the strategic position of aviation safety in Ireland and highlights the strategic choices and best practices.
• The Occupational Safety and Health Administration: Engineering Ethics The issue touches on the ethics and legality of the Occupational Safety and Health Administration to change the levels allowed for benzene exposure in the workplace.
• Safety Management Systems in Aviation The authors consider the current state of the SMS in aviation, suggesting general approaches such as a comparative assessment based on a unified system, offering detailed calculations.
• Nurse Empowerment, Self-Efficacy, and Patient Safety Nursing professionals’ vigilance at the bedside is essential to safeguard patient care and to detect medical errors such as incorrect medication orders.
• Injection Safety and Syringe Reuse The reuse of syringes and needles by nurses, doctors, and other healthcare providers in Nevada and Las Vegas led to the spread of Hepatitis B and Hepatitis C.
• Road Safety Precautions for Drivers Many people, who have disobeyed traffic laws, exist for the safety of everyone; have ended up dead or killing innocent people.
• Health Informatics: Impacts on Patient Safety and Care Informatics is significant in any clinical setting because it provides an opportunity to code data so that it can be processed in different ways.
• Unified Model of Patient Safety and Nursing Care This essay will identify a nursing care model utilized in a real-world setting and discuss other theories contributing to the discipline.
• Genetically Modified Food Safety and Benefits Today’s world faces a problem of the shortage of food supplies to feed its growing population. The adoption of GM foods can solve the problem of food shortage in several ways.
• Fire Safety Education and Risks for Children The paper focuses on adolescent firesetting, children with special needs, fire safety education, and socioeconomic characteristics as determinants of fire risks.
• The Roles of Nurses in Providing Nutrition Safety While health care specialists pay a lot of attention to safety of medications, care, technology, and hygiene, the problem of malnutrition remains heavily underestimated.
• Patient Safety Culture and Its Elements Every patient expects to be safe inside a hospital. It is one of the core priorities of a health provider, to avoid all possible harm that can come to the patient.
• Patient Safety in Dental Hygiene This paper emphasizes the importance of patient safety in the field of dental hygiene and highlights the health risks associated with dental procedures.
• The Implementation of a Safety Improvement Initiative in Healthcare Institutions The paper provides an annotated bibliography of several resources that can help to support the implementation of a safety improvement initiative.
• Discussion of Food Safety Issues The paper discusses food tampering and bioterrorism are those issues that can result in fundamental problems in food safety area.
• Safety Culture in the Healthcare Workplace As healthcare systems become more complex, there are growing concerns about the safety of patients and healthcare workers.
• Occupational Health Safety Management in the USA The Occupational Safety and Health Administration (OSHA) has recorded achievements in enhancing occupational health and safety performance amid participating organizations.
• Family Nurse Practice Promoting Patient Safety Family Nurse Practitioners (FNPs) should get the best education in clinical practice. This essay explains how FNPs can promote patient safety.
• Acme Manufacturing Company and Employees’ Safety AMC is concerned about its employees’ safety and needs to analyze its workplace. This report details the findings from evaluating the company’s ergonomics of the packing line.
• Car Seat Safety and Educational Awareness Programs The paper discusses car seat safety and highlights the safety procedures and recommendations needed to be taken care of.
• Patient Safety in the Healthcare Workplace Culture The participation of the entire workers in the healthcare environment in improving the safety standards enhances the culture of safety.
• Nurse Staffing Standards for Hospital Patient Safety Nurse staffing is one of the burning issues in the US healthcare system that needs effective solutions and proper legislation.
• Safety and Security Solutions at School The current proposal is concerned with enhancing the safety and security of students at schools through following three basic steps.
• Safety Risks in the Modern Aviation Industry The given paper is devoted to the critical evaluation of the existing safety risks in defenses available to mitigate them.
• Ensuring Safety for Health Facility Personnel The paper states that epidemics of dangerous diseases provide a risk to health facility staff, and managers contribute to ensuring their safety.
• Enhancing Construction Safety Through ASTM Standards and Technology This text discusses the importance of construction safety, focusing on ASTM standards and technological advancements.
• Human Factor and Safety Management Methods in Aviation Researchers link the mishaps in the sector to the level of training the professionals undergo to equip them with the required knowledge.
• How Should the Health Benefits of Food Safety Programs Be Measured?
• What Affects Safety When Riding Bicycle?
• How Can the Five HRO Principles Help Health Care Organizations Improve Patient Safety?
• How do Health and Safety Policies and Procedures Protect People?
• Why the FAA Has Hindered the Development of Airline Safety?
• How Are Safety Assessments Conducted on GMOs?
• Can Social Safety Nets Alleviate Seasonal Deprivation?
• How Your Actions Online Could Impact Your Safety?
• How Does Safety Influence Mining Industry?
• How Culture Can Affect an Aviation Organization‘s Safety and Performance?
• How Leadership Styles Can Help Promote Patient Safety?
• How Technology Can Aid Patient Safety during the Medication Administration?
• How Should Colleges and or Legal Regulations Balance Privacy and Safety?
• How does Medical Product Safety Affect the Patients and General Nursing?
• How Interprofessional Communication Can Impact Service User‘s Safety?
• What Does Creativity Mean in Safety-Critical Environments?
• What Are Five Patient Safety Concerns within the Operating?
• How Can Employee Involvement Contribute to Improving Occupational Health and Safety?
• How Does the Roofing Harness Help Ensure Complete Safety?
• Why Gun Safety Should Be Mandatory in School?
• How Can Safety Nets Contribute to Economic Growth?
• Why Product Liability May Lower Product Safety?
• What Safety Features Can Be Added to Cars to Cut Down on Injuries When a Car Crash Occurs?
• How does Nestle Provide Health and Safety at Work?
• How does Race Affect the Public Safety Organization?
• Health and Medicine: The Safety of Patients and Staff The paper states that it is important for management boards in healthcare facilities to focus on the safety of patients and staff.
• Safety During Emergencies The paper discusses safety during emergencies. It can contribute to preserving the lives and health of emergency responders and the public.
• Occupational Health and Safety Act The OSHA Alliance Program is an effective way to improve working conditions, reduce conflicts in the workplace, and reduce the company’s cost of injury.
• Pilot Safety: Why Pilots Must “Fly the Plain First” “Fly the plane first” is a phrase used in aviation to remind pilots to prioritize flying the aircraft and maintaining control and stability before attempting other tasks.
• The Importance of Safety in Chemical Experiments Chemical experiments can teach students a lot and show new unknown properties of substances. To protect oneself and others, it is crucial to adhere to rules.
• Patient Safety Events and Prevention Plan The Patient Safety and Quality Improvement Act addresses this issue by protecting the person who reports the problem and the information they share.
• Construction Safety and Its Importance Construction safety is important because working together, the owner and the contractor secure the high quality of work and enhance the general well-being of employees.
• The US Occupational Safety and Health Review Commission The US Occupational Safety and Health Review Commission is responsible for ensuring the reliability of occupational safety issues related to citations contesting.
• The Role of Nurses in Patient Safety Patient safety is cautious when dispensing drugs to reduce the risks associated with mistakes made by nurses and ensure quality care is provided to patients.
• Maintaining the Safety of Financial Resources The paper states that maintaining security in the field of economic transactions between citizens is a vital step in ensuring the safety of financial resources.
• Occupational Safety and Health Administration Penalties Employers are held accountable by the Occupational Safety and Health Administration to ensure that their facilities are safe from the most significant dangers.
• Nursing: Medication Errors and Patients’ Safety Nursing involves a variety of responsibilities, that are crucial to help patients heal. The paper analyzes medication errors and patients’ safety.
• The Meat Inspection and Food Safety Issues The safety of the food that people consume must be carefully checked before it hits the shelves. However, the inspection only checks some pieces of meat that enter the stores.
• Occupational Health Safety for Nurse Practitioners The paper highlights the four most significant threats to nurse practitioners’ health in the workplace and discusses methods for mitigating hazards.
• Risk Management, Quality and Safety in Healthcare To reduce the risks of errors, clinics improve the quality and safety of medical activities and the efficiency of workers. They carry out internal quality control of medical care.
• The Line Operation Safety Audit (LOSA) Benefits Line operation safety audit (LOSA) is a safety tool designed to gather cockpit observation without jeopardy whenever a normal flight operation occurs.
• Enhancing Patient Safety Through Health Care Standards A shared understanding of standards and practices eliminates prejudice, provides quality treatments for every patient, and makes the healthcare industry more transparent.
• Enhancing Aviation Safety: Monitoring Pilot Fatigue With ECG Signals Fatigue poses a critical safety risk to civil and military aviation because may lead to errors that could potentially compromise the safety of the crew and passengers.
• Occupational Health and Safety Risk Assessment Rapid action is required from emergency response organizations to avert potential dangers to medical personnel.
• NCSBN’s Role in Promoting Quality Nursing Care and Patient Safety Generally, the nursing sector is a sensitive area that requires proper oversight of the practices undertaken by different practitioners and agencies.
• Healthcare Risk Management – Balancing Safety and Efficiency Risk management in healthcare is essential in promoting the quality of services by reducing the errors that reduce an organization’s ability to offer quality care.
• Accountability, Leadership, Professionalism, Good Communication, and Safety in Prescribing An essential worldwide health resource management concern is the dearth of healthcare professionals in many settings.
• Patient Safety and Clinical Handover Process Patient safety is one of the factors that hospitals aim to improve. In settings where the number of patients increases, the clinical handover process becomes an issue of quality.
• Advocating for Workplace Health and Safety in Nursing The current paper states that workplace health and safety standards for nurses are prerequisites for efficient and productive working.
• The Quality and Safety Education for Nurses Project Nurses who acquired competencies identified in the Quality and Safety Education for Nurses project can manage and change practices to improve service standards.
• Environmental & Best Safety (EBS) in China The given article EBS in China, written by Lin Liu and colleagues in 2018, explores the company Environmental & Best Safety (EBS), its background, and initiatives.
• The Lack of Food Safety in Kansas City, Missouri Food safety is crucial in storing, preparing, and handling food in restaurants and other establishments where meals and refreshments can be ordered.
• The Importance of Medication Safety The paper discusses medical safety. It is considered under the prism of modern technologies that allow medical staff to prescribe the treatment.
• Special Response Teams: Safety Issues Though Special Response Teams are beneficial, administrators in law enforcement should effectively manage the risks associated with special response police officers.
• Teamwork and Improved Patient Safety Researches in the field of healthcare present new ideas and concepts for improving practice to the emerging needs of the identified patients.
• Hoeganaes Corporation’s Fire Safety Assessment The paper states that Hoeganaes Corporation in Gallatin reported three incidents related to the violation of the fire safety protocols.
• Patient Safety Culture and Related Practice Changes The paper aims to explain the concept of patient safety culture and the paradigm that can facilitate change in a healthcare environment when practice changes are necessary.
• Self-Assessment of Public Safety Followership When leaders formulate or settle on policies, their followers must carry them out and ensure they have adhered to them.
• Civil Aviation Safety Authorities in Australia Aviation safety is enabled and ensured by a wide range of mandatory practices, policies, assessments, evaluations, and systems.
• Quality Safety and Outcome of Cleveland and Mayo Clinics Healthcare organizations use numerous methods to assess quality; as a result, the data from the Cleveland Clinic and Mayo Clinic will be analyzed in this study.
• Hazard Analysis in Food Safety In the United States, just like in any other country, it is the manufacturers’ responsibility to produce fairly safe products.
• Food Industry: The Safety Issues Among the many problems of the food industry, the identification of food products is the most relevant and multifaceted.
• Risk Management and Patient Safety This report explores the 2022 Safety Management Plan for Management of the Environment of Care (EOC) at Duke University Hospital (DUH), North Carolina.
• The Safety of the McDowell Company’s Employees Abroad The paper discusses the main details necessary for a clear designation of the workspace and the steps needed to ensure the safety of the McDowell company’s employees abroad.
• The Association of Public-Safety Communications Officials International To become a member of the Association of Public-Safety Communications Officials International, a person needs to submit an application and pay a membership fee.
• Medication Safety: Deconstructing Clinical Workflow Pharmaceutical mistakes are risky, and these errors have a high financial and human cost to the American healthcare system.
• Data Safety Monitoring Theory and Practice The present lecture provides information in regard to the process of data safety monitoring and the correct organization of a data safety monitoring board.
• Patient Safety Improvement After Sentinel Event The hospital must ensure the proper quality of medical equipment and supplies so that no errors occur due to equipment failures.
• Domestic Shipping Safety in Pacific Region One of the most challenging difficulties facing Pacific archipelagic states is ensuring the supply of appropriate, efficient, and dependable domestic shipping services.
• Quality and Safety Education for Nurses Project’s Impacts QSEN is a nursing project that aims to link nursing education with best practices regarding quality and safety standards.
• Agriculture and Food Safety in the United States Agriculture in the United States has grown progressively centralized. The shortcomings in the 2018 U.S. farm legislation resulted in multiple challenges in the food system.
• Acetone-Related Safety of Sigma-Aldrich Company Acetone is a dangerous chemical to deal with, and it has several safety guidelines outlined in the Safety Data Sheet of Sigma-Aldrich company.
• The Proactive Aviation Safety There are many indications that commercial air travel increases, meaning that the number of incidents will also increase without specific measures to decrease the accident rate.
• Boeing 737 MAX Aircraft: Safety Issues Safety issues riddled the original Boeing 737 MAX aircraft’s design, pertaining specifically to the functioning aspects of the maneuvering characteristics augmentation system.
• A Spontaneous Reporting System for Drug Safety Surveillance Post-marketing in clinical trials uses a spontaneous reporting system for drug safety surveillance where potential AEs induced by the drugs are detected.
• 911 Evolution: Computer-Aided Design for Personal Safety The computer-assisted 911 vehicle dispatch program includes vehicle dispatch, call dispatch, resources deployment, instruction and protocols, and status modification.
• Safety Improvement in Cockpit and Airport Operations There have been several improvements that have been made in cockpit and airport operations to ensure aircraft safety in the past 50 years.
• Fire Service Safety: Sample Plan This paper studied the main points of drawing up a sampling plan. It consists of three main points: the sampling unit, its size, and procedures.
• Analysis of BP’s Safety Program Failure In order to correct the results identified in the CSB investigation, BP needs to review safety standards regarding blowdown drums and stacks.
• Festivals in Kamloops: Safety and Security Issues Related to the COVID-19 This paper focuses on the safety and security issues related to the COVID-19 pandemic and their effects on the tourists attracted by the festivals held in Kamloops.
• Engineering Ethics: Exploitation and Worker Safety Issues This paper aims to review two types of engineering ethics issues and their solutions: exploitation and worker safety issues.
• How Network Security Devices and Safety of the Computer Systems and Networks Computers connected to any network, be it local or through the internet, are always under constant threat of an attack.
• “Supplements and Safety” Documentary by Frontline The documentary “Supplements and Safety” by Frontline presents an insightful description of the hidden dangers of supplements and vitamins.
• Aviation Safety: Technologies and Approaches This paper highlights current trends and issues related to aviation security and the many innovations and approaches taken to solve fundamental problems.
• Researching of Fire Service Safety This article makes a significant contribution to research on the topic of public safety related to fire services.
• AI, Human Control and Safety The given evaluative analysis will primarily focus on the topic of artificial intelligence, human control, and safety.
• Summer Safety in the Beach: The Viral Video Veronica-Pooh Nash Poleate released a summer safety video that quickly became viral in 2015. Poleate’s video success resulted from word choice and the relevance of content.
• Global Issues in Healthcare: Cultural Competence and Patient Safety Within the framework of domestic issues’ impact on US HCM, the supporting systems are affected to the greatest extent.
• Society’s Safety and Ways of Improvement To stop people from using weapons, the government should develop a strategy for improving the relationships between the police and the citizens.
• Gender, Emotional Labor, Harm, and Safety The video “How ID laws can put trans people in danger” by Vox shows how transgender women are attacked and assaulted for having a different gender identity from their sex.
• Vulnerable Population: Safety Concerns Vulnerable population refers to the disadvantaged subsegments in society. In the healthcare industry, safety concerns for vulnerable people result in better healthcare services.
• Abortion Safety as Topic of Sociological Studies Sociological studies show that about half of all abortions are unsafe, while every third abortion is performed in dangerous circumstances.
• Researching of Patient Safety and EPB System The paper investigated the importance of ensuring patient safety. It was found that the EBP system significantly helps doctors in this area.
• Impact of Information Literacy on Safety Information literacy is crucial today because due to the development ion information and communication technology, data is produced at an unprecedented pace.
• Parents and Children’s E-Safety Education During the Pandemic When it comes to children’s education from a Constructivist perspective, parents are to engage with the children’s activities online to make sense of the Internet knowledge.
• Bullying and Patient Safety in Clinical Settings Besides damaging the atmosphere in clinical settings and negatively affecting the personnel, bullying can lower the quality of healthcare services and harm patient safety.
• The Use of TeamSTEPPS Tools to Advance Patient Safety Team Strategies and Tools to Enhance Performance and Patient Safety are founded on the four competencies: leading teams, mutual support, situation monitoring, and communication.
• Ireland’s Civil Aviation Safety’s Strategic Position This paper aims to analyze the current strategic position of Ireland concerning civil aviation safety and its choice of methods to continue the evolution of the sphere.
• The Healthcare Workplace: Patient Safety Culture Healthcare safety culture influences both the patients and the doctors. Studies have shown that as doctors’ workplace safety culture improves, so does patient safety.
• Safety and Health Care Quality in Nursing Patient safety and healthcare quality are deeply linked and central to improving the well-being of all patients.
• Deadly Deliveries: Insufficient Safety Practices & Maternal Death A short film Deadly Deliveries by Dufour and Gruber to support USA Today’s investigation into recent maternal death cases sheds light on the insufficiency of safety practices.
• Safety Committees of Kindred Hospital Houston Northwest This paper aims to explore the Kindred Hospital Houston Northwest’s safety committee to assess their practices and efficiency.
• Team Strategies and Tools to Enhance Performance and Patient Safety Team Strategies and Tools to Enhance Performance and Patient Safety help with the improvement of teamwork behaviors, communications, and leadership.
• Safety Management System for Non-Part 121 Operator The paper aims to evaluate the preparation and implementation of a safety management system (SMS) among the general aviation companies with 135, 141, and 145 certificates.
• Improving Patient Safety in the Radiology Department of a Hospital Every profession in the radiology unit has a moral responsibility to ensure that patients are protected from radiation through justification, and limiting of the dose given.
• Safety and Effectiveness of Complementary and Alternative Medicine
• Safety Measures of Social Worker in Education
• Gun Safety Policy Towards a Safer Future for Kids
• Safety Responsibility: Samsung Case
• Patient Safety and Quality Improvement Evaluation
• Nursing Areas of Difficulty: Patient Safety and Expectations
• Safety Professional Working In an Australian Context
• Practices for Healthcare Staff’s Personal Safety
• Sao Paulo Airport Safety Evaluation
• Safety, Communication, and Informatics in Nursing
• Nursing Staffing Ratio and Patient Safety & Care
• Sobriety Tests by National Highway Transportation Safety Administration
• Speed Limits as the Cornerstone of Road Safety
• Navigation Safety Management System & Risk Assessment
• Bike Safety Promotion: Grant Application
• Importance of Safety Management System in Aviation: 4 Pillars
• Health and Safety Concerns Among Nurses
• Cultural Safety Position of Family Planning Victoria
• Patient Safety: Caring for the Public’s Health
• Documentation, Emr, and Patient Safety
• Safety Management: Paris-Le Bourget Airport
• Patient Safety and Quality of Care
• Public Safety and Individual Rights
• Criminal Justice System for Public Safety
• Error Chains and Safety Management Systems
• The Online Personal Health Records on Medication Accuracy and Safety
• Fire Laboratory Conversion Into a Lecture Theatre: Fire Safety Report
• Scientific Overview of Orthokeratology Technique and Safety
• Medical Error and Patient Safety
• Psychotropic Medication Prevalence: Safety Issues
• Healthcare: The Focus on Patient Safety
• Threats to Patient Safety in Nursing Practice
• A Safety Case Report: Coast Guard Helicopter
• Occupational Safety and Health Administration: Benzene Exposure Rule
• The Patient Safety Issues in Today’s Diverse Global Environment
• Medication Safety and Drug Therapy Process
• Healthcare: Safety in the Nursing Field
• Safety Evaluation Techniques and Accident Data Analysis
• Health Care and Public Safety in California
• Championing Quality and Patient Safety
• Law That Aims to Protect School Safety Acts of Kindness in Society
• Patients’ Safety in the United States
• Nurse-Led Program on Food Safety Problem
• Reducing Risks Through Safety Design
• Community Resources that Promote Safety. Marion Senior Services
• Traffic Accidents and Infant Safety Seats
• Occupational Health and Safety: Precautionary Principle
• Labor Laws: Occupational Health and Safety Act & Fair Labor Standards Act
• The Motor Vehicle Safety Analysis
• Risk Management and Safety
• Team Strategies & Tools to Enhance Performance and Patient Safety
• Nurse Staffing Standards for Patient Safety
• An Approach to Studying Patient Safety by Stichler
• Safety Presented by the Use of Bisphenol-A (BPA)
• Port Safety and How to Improve It
• Improvement in Aviation Safety Management Systems
• Crises Management in Aviation Safety
• Medication Safety and Reconciliation in a Homecare Setting after Discharge from the Hospital
• Safety, Independence and Least Restrictive Environments
• Proactive Safety Management System in Aviation
• Motorcycle Safety and Its Psychological Aspect
• Model of Nursing Care and Patient Safety
• How Health Informatics Impacts Patient Safety: Telemedicine and Virtual Visits
• Radiation Safety at an Organization
• Ireland’s Aviation Safety Strategic Plan
• Electrical Safety in the Perioperative Environment
• Safety Management System at Work
• Alternative Methods in Safety Management in Engineering
• Aviation Industry and Safety Management Systems
• The National Institute for Occupational Safety and Health
• Allowing Armed Teachers on Campus as Safety Measures
• Performance in Safety Management Systems (SMS)
• Consumer Product Safety: Relations and Standarts
• Enhancing Quality and Safety of the Patient
• The Safety Hierarchy and Hierarchy of Controls
• Plastic Contamination and Marine Ecosystem Safety
• Health Safety in the Police Department
• Research Drug Safety Approaches
• Patient Safety Incidents in the Home: Nursing Case
• Incomplete or Missing Documentation: Patient Safety in Healthcare
• How Health Informatics Impacts Patient Safety
• Design and Implementation of the Safety Program
• Does Lean Management Improve Patient Safety Culture
• Patient Safety Culture in the Healthcare Workplace
• Public CCTV Surveillance: Safety vs. Privacy
• National Patient Safety Overview
• What Is Process Safety Management and Why Is It Important?
• Management of Change and Professional Safety – Article Critique
• The Safety in Nursing Analysis
• Safety & Lean: One Manufacturer’s Lessons Learned and Best Practices
• A Car: Technical Specifications & Safety Features
• Research Methodologies for Crane Workers Safety
• Energy Safety and Earthquake Hazards Program
• Food Safety in the Commercial Industry
• A Person’s Safety Is Not Increased by Buying a Gun
• Risk and Safety Management in Project Development
• Food Safety Issues and Standards
• Public Safety Department of Connecticut vs. John Doe
• Health Care Leaders and Patient Safety
• Efficacy and Safety of Human Papillomavirus ‘Gardasil’
• Airline Safety Practices and Medication Administration
• The Range of Regulations Applicable to Health and Safety in Construction
• Nursing Research for Patients’ Safety and Health
• Organizational Culture in Public Safety in Harris County
• Safety and Secure Risk Management
• Safety and Security Risk Management
• Oncology Nursing Society: Chemotherapy Safety Standards
• Nurse Safety Adherence During Chemotherapy
• Implementation of a Patient Engagement Tool to Improve In-Clinic Safety of Diabetic Patients
• Effects of Nurse Staffing Levels on Patient Safety
• National Patient Safety Goals: Critical Care Access
• Patient Safety: Practice Change Project
• Patient Safety Promotion as Nursing Practice Issue
• Patient Safety Culture and Practice Change Frameworks
• Effect of Transformational Leadership on Job Satisfaction and Patient Safety
• Jackson Memorial Hospital: Risk Management and Safety Officers
• Community Health Nursing and Occupational Safety
• The Relationship Between Understaffing of Nurses and Patient Safety
• Nurse Staffing and Patient Care Quality and Safety
• The Relationship Between Understaffing of Nurses and Patient Safety in Hospitals
• Patient Safety and Nursing Satisfaction Project
• Safety Officer at the Palmetto General Hospital in Miami
• Safety Guidance Adherence Among Oncology Nurses
• Violence and Safety Concerns in the Emergency Department
• Safety and Violence Protocol: Evaluation Plan
• The Issues of Safety and Violence in the Emergency Care
• Pressure Ulcers as a Patient Safety Issue
• Medication Errors: Patient Safety Concern in Nursing
• School Safety and Gun Violence Prevention
• Train Control and Safety: Public Policy Meeting
• Crime Scene Safety and Security in the United States
• Irish Aviation Safety: Strategic Position and Strategic Choices
• Pedestrian: Promoting Safety and Reducing Risk
• Economic Analysis of Airline Safety
• Employee Subsidies, Benefits and Workplace Safety
• RFID Chips: Safety in Personal Identification Tags
• Six Sigma Phases and Lean Principles for Safety
• Clinical Decision Support System for Patient Safety
• Urban Parks between Safety and Aesthetics
• Implementation of Workplace Safety Standards Regarding Chemicals
• Pressure Ulcer: Safety Score Improvement Plan
• Healthcare Reform for Availability and Safety
• Employee Engagement in Safety Improvement
• Medication Administration Errors and Patient Safety Risks
• Safety and Violence Policies in Emergency Departments
• Private Health Information’s Safety
• Patient Safety and Nurse Working Conditions
• Patient Safety and Healthcare Quality
• Medication Compliance and Safety Use
• Hospital Risk Management and Patient Safety
• Nurses’ Burnout and Patients’ Safety
• Healthcare-Associated Infections and Safety Practice
• Patient Safety Standards and Medication Errors Policy
• Nursing Education: Quality, Safety and Systems Thinking
• Auditing and Metrics in Process Safety Management
• Patient Care in Quality and Safety Education for Nurses
• Medical Errors Minimization for Patient Safety
• Nurses’ Work-Life Balance and Patient Safety
• Malnutrition and Patient Safety Healthcare Policy
• Safety Check Improvement at Sikorsky Aircraft
• Drug Safety Approach in Advanced Nursing Practice
• Medical Errors as a Threat to Patient Safety
• Nursing’s Informatics and Patient Safety
• How Canadian Government Could Improve Food Safety?
• Quality and Safety Education for Nurses: Conceptual Model
• Medical Errors, Economic Effect and Patient Safety
• Fire and Life Safety Education Program for K-12
• Labor Relations Issue: Occupational Health and Safety
• Patient Safety Competency of Nursing Education
• Alzheimer’s Patient Safety Improvement Strategies
• Safety of Healthcare Information: The Health Insurance Portability and Accountability Act
• Patient-Oriented Care and Safety in Healthcare
• Ergonomics and Work Safety in the Foundry Industry
• Quality and Safety Education for Nurses Competencies
• Electronic Health Records and Safety Incidents
• Occupational Health and Safety: Workers Neglect of Precautionary Measures
• Casinos: Occupational Safety and Drug-Free Workplace
• Medication Safety in Patient-Centered Nursing Care
• PharmaCARE: Product Safety & Intellectual Property
• Patient Safety in the Delivery of Nursing Services
• Drug Safety Approach in Administration and Nursing
• Iraq and Afghanistan Wars for American Safety
• Healthcare Accessibility, Disparity, and Safety
• Royal Caribbean Cruises Ltd.’s Safety Policies
• Patient Safety and Risk Management Plan Development
• Patient Safety as Nursing Core Competency
• Immunization, Safety Concerns, and Public Attitude
• Occupational Safety Change Management
• Packaging in Marketing, Food Safety, Environment
• Safety Plan for the Warehouse with Refrigeration
• Linking Cultural Diversity and Work Safety
• Food Safety and Information Bulletin
• Joint Commission: National Patient Safety Goals

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StudyCorgi . "390 Safety Research Topics & Examples." September 9, 2021. https://studycorgi.com/ideas/safety-essay-topics/.

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These essay examples and topics on Safety were carefully selected by the StudyCorgi editorial team. They meet our highest standards in terms of grammar, punctuation, style, and fact accuracy. Please ensure you properly reference the materials if you’re using them to write your assignment.

This essay topic collection was updated on June 24, 2024 .

99 Occupational Health Essay Topic Ideas & Examples

🏆 best occupational health topic ideas & essay examples, 👍 good essay topics on occupational health, ⭐ simple & easy occupational essay titles, ❓ essay questions on occupational health and safety.

• Occupational Health and Safety: The Need and Importance Occupation Health and Safety can be termed as the rules, legislation, policies, procedures and activities intended to care for the health, safety and welfare of the workers and all the individuals in an organization.
• Occupational Health and Safety Theories: La_Camera Restaurant The recommendations offered for La_Camera include the use of more positive methods of enforcing occupational health policies, reduction in the use of the punitive measures, and the implementation of the measures to mitigate not just […]
• Occupational Health: Safety and Human Resources Law Providing important facets of the case, Mendelson, discussed important matters concerning the employer’s negligence and circumstances leading to reasonable ‘Foreseeability’ in the case of ‘psychiatric injuries’ in the workplace.
• Occupational Health Hazards at a Factory The occurrence of particular health hazards in a confined space entry can be identified by a range of signs and symptoms that may be present in a person.
• Occupational Health and Safety The security management and occupation health and safety officers recommend risk assessment of the possibility of violence and provide possible measures and programs that may significantly assist in the prevention of their occurrence of workplace.
• Occupational Health Safety in Nursing It is no secret that the healthcare industry is one of the most dangerous ones due to the high prevalence of potentially harmful organisms, chemicals, and other hazards.this formal research report aims to catalog the […]
• Silica Exposure and Occupational Safety and Health Administration In this research, the main focus is to investigate whether the exposure rate on a worker at the Iron Foundry is above the set standard by the OSHA.
• German Approach to Occupational Safety and Health The main goal of improving working conditions in production is to reduce diseases and accidents at work, to preserve the life and health of workers.
• Occupational Health: Workplace Stress To avoid noise-related stress, Ruth handles her job with a positive attitude and this makes it easy to enjoy work. In conclusion, work-related stress is a major cause of poor performance by employees due to […]
• Emergency Action Plan: Occupational Safety and Health Administration Company Name: Company Name. Company Contact: Name: Your Name Title: Position Telephone/Cell: Email: In the event of an emergency, employees are alerted by:
• Amazon’s Occupational Safety and Health Administration The story of one of the Amazon workers presents the company as a firm that does not value ethics in its strategic scheme. It is a matter of ethics to prioritize the employee’s well-being and […]
• Fundamentals of Occupational Safety and Health Being a Chinese-Canadian physician, Margaret Chan Fung Fu-Chun was the Director of Health in Hong-Kong, a representative of the WHO Director-General for Pandemic Influenza and the WHO Assistant Director-General for Communicable Diseases.
• Problems of Occupational Health in the Oil and Gas Industry Workers’ exposure to silica dust is one of the most prevalent occupational health concerns facing the oil and gas industry. Thousands of workers in the oil and gas industry are subjected to unreasonably high concentrations […]
• Occupational Safety and Health Act: Source of Funding and Future Changes in Its Operation Since this agency is part of the Department of Labor, It is headed by the Assistant Secretary of Labor for Occupational Safety and Health.
• Occupational Health and Safety: Case Foster’s Abbotsford The report intends to elaborate on the facts surrounding the fatal incident and how the court proceedings were conducted up to the delivering of a ruling.
• Occupational Health Assessments The essay discusses occupational health assessment and how it can be used to enhance the quality of health. Occupational health refers to a specialty in the field of medicine which is concerned with understanding the […]
• Management of Occupational Health and Safety in Schools in Libya Tripoli How effective are the current strategies in facilitating the implementation and management of occupational health safety in Libyan primary schools? The following sub-objectives were created: To contribute new knowledge on effective management and implementation of […]
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300+ Health Related Research Topics For Medical Students(2023)

In the world of academia and healthcare, finding the right health-related research topics is essential. Whether you are a medical student, a college student, or a seasoned researcher, the choice of your research topic greatly impacts the quality and relevance of your work. This blog, health related research topics, is your guide to selecting the perfect subject for your research.

In this post, we will share 5 invaluable tips to help you pick suitable health-related research topics. Additionally, we will outline the crucial elements that every health-related research paper should incorporate.

Furthermore, we’ve compiled a comprehensive list of 300+ health-related research topics for medical students in 2023. These include categories like mental health, public health, nutrition, chronic diseases, healthcare policy, and more. We also offer guidance on selecting the right topic to ensure your research is engaging and meaningful.

So, whether you are delving into mental health, investigating environmental factors, or exploring global health concerns, health-related research topics will assist you in making informed and impactful choices for your research journey, even within the hardest medical specialties .

What Is Health Research?

Table of Contents

Health research is like detective work to understand how our bodies work and how to keep them healthy. It’s like asking questions and finding answers about things like sickness, medicine, and how to live better. Scientists and doctors do health research to learn new ways to treat illnesses, like finding better medicines or discovering new ways to prevent diseases.

Health research is a puzzle, where scientists collect information, do experiments, and study many people to find out what makes us healthy or sick. They want to find clues and put them together to help us stay well and live longer. So, health research is like a quest to learn more about our bodies and find ways to make them work their best, keeping us happy and strong.

5 Useful Tips For Choosing Health Related Research Topics

Here are some useful tips for choosing health related research topics: 

Tip 1: Follow Your Interests

When picking a health research topic, it’s a good idea to choose something you’re curious and excited about. If you’re interested in a subject, you’ll enjoy learning more about it, and you’ll be motivated to do your best. So, think about what aspects of health catch your attention and explore those areas for your research.

Tip 2: Consider Relevance

Your research topic should be meaningful and have real-world importance. Think about how your research can contribute to solving health problems or improving people’s well-being. Topics that are relevant and can make a positive impact on health and healthcare are usually more valuable.

Tip 3: Check Available Resources

Before deciding on a research topic, make sure you have access to the necessary resources, like books, articles, or equipment. It’s important that you can find the information and tools you need to conduct your research effectively.

Tip 4: Keep It Manageable

Select a research topic that you can handle within the available time and resources. It’s better to choose a more focused and manageable topic rather than something too broad or complex. This way, you can delve deep into the subject and produce meaningful results.

Tip 5: Seek Guidance

Don’t hesitate to ask for guidance from teachers, professors, or experts in the field. They can help you refine your research topic, provide valuable insights, and suggest improvements. Seeking advice can make your research journey smoother and more successful.

Important Elements That Must Be Present In A Health Related Research Paper

Here are some important elements that must be present in a health related research paper: 

1. Clear Title and Introduction

A good health research paper needs a clear title that tells people what it’s about. The introduction should explain why the research is important and what the paper will discuss. It’s like the map that shows the way.

2. Methods and Data

You should describe how you did your research and the data you collected. This helps others understand how you found your information. It’s like showing your work in math so that others can check it.

3. Results and Conclusions

After doing your research, you need to show what you discovered. Share the results and what they mean. Conclusions tell people what you found out and why it’s important. It’s like the “So what?” part of your paper.

4. Citations and References

When you use other people’s ideas or words, you need to give them credit. Citations and references show where you got your information. It’s like saying, “I learned this from here.”

5. Clear Language and Organization

Make sure your paper is easy to read and well-organized. Use clear and simple language so that everyone can understand. Organize your paper logically, with a beginning, middle, and end, like a good story. This makes your research paper more effective and useful.

In this section, we will discuss 300+ health related research topics for medical students(2023): 

Health Related Research Topics

• How living choices affect health and how long people live.
• Ways to make it easier for people in underserved areas to get medical care.
• The role of DNA in determining susceptibility to different diseases.
• There are differences in health between race and ethnic groups and between socioeconomic groups.
• Checking how well health education programs encourage people to behave in a healthy way.
• The effects that stress has on the body and mind.
• Looking at the pros and cons of different vaccine plans.
• The link between how well you sleep and your general health.
• The use of technology to make health care better.
• How cultural beliefs and habits affect how people seek health care.

Mental Health Related Research Topics

• Identifying the factors contributing to the rise in mental health disorders among adolescents.
• Examining the effectiveness of different therapeutic approaches for treating depression and anxiety.
• How social media can hurt your mental health and self-esteem.
• We are looking into the link between traumatic events in youth and mental health problems later in life.
•  Stigma and racism in mental health care, and how they make people less healthy.
•  Ways to lower the suicide rate among people who are at high risk.
•  Exercise and other forms of physical action can help your mental health.
•  The link between using drugs and having mental health problems.
•  Mental health support for frontline healthcare workers during and after the COVID-19 pandemic.
•  Exploring the potential of digital mental health interventions and apps.

Health Related Research Topics For College Students

• The impact of college stress on physical and mental health.
•  Assessing the effectiveness of college mental health services.
•  The role of peer influence on college students’ health behaviors.
•  Nutrition and dietary habits among college students.
•  Substance use and abuse on college campuses.
•  Investigating the prevalence of sleep disorders among college students.
•  Exploring sexual health awareness and behaviors among college students.
•  Evaluating the relationship between academic performance and overall health.
•  The influence of social media on college students’ health perceptions and behaviors.
•  Ideas for getting people on college grounds to be more active and eat better.

Public Health Related Research Topics

• Evaluating the impact of public health campaigns on smoking cessation .
•  The effectiveness of vaccination mandates in preventing disease outbreaks.
•  Looking into the link between the health of the people in cities and the quality of the air.
•  Strategies for addressing the opioid epidemic through public health initiatives.
•  The role of public health surveillance in early disease detection and response.
•  Assessing the impact of food labeling on consumer choices and nutrition.
•  Looking at how well public health measures work to lower the number of overweight and obese kids.
•  The importance of water quality in maintaining public health.
•  This paper examines various strategies aimed at enhancing mother and child health outcomes in emerging nations.
•  Addressing the mental health crisis through public health interventions.

Mental Disorder Research Topics

• The mental health effects of social isolation, with a particular focus on the COVID-19 pandemic.
•  Exploring the relationship between mental health and creative expression.
•  Cultural differences influence the way in which mental health disorders are perceived and treated.
•  The use of mindfulness and meditation techniques in managing mental health.
•  Investigating the mental health challenges faced by LGBTQ+ individuals.
•  Examining the role of nutrition and dietary habits in mood disorders.
•  The influence of childhood experiences on adult mental health.
•  Innovative approaches to reducing the stigma surrounding mental health.
•  Mental health support for veterans and active-duty military personnel.
•  The relation between sleep disorders and mental health.

Nutrition and Diet-Related Research Topics

• The impact of dietary patterns (e.g., Mediterranean, ketogenic) on health outcomes.
•  Investigating the role of gut microbiota in digestion and overall health.
•  The effects of food labeling and nutritional education on dietary choices.
•  The correlation between chronic disease prevention and nutrition.
•  Assessing the nutritional needs of different age groups (children, adults, elderly).
•  Exploring the benefits and drawbacks of various diet fads (e.g., intermittent fasting, veganism).
•  The role of nutrition in managing obesity and weight-related health issues.
•  Studying nutrition and mental wellness.
•   Impact of food insecure areas on population health and diet.
•  Strategies for promoting healthy eating in schools and workplaces.

Chronic Disease Research Topics

• The contribution of inflammation to the progression and development of chronic diseases.
•  Evaluating the effectiveness of lifestyle modifications in managing chronic conditions.
•  The impact of chronic stress on various health conditions.
•  Investigating disparities in the management and treatment of chronic diseases among different populations.
•  Exploring the genetics of chronic diseases and potential gene therapies.
•  The impact that environmental factors, including pollution, have on the prevalence of chronic diseases.
•  Assessing the long-term health consequences of childhood obesity.
•  Strategies for improving the quality of life for individuals living with chronic diseases.
•  The importance of maintaining a healthy level of physical activity and exercise for both the prevention and treatment of chronic illnesses.
•  Investigating innovative treatments and therapies for chronic diseases, such as gene editing and personalized medicine.

Healthcare Policy and Access Research Topics

• Assessing how the Affordable Care Act affects healthcare access and outcomes.
•  Telehealth’s impact on rural healthcare access.
•  Investigating the cost-effectiveness of various healthcare payment models (e.g., single-payer, private insurance).
•  Assessing healthcare disparities among different racial and socioeconomic groups.
•  The influence of political ideologies on healthcare policy and access.
•  Healthcare professional shortage solutions, including nurses and doctors.
•  The impact of malpractice reform on healthcare quality and access.
•  Examining the role of pharmaceutical pricing and regulation in healthcare access.
•  The use of technology in streamlining healthcare administration and improving access.
•  Exploring the intersection of healthcare policy, ethics, and patient rights.

Environmental Health Research Topics

• The impact of climate change on public health, including increased heat-related illnesses and vector-borne diseases.
•  Studying air pollution’s effects on the cardiovascular and respiratory systems.
•  Assessing the health consequences of exposure to environmental toxins and pollutants.
•  Exploring the role of green spaces and urban planning in promoting public health.
•  The impact of water quality and sanitation on community health.
•  Strategies for minimizing the health risks linked with natural catastrophes and extreme weather events.
•  Investigating the health implications of food and water security in vulnerable populations.
•  The influence of environmental justice on health disparities.
•  Evaluating the benefits of renewable energy sources in reducing air pollution and promoting health.
•  The role of public policy in addressing environmental health concerns.

Infectious Disease Research Topics

• Tracking the evolution and spread of infectious diseases, including COVID-19.
•  Investigating the effectiveness of vaccination campaigns in preventing outbreaks.
•  Antimicrobial resistance and strategies to combat it.
•  Assessing the role of vector-borne diseases in global health, such as malaria and Zika virus.
•  The impact of travel and globalization on the spread of infectious diseases.
•  Strategies for early detection and containment of emerging infectious diseases.
•  The role of hygiene and sanitation in reducing infectious disease transmission.
•  Investigating the cultural factors that influence infectious disease prevention and treatment.
•  The use of technology in disease surveillance and response.
• Examining the ethical and legal considerations in managing infectious disease outbreaks.

Women’s Health Research Topics

• Exploring the gender-specific health issues faced by women, such as reproductive health and menopause.
• Investigating the impact of hormonal contraception on women’s health.
• Assessing the barriers to accessing quality maternal healthcare in low-income countries.
• The role of gender-based violence in women’s mental and physical health.
• Strategies for promoting women’s sexual health and reproductive rights.
• Exploring the relationship between breast cancer and genetics.
• The influence of body image and societal pressures on women’s mental health.
• Investigating healthcare disparities among different groups of women, including racial and ethnic disparities.
• Strategies for improving access to women’s healthcare services, including family planning and prenatal care.
• The use of telemedicine and technology to address women’s health needs, especially in remote areas.

Children’s Health Research Topics

• The impact of early childhood nutrition on long-term health and development.
• Environmental toxin exposure and child health.
• Assessing the role of parenting styles in children’s mental and emotional well-being.
• Strategies for preventing and managing childhood obesity.
• The influence of media and technology on children’s physical and mental health.
• Exploring the challenges faced by children with chronic illnesses and disabilities.
• The relevance of early child mental wellness and developmental condition intervention.
• Investigating the role of schools in promoting children’s health and well-being.
• Strategies for addressing child healthcare disparities, including access to vaccines and preventive care.
• Adverse childhood experiences and adult health.

Aging and Gerontology Research Topics

• Investigating the factors contributing to healthy aging and longevity.
• Assessing the impact of dementia and Alzheimer’s disease on elderly individuals and their families.
• Strategies for improving elder care services and addressing the aging population’s healthcare needs.
• Exploring the social isolation and mental health challenges faced by the elderly.
• The importance of nutrition and exercise in old age.
• Investigating the impact of age-related chronic diseases, such as arthritis and osteoporosis.
• Assessing the financial and ethical aspects of end-of-life care for the elderly.
• Strategies for promoting intergenerational relationships and support networks.
• The influence of cultural differences on aging and health outcomes.
• Exploring technology and innovation in elder care, including assistive devices and telemedicine.

Health Technology and Innovation Research Topics

• The impact of telemedicine and virtual health platforms on patient care and outcomes.
• Investigating the use of wearable health technology in monitoring and managing chronic conditions.
• Assessing the ethical and privacy considerations of health data collection through technology.
• Investigating medical diagnoses and treatment with AI and ML.
• The role of robotics in healthcare, including surgical procedures and elder care.
• Investigating the use of 3D printing in healthcare, such as prosthetics and medical devices.
• The influence of mobile health apps on patient engagement and self-care.
• Strategies for implementing electronic health records (EHRs) and interoperability.
• The impact of precision medicine and genomics on personalized healthcare.
• Exploring the future of healthcare delivery through telehealth, remote monitoring, and AI-driven diagnostics.

Global Health Research Topics

• Investigating the challenges of global health equity and healthcare access in low- and middle-income countries.
• Assessing the effectiveness of international health organizations in addressing global health crises.
• Resource-limited mother and child health strategies.
• Exploring the impact of infectious diseases in global health, including tuberculosis and HIV/AIDS.
• The role of clean water and sanitation in improving global health outcomes.
• Investigating the social determinants of health in different global regions.
• Assessing the impact of humanitarian aid and disaster relief efforts on public health.
• Strategies for combating malnutrition and food insecurity in developing countries.
• The influence of climate change on global health, including the spread of vector-borne diseases.
• Exploring innovative approaches to global health, such as community health workers and telemedicine initiatives.
• Exploring the artificial intelligence and machine learning in medical treatment.

Health Disparities and Equity Research Topics

• The impact of socioeconomic status on healthcare access and health outcomes.
• Strategies to decrease racial and ethnic disparities in maternal and child health.
• LGBTQ+ healthcare disparities and interventions for equitable care.
• Health disparities among rural and urban populations in developed and developing countries.
• Cultural competence in healthcare and its role in reducing disparities.
• The intersection of gender, race, and socioeconomic status in health disparities.
• Addressing health disparities in the elderly population.
• The role of discrimination in perpetuating health inequities.
• Strategies to improve healthcare access for individuals with disabilities.
• The impact of COVID-19 on health disparities and lessons learned for future pandemics.

Cancer Research Topics

• Advancements in precision medicine for personalized cancer treatment.
• Immunotherapy breakthroughs in cancer treatment.
• Environmental factors and cancer risk: A comprehensive review.
• The role of genomics in understanding cancer susceptibility.
• Cancer treatment and survivorship, as well as quality of life following cancer therapy.
• The economics of cancer treatment and its impact on patients.
• Cancer prevention and early detection strategies in underserved communities.
• Palliative care and end-of-life decisions in cancer patients.
• Emerging trends in cancer epidemiology and global burden.
• Ethical considerations in cancer clinical trials and research.

Pharmaceutical Research Topics

• Repurposing existing medications in order to address uncommon illnesses.
• The impact of nanotechnology in drug delivery and targeting.
• Pharmacogenomics and personalized medicine: Current status and future prospects.
• Challenges and opportunities in developing vaccines for emerging infectious diseases.
• Quality control and safety in the pharmaceutical manufacturing process.
• Drug pricing and access: A global perspective.
• Green chemistry approaches in sustainable pharmaceutical development.
• The part that artificial intelligence plays in the search for new drugs and their development.
• Biopharmaceuticals and the future of protein-based therapies.
• Regulatory challenges in ensuring drug safety and efficacy.

Epidemiology Research Topics

• Emerging infectious diseases and global preparedness.
• The COVID-19 pandemic will have long-term effect on the health of the general population.
• Social determinants of health and their impact on disease prevalence.
• Environmental epidemiology and the study of health effects of pollution.
• Big data and its role in modern epidemiological research.
• Spatial epidemiology and the study of disease clusters.
• Epidemiological aspects of non-communicable diseases (NCDs) like diabetes and obesity.
• Genetic epidemiology and the study of hereditary diseases.
• Epidemiological methods for studying mental health disorders.
• Epidemiology of zoonotic diseases and their prevention.

Alternative and Complementary Medicine Research Topics

• Efficacy and safety of herbal remedies in complementary medicine.
• Mind-body interventions and their role in managing chronic pain.
• Acupuncture and its potential in the treatment of various conditions.
• Integrating traditional and complementary medicine into mainstream healthcare.
• Yoga and meditation for stress reduction and mental health.
• Biofield therapies and their impact on well-being.
• Ayurvedic medicine and its modern applications in health and wellness.
• Chiropractic care and its use in musculoskeletal health.
• Ethical considerations in the practice and regulation of alternative medicine.
• Integrating traditional Chinese medicine into Western healthcare systems.

Occupational Health and Safety Research Topics

• Occupational hazards in healthcare settings and strategies for prevention.
• The impact of remote work on occupational health and well-being.
• Ergonomics and its role in preventing workplace injuries.
• Occupational exposure to hazardous chemicals and long-term health effects.
• Mental health in the office: Stress, burnout, and interventions.
• Occupational safety in the construction industry: Recent developments.
• Role of technology in enhancing workplace safety.
• Occupational health disparities among different industries and occupations.
• The economics of workplace safety and the cost-benefit analysis.
• Business impacts of OSHA regulations.

Addiction and Substance Abuse Research Topics

• The opioid epidemic: Current status and future strategies.
• Dual diagnosis: Co-occurring mental health disorders and substance abuse.
• Harm reduction approaches in addiction treatment.
• The role of family and social support in addiction recovery.
• Behavioral addictions: Understanding and treating non-substance-related addictions.
• Novel pharmacotherapies for addiction treatment.
• The impact of COVID-19 on substance abuse and addiction.
• Substance abuse prevention programs in schools and communities.
• Stigmatization of addiction and its impact on treatment-seeking behavior.
• Substance abuse in the elderly population: Unique challenges and solutions.

Biomedical Research Topics

• Recent advancements in gene editing technologies (e.g., CRISPR-Cas9).
• Regenerative medicine and tissue engineering for organ replacement.
• Bioinformatics and its role in analyzing large-scale biological data.
• Stem cell research and its important applications in regenerative medicine.
• Biomarker discovery for early disease detection and monitoring.
• Precision medicine and its potential to transform healthcare.
• The microbiome and its impacts on human health and disease.
• Aging-related research and interventions for healthy aging.
• Neurodegenerative diseases and potential therapeutic approaches.
• Biomedical ethics in the age of cutting-edge research.

Maternal and Child Health Research Topics

• The influence of the mother’s nutrition on the development and health of the fetus.
• Maternal mental health and its positive effects on child development.
• Preterm birth prevention and interventions for at-risk pregnancies.
• Neonatal screening and early diagnosis of congenital diseases.
• Breastfeeding promotion and support for new mothers.
• Pediatric immunization programs and vaccine hesitancy.
• Child obesity prevention and intervention strategies.
• Maternal and child health in low-resource and conflict-affected areas.
• Maternal mortality reduction and improving access to obstetric care.
• Adverse childhood experiences (ACEs) and their long-term health consequences.

Mental Health Stigma Research Topics

• Understanding the origins and perpetuation of mental health stigma.
• Media and pop culture’s impact on mental disease views.
• Reducing stigma in the workplace and promoting mental health support.
• Stigma associated with specific mental health conditions (e.g., schizophrenia, bipolar disorder).
• Intersectionality and how it influences mental health stigma.
• Anti-stigma campaigns and their effectiveness in changing public attitudes.
• Stigma in online communities and the role of social media in shaping opinions.
• Cultural and cross-cultural perspectives on mental health stigma.
• The impact of self-stigma on individuals seeking mental health treatment.
• Legislative and policy efforts to combat mental health stigma.

Health Education and Promotion Research Topics

• Health literacy and its impact on informed decision-making.
• Promoting healthy behaviors in schools and educational settings.
• Social marketing campaigns for health behavior change.
• Community-based health promotion programs in underserved areas.
• The role of technology and social media in health education.
• Tailoring health messages to diverse populations and cultural sensitivity.
• The use of behavioral economics in health promotion strategies.
• Investigating the effectiveness of school-based sex education programs.
• Health education for the elderly population: Challenges and solutions.
• Promoting mental health awareness and resilience through education.

Healthcare Quality and Patient Safety Research Topics

• Patient-centered care and its impact on healthcare quality.
• Reducing medical errors and negative events in healthcare settings.
• Continuous quality improvement in healthcare organizations.
• The role of healthcare accreditation in ensuring quality and safety.
• Patient engagement and shared decision-making in healthcare.
• Electronic health records and patient safety.
• The ethics of telling patients and families about medical blunders.
• Medication safety and preventing adverse drug events.
• Cultural competence in healthcare and its effect on patient safety.
• Disaster preparedness and response in healthcare settings.

Health Informatics and Data Analytics Research Topics

• Big data analytics in healthcare for predictive modeling.
• Artificial intelligence in medical image analysis and diagnostics.
• Health information exchange and interoperability challenges.
• Electronic health record (EHR) usability and user satisfaction.
• Patient data privacy and security in health informatics.
• Telemedicine and its impact on healthcare delivery and data management.
• Real-time monitoring and data analytics for disease outbreaks.
• Health informatics applications in personalized medicine.
• Natural language processing for clinical notes and text analysis.
• The role of data analyticsin enhancing healthcare quality and outcomes.

Neurological Disorders Research Topics

• Neuroinflammation in neurodegenerative diseases (e.g., Alzheimer’s and Parkinson’s).
• Stroke prevention and rehabilitation strategies.
• Advances in brain imaging techniques for diagnosing neurological disorders.
• Pediatric neurological disorders: Diagnosis and intervention.
• Neurogenetics and the role of genetics in neurological conditions.
• Traumatic brain injury: Long-term effects and rehabilitation.
• Neurorehabilitation and quality of life improvement in patients with neurological disorders.
• Neurological consequences of long COVID and post-viral syndromes.
• The gut-brain connection and its implications for neurological health.
• Ethical considerations in neurological research and treatment.

Bioethics in Health Research Topics

• Informed consent and its challenges in clinical trials and research.
• Ethical considerations in human genome editing and gene therapy.
• Allocation of healthcare resources and the principles of distributive justice.
• The ethics of organ transplantation and organ trafficking.
• End-of-life decision-making, including physician-assisted suicide.
• Ethical issues in the use of Artficial intelligence in healthcare decision-making.
• Research involving vulnerable populations: Balancing benefits and risks.
• Ethical considerations in global health research and disparities.
• Ethical implications of emerging biotechnologies, such as CRISPR-Cas9.
• Autonomy and decision-making capacity in healthcare ethics.

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Points To Be Remembered While Selecting Health Related Research Topics

When selecting a health-related research topic, there are several important considerations to keep in mind to ensure your research is meaningful and effective. Here are 7 key points to remember:

• Interest and Passion: Choose a topic that is according to your interests you, as your enthusiasm will fuel your research.
• Relevance: Ensure your topic addresses a real health issue or concern that can make a positive impact.
• Resources Availability: Confirm that you have access to the necessary materials and information for your research.
• Manageability: Pick a topic that is not too broad, ensuring it’s something you can investigate thoroughly.
• Guidance: Seek advice from experts or mentors to refine your topic and receive valuable insights.
• Ethical Considerations : Always consider the ethical implications of your research and ensure it complies with ethical guidelines.
• Feasibility: Ensure that the research can be completed within the available time and resources.

In the ever-evolving landscape of health research, selecting the right topic is the foundation for meaningful contributions. This blog has provided a roadmap for choosing health-related research topics, emphasizing the importance of personal interest, relevance, available resources, manageability, and expert guidance. Additionally, it has offered 300+ research topics across various domains, including mental health, public health, nutrition, chronic diseases, healthcare policy, and more. 

In addition, with these insights, researchers, students, and healthcare professionals can embark on journeys that not only align with their passions but also address critical healthcare challenges. By making informed choices, we can collectively advance the frontiers of health and well-being.

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Thursday, August 29, 2024

Media Contact: Sydney Trainor | Communications and Media Relations Specialist | 405-744-9782 | [email protected]

As the school year starts, so do sports activities at all levels, from elementary school to college. With increased activity and severe temperatures, the risk of athletes collapsing rises.  

When Oklahoma State University Athletics team physician Dr. Jason Moore discusses heat exposure in triple-digit temperatures, he often encounters a common misconception. The first question he hears is whether hydration affects the risk.  

“You can be hydrated, or you can be dehydrated, you still have a risk depending upon what the relative humidity, the temperature, the direct sunlight exposure is,” Moore said. “I think you need to hydrate when exposed to high temperatures, there is evidence showing electrolyte abnormalities in hydration may have an impact on the body leading to heat cramps, but you're just as at risk of heat stroke regardless of hydration status.”   

Moore led the August Athletic Training-Sports Medicine Project ECHO — a collaboration between the Human Performance and Nutrition Research Institute and OSU Center for Health Sciences . He provided critical resources to help medical and school professionals prepare to respond appropriately when an athlete collapses from suspected arrhythmia, heat exposure or head injury.   

Project ECHO is a guided-practice model that reduces health disparities in underserved and remote areas of the state. Expert teams share their knowledge via virtual clinics to help local providers deliver best-in-practice care to rural communities.

“There are really three different types of heat illness that we're worried about, heat cramps, heat exhaustion and heat stroke,” Moore said.  

Heat cramps are likely caused by electrolyte imbalances. Athletes should hydrate more both at home and during practice, while also supplementing with electrolytes as needed.  

Heat exhaustion can cause nausea, vomiting, fatigue, headaches and an increased internal temperature. Affected athletes should be moved to a cool environment immediately, rest for 48-72 hours, and gradually return to heat for acclimatization.  

Heat strokes have similar symptoms but include neurological signs, putting athletes at high risk of seizures. Personnel should call 911 immediately and initiate cooling procedures according to the emergency action plan.  

Heat exposure can be mitigated through acclimatization, frequent breaks and practicing when the risk is lower.  

When it comes to head injuries during games or training, Moore said any loss of consciousness, confusion, headache, dizziness or any other neurologic symptoms should be treated like a concussion and evaluated urgently by a certified athletic trainer or physician.  

Sudden cardiac collapse is another concern we should all be prepared to deal with on the field of play.   

When NFL player Damar Hamlin collapsed during the Jan. 2, 2023, Monday Night Football game, he experienced a traumatic cardiac arrest.  

Hamlin had no known congenital conditions like hypertrophic cardiomyopathy or arrhythmias that would increase his risk.   

Although we cannot predict this type of cardiac arrest, a simple EKG can detect irregular rhythms, and abnormal electrical patterns of the heart allowing a preventative approach and a well-prepared emergency action plan can ensure personnel are ready for such events.  

“One issue with an EKG is, you're not going to catch every arrhythmia out there, but just discovering one may save a life and by getting them to a cardiologist or electrophysiologist before the season even starts allows you to make a more informed decision about fitness to play,” Moore said.   

An emergency action plan is crucial for these types of circumstances, and can save an athlete's life by ensuring equipment, like an automated external defibrillator is available at all games and practices, as well as having at least one CPR-certified person on the sidelines and having a plan for medical transportation.  

The Athletic Training-Sports Medicine ECHO line funded by the Tobacco Settlement Endowment Trust is held from noon to 1 p.m. on the second and fourth Wednesday of each month and presents expert knowledge of best practices in the identification, reduction, and treatment of sports-related injuries to keep student athletes active, healthy, and expedite return to play.  

Register for upcoming Athletic Training-Sports Medicine ECHO sessions.  

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Supporting Occupational Health and Safety Risk Assessment Skills: A Case Study of Five Companies

Financial burden due to poor occupational safety practices remains high although occupational health and safety (OHS) have improved in recent years. Conducting risk assessment is one way to improve OHS. Workplaces may not have sufficient expertise in risk assessment. The aim of this study was to identify the needed OHS risk assessment skills, current support in the workplaces and the ways to improve risk assessment skills. This study was conducted with the Delphi survey for OHS experts ( n = 13) and with interviews ( n = 41) in the case companies. OHS experts agreed that the most significant skills were for employees to identify hazards and minimize risks in one’s work; for supervisors to influence others with a good example; and for OHS experts to understand and manage the wholeness of safety practices and understand and manage the meaning, concepts, and criteria of risk assessment. The current main support methods were learning at work, training and written instructions. However, many of the interviewees felt that they had not received risk assessment training and that the support depended on their activity. Finally, the OHS experts determined that the most feasible ways to improve risk assessment skills were training, coaching and giving clear instructions. Likewise, the interviewees suggested various training methods. Based on these results, concrete development plans to improve risk assessment skills can be made.

1. Introduction

Even though occupational health and safety (OHS) have been developed and improved in recent years, almost two million employees die each year because of exposure to work-related risks [ 1 ]. The economic burden of poor OHS practices is estimated to be 3.9% of the global gross domestic product (GDP) (i.e., EUR 2680 billion) each year [ 2 ]. According to previous studies, health promotion programs and various interventions related to occupational safety and health seem to reduce absenteeism and healthcare costs, and they have the potential to achieve business benefits [ 3 , 4 ]. At workplaces based on Finnish Occupational Health and Safety Act [ 5 ] and European OSH legislation [ 6 ], employers are responsible for ensuring the safety and health of their employees, for preventing occupational accidents and diseases and for eliminating hazards stemming from the work environment and the work itself. One key responsibility of employers is to carry out hazard identification and risk assessment [ 5 , 7 ].

The OHS risk management process involves different concepts (e.g., hazard, hazardous events, consequences and risk) which can be defined in different ways, thus affecting the results of the risk assessment [ 8 , 9 ]. How risk assessors understand these concepts, the differences between them, and the process of risk assessment has a remarkable effect on the results and the success of the risk assessment [ 10 , 11 , 12 ]. Overall, the specific knowledge, experience, abilities, skills, attributes, values, attitudes, understanding and behaviors of the risk assessor may affect the OHS risk assessment results [ 13 , 14 , 15 ]. In addition to the risk assessor, initial assumptions, oversimplification, inaccuracy of consequence models, ill-defined data, as well as poor hazard identification, teamwork, chosen method and documentation may all affect the quality of a risk analysis [ 16 , 17 , 18 ]. Previous studies have found that risks remain unidentified or uncontrolled due to limitations in OHS risk assessment skills, processes and tools [ 11 , 12 , 19 , 20 ]. Risk assessments may also be omitted altogether or delayed [ 21 ]. In addition, the research suggests that insufficient guidance on how to use risk matrices may lead to variation in the quality of risk assessment [ 22 ].

Even though previous studies have recognized the effect of the risk assessor’s and the risk assessment team’s skills to conduct a risk assessment, not many studies have primarily focused on these assessment skills or on developing them. However, for example, Hrica and Eiter [ 23 ] identified critical competencies (i.e., general hazard knowledge, site-specific hazard knowledge and situational awareness) regarding hazard recognition, which is a part of OHS risk assessment skills. Previous research has revealed that when workers are trained by effective training methods, they are able to recognize more hazards and experience higher risk levels in similar cases than workers who have not received training [ 24 ]. Hazard identification can, for example, be developed through visual hazard identification exercises [ 25 ]. Brandt et al. [ 26 ] found that, in a participatory workshop, participants can discuss problems with their colleagues and might learn from others. Namian et al. [ 27 ] argued that both the type of education (low engagement or high engagement) and the training transfer effect (e.g., upper management engagement and supervisor support) are important. Achieving a better training transfer does not necessarily mean creating new processes, but more benefits accrue by integrating learning into the company’s existing process and reward systems [ 28 ].

OHS training often uses lectures and courses as teaching and training methods. In addition, novel approaches are being used, such as e-learning, online and distance learning, as well as computer-assisted teaching and virtual reality simulation [ 29 ]. Approaches requiring participation and commitment are generally considered to be more effective [ 30 , 31 ], and using examples pictures, and other illustrative methods has often been found to be more effective than using traditional lectures or reading material [ 32 , 33 ]

The need to develop risk assessment skills, and to do it based on one’s own initiative, is a widespread phenomenon in Finnish workplaces [ 21 , 34 , 35 , 36 ]. Previous research states that companies typically do not evaluate the risk assessment skills of risk assessors or the success of risk assessment [ 37 ]. Using the Occupational Health and Safety Act as framework, the aim of this study was to recognize what are the risk assessment skills of persons who carry out risk assessment related to OHS; how the skills are currently supported in the workplaces; and how the risk assessment skills can be improved. The results of the study can be used to make the OHS risk assessment more resource-efficient and better meet the needs of the workplace. Thus, risk assessment can reap the necessary benefits and serve as a tool for safety management and safety improvement. The practical contribution of the study consists of suggestions about what the risk assessment skills of employees, supervisors and OHS experts should include, and how to support risk assessment skills.

The subsequent Materials and Methods subsection contains background information on the companies that cooperated and the research methods we used. The results obtained are presented grouped by theme. First, the OHS risk assessment skills of employees are discussed, in which the research method was the Delphi survey. Then, the results of the interviews on the current support for risk assessment skills are provided. Finally, the development of risk assessment skills was examined through both the Delphi survey and interviews. The discussion section considers the results obtained by different methods and compares them with previous research. In addition, further research and research limitations are presented at the end of the section. Finally, the main results and the obtained contribution are highlighted in these conclusions.

2. Materials and Methods

The aim of this study was descriptive in nature, and the phenomena of interest are contextual so that the researchers have limited influence on them [ 38 ]. In this mixed methods study [ 39 ], there were two different phases. In phase 1 (December 2020–January 2021), a Delphi survey [ 40 , 41 ] was conducted to explore what kind of risk assessment skills people in different positions need to have and how their risk assessment skills can be supported. In order to gain a deeper understanding of the current OHS risk assessment skills, in phase 2 (January–March 2021), a qualitative interview study was conducted using a semi-structured interview form [ 42 ]. The interviews were conducted in five Finnish companies from different industries: manufacturing, transportation and storage, electrical power generation, and another technical testing and analysis field. This qualitative and descriptive study has followed research ethical principles in accordance with the Finnish National Board on Research Integrity [ 43 ] and the General Data Protection Regulation [ 44 ]. Companies involved in this study committed to participate in interviews and surveys. Participants agreed to participate in the study after being informed of voluntary participation, anonymity and confidentiality.

2.1. Delphi Survey

The iterative Delphi survey is a method in which respondents evaluate their anonymous responses until a consensus is reached on the responses [ 40 , 41 ]. The Delphi survey consisted of three rounds in which the aim was to gather the views of OHS specialists and managers on what should be included in the risk assessment skills of the employee, the supervisor and the expert (e.g., the OHS representative or OHS manager). The request to participate included information about the study; instructions on how to participate in the survey; and the link to the survey. It was emailed to 17 individuals; 13 agreed, yielding a response rate of 76.5%. Three rounds of the Delphi survey were conducted. The response percentages for each round were 47.1% ( n = 8) in the first; 70.6% ( n = 12) in the second; and 76.5% ( n = 13) in the third round. It was possible for the respondents to take part in the survey later, even if they had not been involved in the first round. In addition, it was assumed that OHS specialists and managers are, by definition, aware of the risk assessment principles. Their experience in occupational safety was on average 13 years (SD = 16). The respondents worked for industrial companies, research institutions and authorities (see summary in Table 1 ). The survey was created through Lime Survey.

Background information of the Delphi survey ( n = 17).

Questions asked in the first round of the Delphi survey were “What is included in the risk assessment skills of (a) the employee, (b) the supervisor, and (c) the OHS expert?” and “How can risk assessment skills be supported?” Respondents ( n = 8) answered open-ended questions and the length of the answers was not limited. Background information collected from the respondents included their name, the name of the company, the position in the organization (supervisor, specialist), work experience in the current position and work experience in similar positions. The name of the respondent was asked so that reminder emails could be targeted to people who had not yet responded.

Researchers performed a qualitative analysis and the participants received feedback. The thematic categorization of the qualitative material of the first round was conducted by applying the open coding analysis approach [ 45 ]; the process identified four factors in the OHS risk assessment skills of employee, six factors in the OHS risk assessment skills of the supervisor and six factors in the OHS risk assessment skills of experts. In addition, responses to the question about how to support OHS risk assessment skills received 12 suggestions. In the second round of the survey, respondents ( n = 12) commented on the categorized lists and explained their answers to open-ended questions.

After the second round, a quantitative analysis was performed using Microsoft (MS) Excel, and the participants again received feedback. In the third round of the survey, the respondents ( n = 13) chose the four most important factors for employee’s OHS risk assessment skills, the five most important factors for supervisor’s and expert’s OHS risk assessment skills, and the eight ways to support OHS risk assessment skills. In addition, respondents chose the eight most feasible ways to support OHS risk assessment skills. If desired, respondents were allowed to choose fewer options for their response. The third-round answers were again analyzed using MS Excel and IBM SPSS. Before each round ended, participants were sent reminders to answer.

2.2. Semi-Structured Interviews

The companies were chosen based on their needs and interests to develop their risk assessment processes. There are some similarities and differences between the companies. Four of the companies are large, while one is medium sized, employing approximately 200 people. In addition, almost all companies employ subcontractors. One company operates only in Finland, while others have international operations, or they are part of larger international corporations. The companies involved in this study are stable, traditional Finnish companies, where attention is paid to employee persistence. The duration of employment of the persons interviewed at the company was on average 14 years (SD = 10). This study focused on the Finnish sites of these companies.

The interviews were conducted with members of the risk assessment team or with managers. The position of the interviewees varied widely depending on the company. In one company, the interviewees were chosen as a cross-section of the process from design to implementation, while in another, mainly managers and immediate supervisors were interviewed. Altogether, the interviewees’ positions were manager ( n = 10), immediate supervisor ( n = 15), employee ( n = 20), and OHS manager or representative ( n = 8). When describing the status of the interviewees, it must be considered that, for example, the OHS manager can also be the supervisor and that the OHS representative of employees is usually an employee themselves or an expert on certain tasks. They are classified here as OHS managers and representatives. Table 2 summarizes the distribution of the companies, the interviewees and the interviews. All the interviews were held via MS Teams. Interview types were divided into individual interviews ( n = 32) and group interviews ( n = 9), and the average duration of interview was 59 min, lasting between 38 and 96 min. The transcriptions resulted in 324 pages.

Background information about the interviews ( n = 41) and interviewees ( n = 53).

The semi-structured interview form included questions such as the following: “How is the conducting of a risk assessment instructed?”; “Have you/others involved in the risk assessment received orientation about the risk assessment? What kind?”; “How are individual employees instructed to assess the risks of their own duties?”; “How are risk assessment skills currently supported?”; and “In what ways could the risk assessment skills be improved?” A few questions had to be slightly modified for companies to suit their operations. The question “How are individual employees instructed to assess the risks of their own duties?” received an answer in 25 interviews. It was not answered if the interviewee was an expert with no subordinates, if there was time pressure due to the group interview, or the discussion was about guidance in general. One interviewee did not answer the questions “How are risk assessment skills currently supported?” and “In what way the risk assessment skills could be improved?” All the interviews were recorded except for one, when the interviewee did not want to be recorded. However, the notes from that interview were added to transcriptions. A total of three companies had both individual and group interviews; one company had only group interviews, and one had individual interviews. The duration of the interviews varied depending on whether it was a group or an individual interview.

Transcriptions were analyzed using Atlas.ti version 9 software by applying the open-coding analysis approach [ 46 ] (i.e., written data were conceptualized into separate categories and given a name that represents or stands for it) [ 47 ] in order to identify the current risk assessment support and how to develop it. During the analysis, the codes that needed further processing were discussed together. Researchers coded one interview at a time, resulting in 482 codes. The researchers then checked the codes for consistency, removed unnecessary codes, and compiled similar codes, resulting in 409 codes. During the third round, the researchers categorized the codes into 104 themes. A thematic categorization of the data was conducted by using Whimsical SaaS because of its visuality for categorizing the themes that emerged. Questions with clear answers did not require thematic processing. Hence, two groups of codes were obtained, some of which were processed numerically and some through thematic design. Because there is more than one code categorized within a single theme, participants might have mentioned a particular theme more than once per interviewee. In other words, the number of respondents or interviews does not necessarily correlate with the number of themes. In addition, MS Excel was used as a support tool in the analysis. The questions and their occurrences in the interviews are presented in Appendix A , Table A1 .

The used risk assessment methods in the companies were checklists, the potential problems analysis (PPA) method and the task risk assessment completed either in the OHS system or with MS Excel and MS Word forms. The composition of the risk assessment team varied considerably depending on the company but usually comprised of the immediate supervisor and the employee(s), the OHS representative, and in some cases, safety/quality manager as well as the work experts.

3.1. Required OHS Risk Assessment Skills of Employee, Supervisor, OHS Expert

In the Delphi survey, the most significant OHS risk assessment skills of employees and supervisors were unanimously found. Identifying hazards and minimizing personal risks were the most significant skills for employees. Influencing others by their own example and attitude was seen as the most considerable skill for supervisors. The skill requirements of the experts were not as unanimously chosen as for the employees and supervisors. The two things considered to be the most significant OHS risk assessment skills were both understanding and managing the wholeness of safety practices and understanding and managing the meaning, concepts and criteria of risk assessment as well as the related workplace safety legislation.

3.1.1. Employees’ Risk Assessment Skills

All respondents considered identifying risk factors in their own work and minimizing risks to be the most important factors in an employee’s OHS risk assessment skills. In addition, the theme “Identify situations where work should be suspended” was highlighted in the second round and was considered the second most important factor by over 80% of the respondents in the third round. “Identifying situations in which a risk will be taken” and “Knowledge of one’s own responsibilities and rights (in occupational protection)” were chosen as the third and fourth most important factors by 46% of the respondents, respectively. Employees are expected to have experience of the work and knowledge of the work-related hazards, which is why understanding the meaning, principles, and concepts of risk assessment was considered to be the least important factor in an employee’s OHS risk assessment skills. Two respondents chose only three options instead of four. Figure 1 shows the results given by occupational health specialists and managers on the requirements for employee risk assessment skills.

Opinions of occupational health specialists and managers on the most important risk assessment skills needed by the employee.

3.1.2. Supervisors’ Risk Assessment Skills

The most important factor in the supervisor’s OHS risk assessment skills was unanimously “influencing others through one’s own example and attitude (developing safety thinking and safety culture).” This option was added based on comments from the second round. The second most important factor, “Responsibility for risk assessment (able to guide and participate as well as identify and minimize risks in the work environment),” was chosen by 92% of the respondents. The third and fourth options also received more than 60% of choices. “Team motivation (for risk assessment and daily safe operations)” was added based on the second-round answers and was chosen by 69% of the respondents. “Identifying situations where risks need to be assessed” received the fourth highest score, as was chosen by 62% of the respondents. The fifth, “General duty to exercise care of safety at work,” received only 38% of the choices. The options which were only chosen once were “Competence in the use of risk management tools,” “Knowledge of the task to be assessed and ability to identify hazards,” and “Competence to assess the magnitude and probability of the identified risk.” Four respondents decided to choose only four factors instead of five. Figure 2 shows the results given by occupational health specialists and managers on the requirements for supervisor risk assessment skills.

Opinions of occupational health specialists and managers on the most important risk assessment skills needed by the supervisor.

3.1.3. Experts’ Risk Assessment Skills

The most important factors related to an expert’s risk assessment skills caused more variation than those of employees and supervisors. The two most important were “Understanding and managing the wholeness of safety practices” and “Understanding and mastering the meaning, concepts, rationale, and knowledge of risk assessment (occupational safety legislation),” which received 85% of the choices. “Guiding in the risk assessment and in the use of risk assessment tools” also received more than 60% of the choices. “Knowledge of good practices in risk management” and “Understanding human factors” were chosen as the fourth and fifth factors by 46% of the respondents. Indicating the variation of the answers, even the least voted factors received more than 20% of the points. For the experts, these factors were “Be able to identify risks, assess the magnitude and probability of the identified risk, and target measures and evaluate their effectiveness” and “Knowledge of the use of risk management tools.” Two respondents felt that four of the five factors were sufficient. Figure 3 shows the results given by occupational health specialists and managers on the requirements for expert risk assessment skills.

Opinions of the occupational health specialists and managers on the most important risk assessment skills needed by the expert.

3.2. OHS Risk Assessment Skills Support at The Case Companies

Based on the interviews, learning at work and training were considered to be the most often used forms of orientation, mentioned in 56% and 59% of the interviews, respectively. Almost as many felt that they had not received risk assessment orientation. Written instructions were raised in all companies as a considerable way to guide the conduct of an OHS risk assessment. Perceiving the dangers in one’s own job was seen as a part of everyday activities. Some companies also use a so-called last-minute risk assessment, being mentioned in 29% of interviews. Lastly, in 63% of interviews, the interviewees felt that the support they received mainly depended on the employee’s own activity and that they needed to be able to either ask for it or apply it. The number of responses per interviews or mention per theme varied in each question. All results are presented in Appendix A , Table A1 .

3.2.1. Orientation Regarding Risk Assessment Process

There are different ways to support OHS risk assessment skills in the workplace. One way to support employees involved in OHS risk assessment is to have an orientation about how to carry it out. In OHS risk assessment orientation, the three most often mentioned themes in interview responses were almost equally divided between “Learning at work” in 56% of the interviews, “Training” in 59% of the interviews and “Employees feel that there was no orientation” in 56% of the interviews. It was felt that orientation can be obtained almost as much through on-the-job learning as through training:

“Online training materials where all supervisors need to undergo these trainings. They are compulsory trainings.” “I actually started using that program—and practiced myself.”

It was generally pointed out in the responses that the skills were gained through work even prior to present-day orientations. Those who had worked less time felt that they had received more orientation. However, in an equal amount of the interviews, the respondents did not feel that they had received any orientation at all with regard to performing the risk assessment.:

“I have not received any orientation with risk assessment in particular.”

Responses to interviews in the “Other” category (20%) refer to a review of instructions prior to conducting a risk assessment, ongoing safety discussions and developing risk assessment models. Responses regarding orientation received similar answers in each company.

3.2.2. Instructions to Perform a Risk Assessment and for Individual Employee to Assess the Risks of Their Own Duties

By instructing employees, support can be provided both to conducting the risk assessment and guiding the individual employee to identify the hazards associated with their own work. When asked how to conduct a risk assessment, in 56% of interviews, the risk assessment guidelines as well as the written instructions used in the company and their location were mentioned. Some companies also received instructions from their customers:

“When you start doing a risk assessment, it goes how it is in this risk assessment form. It helps us, but it is not slavishly observed. ”

However, in 41% of the interviews, the respondents were uncertain regarding the instructions, the number of instructions was considered low, or the interviewee was unsure about the location of the guidelines or instructions. There was only one company where no one was unsure of guidance:

“If I have to name a guide, I find it terribly difficult to say. But yes, I go to a safety management system where I don’t remember exactly what it says.“

Training was mentioned in 34% of interviews. The interviewees felt that they had received guidance in various trainings, such as e-learning programs, educational days and video trainings. In addition, in 17% of interviews, guidance provided by a particular person, such as an OHS manager, or a leader of the risk assessment before each audit, was mentioned. In one interview, unwritten instructions were highlighted. At the corporate level, there were two themes—training and guidance provided by a particular person—that were not recognized in two companies.

A total of 39 responses were received from the 25 interviews regarding the instructions of an individual employee concerning the assessment of the risks of their own work tasks. Nearly half of the respondents felt that assessing the risks of one’s own job was a daily activity:

“A proactive approach to occupational safety [is needed], with the aim of making safety observations or reporting near misses, perhaps to achieve day-to-day foresight. ”

The second most common way to instruct assessing the risks of one’s own work is a last-minute risk or hazard assessment, which was mentioned in 29% of interviews. One of the companies used a paper memory card to perform a last-minute hazard assessment. In addition, one’s own activity was felt to be important in obtaining information in three responses. The oral work permit policy used in one company was also mentioned twice here as a guideline for assessing the risks of one’s own work. Two of the respondents felt that they were not introduced to how to assess the dangers of their own work.

3.2.3. Current Risk Assessment Skills Support

In 63% of interviews, the respondents thought that when they are active themselves, they also receive support. In other words, it was felt that support was available as long as it was requested. In addition, it was felt that individual initiative was needed to go through the guidelines:

“But it [support] may not be actively offered directly. In that sense, … one has to be active if one wants to further develop it.”

The next most usual way to support OHS risk assessment skills was various training sessions and guidelines, which were mentioned in 41% of interviews. In 29% of interviews, the respondents said that OHS risk assessment skills were not supported. In 22% of interviews, guided discussions, such as safety talks and meetings led by the supervisor, were seen as one way to support risk assessment skills.

3.3. Development of OHS Risk Assessment Skills

Based on the Delphi survey, no overwhelming feasible proposal was found for the development of OHS risk assessment skills. The two most frequently chosen development methods were the organization of training and coaching related to OHS risk assessment methods and clear instructions for the implementation of OHS risk assessments. Various training methods emerged in the interviews as the most significant way to develop OHS risk assessment skills.

3.3.1. Feasible Ways to Support Risk Assessment Skills

In the Delphi survey, the experts were asked to choose the eight most feasible ways to support OHS risk assessment skills. The question divided opinions and only seven of the respondents chose all eight options. The other six respondents either did not feel that they found any other feasible options on the list or were satisfied with fewer choices. The number of selected choices ranged from four to eight. The options receiving the most choices (77%) were “Organizing trainings and coaching on risk assessment methods” and “Clearly guiding the implementation of the risk assessment.” The other most viable forms of support that received more than 50% of the votes were “Defining consistent processes and models for risk management” (69%), “Providing easy-to-use tools” (69%), “Providing expert support to supervisors and employees” (62%), “Conducting a risk assessment participatory with employees, specialists, and supervisors from different departments” (62%) and “Incorporating the results of risk assessments into everyday decision-making” (54%). The choice for the most feasible way to support OHS risk assessment skills was not as unanimous as in the previous questions, which was partly due to the different risk assessment practices of companies. None of the respondents saw “Using support provided by an insurance company” as a the most feasible way to support OHS risk assessment skills. The form of support “By clearly defining the risk matrix (explaining verbally what probability and severity of consequences mean for different factors, such as physical and chemical factors)” was only chosen once. Figure 4 shows the results from the occupational health experts and supervisors on feasible ways to support risk assessment skills.

Opinions of occupational health specialists and managers for the most feasible ways to support risk assessment skills.

3.3.2. Ideas for Developing OHS Risk Assessment Skills

Ideas for developing risk assessment skills varied more than the themes in the previous subsections. In 63% of interviews, participants mentioned training activities as the largest factor to improve risk assessment skills. The various training methods related to OHS risk assessment skills included, for example, training given by an outsider, video training, or training provided by a specific person working in the organization. In addition, the regular reviewing of the risk assessments, orientation of new employees and mentoring were mentioned:

“It could be, for example, an online course that allows you to concretely identify certain dangers from pictures and in some way figure out the risks associated with them.”

The next most common point was to increase the understanding of risk assessment (mentioned in 32% of the interview responses) and obtain different perspectives (mentioned in 24% of the interview responses):

“It would be good to hear how to carry out a risk assessment elsewhere—whether it’s similar, whether similar forms, for example, or are those matrices different, whether something else would work for us. Or the whole world of risk assessment could be opened up to us from a little different scope.”

In connection with the development of communication, in 17% of the interviews’ responses, participants mentioned that repeating information improves the person’s recollection. In 12% of the interviews categorized as “Other”, the respondents could not give any development proposal. The activities and discussions of the team as well as clear guidance and resources were mentioned in 10% of the interviews.

4. Discussion

In this study, the OHS risk assessment skills were examined. The Delphi survey provided information gathered from OHS experts on what they considered to be the important OHS risk assessment skills of people working in different roles. The role of safety experts in research extensively covers the need for safety management and related training, but there are few actual competence criteria related to purely risk assessment [ 48 , 49 , 50 ]. The present study shows that the experts agreed that the most important issue for an employee’s OHS risk assessment skills is identifying the hazards of their own work and minimizing the associated risks. According to the literature, various methods have been developed to identify hazards, such as using visual hazard identification and transmission boards [ 12 , 19 , 25 ].

The second most important requirement for employee’s OHS risk assessment skills was being able to identify situations in which work needs to be suspended. According to the Finnish Occupational Safety and Health Act [ 5 ], an employee has the right to refrain from doing work that poses a danger to their own health or the health of others. The employee is also obliged to notify the employer that they have eliminated or rectified the defect or deficiency. Wang et al. [ 51 ] have investigated the safety risks posed by high frequency and low severity that could be avoided if corrective action is taken in a timely manner. In two of the companies included in this study, the nature of the work was such that unsafe work was prevented by redesigning the work plan.

Regarding the skills of supervisors in the OHS risk assessment, “influencing by one’s own example and attitude” was considered to be the most significant by experts. This was somewhat highlighted in the interviews when participants discussed different safety sessions and discussions and reviewed risk assessments with the employees involved. In addition, improving the understanding of risk assessment was mentioned as a development measure, which also affects the supervisor’s motivation. This is in line with the study by Huang et al. [ 52 ], which emphasized that when a supervisor leads by example, they encourage subordinates to maintain a safer workplace. It should be noticed that employee’s and supervisor’s skills include more specific factors than OHS experts. For the OHS expert, the most important risk assessment skills were related to understanding and managing the wholeness, concepts and principles of the risk assessment. As the quality of risk assessment is dependent on many steps [ 16 ], it is important that certain persons have a holistic view of the risk assessment.

In the interviews, the most important guidelines for assessing the hazards of one’s own work were considered to be daily activities, which is in line with previous studies, as safety management should be a daily activity in which supervisors and managers lead by example and encourage their subordinates to work safely [ 52 ]. However, Jeschke [ 53 ] has revealed a major conflict between managers’ daily work and safety, which they viewed as an extra task. In this study, it was found that, in the workplaces, employees are encouraged to make safety reports and do various safety rounds, sessions, or walks. In addition, incidents are regularly reviewed under the supervision of a supervisor. The last-minute hazard assessment emerged as another form of guidance in the interviews. Both the memory card method and the silent self-assessment of work hazards were used.

In this study, the interviewees mainly named written instructions, on-the-job learning and training as methods of current orientation, training, and guidance. In addition to traditional training methods, interviewees mentioned, among other things, training via MS Teams, video training and e-learning. Based on previous studies, the use of different training methods in developing skills has been highlighted [ 23 , 24 ]. For example, COVID-19 has caused changes in the organization in terms of teaching and accelerated the possibilities of distance learning [ 54 ]. Although it is often assumed that skills are developed in training programs, especially via textbook- and computer-based methods, previous research has shown that this is not a certainty. Training with both safe and high-risk examples has shown the highest accuracy and may lead to fewer under- or overestimations of risk in the assessment [ 32 ]. However, this study revealed an experience of not receiving any risk assessment-related orientation. In addition, companies did have written instructions and guidelines but a large proportion of respondents were uncertain about the instructions, felt the amount of instructions was low, or were unsure where to find the instructions. Furthermore, it was felt that although support is available, one must be able to take the initiative and ask for support from the right party.

Further study is needed to explore the effective intervention for training OHS risk assessment skills. In the current study, the experts thought that training and coaching are among the most feasible methods of developing risk assessment skills. Burke et al. [ 30 ] suggested enhancing learning through activity, dialogue and reflections. Ho and Dzeng [ 29 ] revealed that an e-learning method can be effective if the learning environment motivates the learner. In this study, the interviewees also raised education as the most significant way to develop OHS risk assessment skills. Suggested training methods included training given by a person outside of the organization, self-learning on the computer and mentoring. The OHS experts said that another feasible method of developing employees’ risk assessment skills is having clear guidance. Supporting this, a study by Bruhn and Frick [ 55 ] showed how a project can fail with under- or oversteering as well as with overly general or overly detailed guidance. Furthermore, in this study, the interviewees suggested improving risk assessment understanding and reviewing different perspectives.

Huang et al. [ 52 ] emphasized the importance of supervisors having a comprehensive understanding of safety rules and raised the need for communicating well with their employees. The current study made similar findings [ 52 ]; there is a need to improve communication between management and employees. Furthermore, the results of risk perceptions among employees and assessors differ, but the situation can be improved by using information strategies that simplify learning and improve risk perception [ 56 ]. Further research should be focused on how to make existing instructions and guidance better known to workers. Important questions include, why does one person easily find the right instructions and another feels that the instructions are unclear? Likewise, the employees’ experience of their own activity in obtaining support also raises questions, so how much can the support depend on the person? The focus could be on the communication and communications methods by studying various case companies.

Limitations

The companies that participated in this study developed their own OHS management systems long before this study. Consequently, the results of the study may not be directly generalizable to companies with a lower level of safety. Furthermore, the reference framework for this study was European OSH legislation [ 6 ] and its national Finnish Occupational Health and Safety Act [ 5 ]. As this is an EU Framework Directive, it sets minimum standards risk assessment and hence, the results are generalizable to European countries at some level. As the Delphi survey and interview process are explained in detail with explanations about the demographics of the participants, similar research can be carried out by other researchers in other countries. Further studies are recommended in multiple companies under different conditions, for example micro and small companies, in order to further generalize the results.

The other limitations of this study are the response rate to the Delphi survey and the limited number of interviewees ( n = 53) in the qualitative studies as well as the interpretation of these studies. A Delphi survey was e-mailed to the OHS specialists and managers, whose response rates varied [ 57 , 58 ]. By sending a reminder email each round, the number of responses increased. Small variations in the questionnaire questions or in the words used may affect the results obtained; consequently, in the second round, organizational factors were asked in addition to individual ones [ 47 ]. The results of this study were supported by the fact that the number of respondents increased in each round: 8 respondents in the first round, 12 respondents in the next round and 13 respondents in the last round.

Some of the interviews were conducted under time pressure, and in some of the companies interviewed, participants were supervisors, managers, and occupational safety and health representatives with no employees. However, the ratio of employees’ positions was overall fairly uniform. Although the interviewees had different education levels, work experience and backgrounds, similar issues began to emerge from the responses, so it can be said that this study used enough interviews. The design of the interviews took into account the interaction between the researchers and the interviewees. The interview questions were shown as text and spoken aloud. The semi-structured interview ensured that all themes were discussed, but it also provided room for more in-depth and free discussion [ 59 ]. This was done to make the interviewees feel comfortable and ensure that the discussion stayed on topic [ 42 ]. Similarly, some pitfalls and problems were taken into account when conducting a qualitative interview [ 60 ]. Efforts were made to improve the reliability of the study in a number of ways. The interviews were conducted in collaboration with two researchers. After each interview, the notes were reviewed and a separate file was compiled from them. The material was mainly coded by the same two researchers, who discussed the meaning of citations and codes [ 61 ]. The coding was iteratively carried out, reviewing the citations of a particular code if necessary and ensuring that they corresponded to the code [ 62 ]. In addition, the theme design was done by two researchers.

5. Conclusions

The results of this study are in line with those of previous studies. The most important issues related to the risk assessment skills of the employees and supervisors were unanimously determined to be identifying hazards and minimizing the risks of one’s own work for employees and the supervisors influencing of their subordinates through their own example and attitude. Understanding and managing the wholeness of safety practices and understanding and managing the meaning, concepts, and criteria of risk assessment as well as the related workplace safety legislation were the most important risk assessment skills for the OHS experts.

The interviews were used to determine the most significant ways to support risk assessment skills. Currently, learning at work and training as well as written instructions are the most often used support methods. However, there were some uncertainties about the instructions and feelings of not receiving enough orientation, guidance and support. Interviewees felt that in order to receive the support, they have to be the active party.

For the development of risk assessment skills, the survey provided expert opinions on the most feasible ways to support risk assessment skills, such as training and coaching, clear instructions, as well as suggestions from interviews on how risk assessment skills can be supported, such as via various training methods. Training methods included video teaching and training provided by a person outside the organization. In addition, the need to increase understanding of risk assessment and utilizing different perspectives were highlighted.

The results of this study can be used to find the most import development needs in order to create concrete development plans to improve risk assessment skills. Based on a Delphi survey, companies receive information on what OHS experts consider important risk assessment skills for personnel in different positions. Furthermore, this study presents how risk assessment skills are currently supported and suggests ways to further support and develop the risk assessment skills. Knowledge of the current situation can enable a company to choose the best development actions and implementations. Hence, it is recommended that companies perform a similar survey and interviews to determine their personnel’s need and receive feedback on risk assessment skills and support.

The number and percentage of responses to the themes as well as the number and percentage of interviews in which the theme is mentioned.

Author Contributions

Conceptualization, M.R. and M.L. Data curation, M.R. and M.L. Formal analysis, M.R. and M.L. Funding acquisition, S.T. Investigation, M.R. and M.L. Methodology, M.R. and M.L. Project administration, S.T. Supervision, S.T. Visualization, M.R. Writing—original draft, M.R. Writing—review and editing, M.R., M.L. and S.T. All authors have read and agreed to the published version of the manuscript.

This research was funded by the Finnish Work Environment Fund, grant number 200089.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Conflicts of Interest

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Guidance Regarding Methods for De-identification of Protected Health Information in Accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule

This page provides guidance about methods and approaches to achieve de-identification in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule. The guidance explains and answers questions regarding the two methods that can be used to satisfy the Privacy Rule’s de-identification standard: Expert Determination and Safe Harbor 1 .  This guidance is intended to assist covered entities to understand what is de-identification, the general process by which de-identified information is created, and the options available for performing de-identification.

In developing this guidance, the Office for Civil Rights (OCR) solicited input from stakeholders with practical, technical and policy experience in de-identification.  OCR convened stakeholders at a workshop consisting of multiple panel sessions held March 8-9, 2010, in Washington, DC. Each panel addressed a specific topic related to the Privacy Rule’s de-identification methodologies and policies. The workshop was open to the public and each panel was followed by a question and answer period.  Read more on the Workshop on the HIPAA Privacy Rule's De-Identification Standard. Read the Full Guidance .

1.1 Protected Health Information 1.2 Covered Entities, Business Associates, and PHI 1.3 De-identification and its Rationale 1.4 The De-identification Standard 1.5 Preparation for De-identification

Guidance on Satisfying the Expert Determination Method

2.1 Have expert determinations been applied outside of the health field? 2.2 Who is an “expert?” 2.3 What is an acceptable level of identification risk for an expert determination? 2.4 How long is an expert determination valid for a given data set? 2.5 Can an expert derive multiple solutions from the same data set for a recipient? 2.6 How do experts assess the risk of identification of information? 2.7 What are the approaches by which an expert assesses the risk that health information can be identified? 2.8 What are the approaches by which an expert mitigates the risk of identification of an individual in health information? 2.9 Can an Expert determine a code derived from PHI is de-identified? 2.10 Must a covered entity use a data use agreement when sharing de-identified data to satisfy the Expert Determination Method?

Guidance on Satisfying the Safe Harbor Method

3.1 When can ZIP codes be included in de-identified information? 3.2 May parts or derivatives of any of the listed identifiers be disclosed consistent with the Safe Harbor Method? 3.3 What are examples of dates that are not permitted according to the Safe Harbor Method? 3.4 Can dates associated with test measures for a patient be reported in accordance with Safe Harbor? 3.5 What constitutes “any other unique identifying number, characteristic, or code” with respect to the Safe Harbor method of the Privacy Rule? 3.6 What is “actual knowledge” that the remaining information could be used either alone or in combination with other information to identify an individual who is a subject of the information? 3.7 If a covered entity knows of specific studies about methods to re-identify health information or use de-identified health information alone or in combination with other information to identify an individual, does this necessarily mean a covered entity has actual knowledge under the Safe Harbor method? 3.8 Must a covered entity suppress all personal names, such as physician names, from health information for it to be designated as de-identified? 3.9 Must a covered entity use a data use agreement when sharing de-identified data to satisfy the Safe Harbor Method? 3.10 Must a covered entity remove protected health information from free text fields to satisfy the Safe Harbor Method?

Glossary of Terms

Protected health information.

The HIPAA Privacy Rule protects most “individually identifiable health information” held or transmitted by a covered entity or its business associate, in any form or medium, whether electronic, on paper, or oral. The Privacy Rule calls this information protected health information (PHI) 2 . Protected health information is information, including demographic information, which relates to:

• the individual’s past, present, or future physical or mental health or condition,
• the provision of health care to the individual, or
• the past, present, or future payment for the provision of health care to the individual, and that identifies the individual or for which there is a reasonable basis to believe can be used to identify the individual. Protected health information includes many common identifiers (e.g., name, address, birth date, Social Security Number) when they can be associated with the health information listed above.

For example, a medical record, laboratory report, or hospital bill would be PHI because each document would contain a patient’s name and/or other identifying information associated with the health data content.

By contrast, a health plan report that only noted the average age of health plan members was 45 years would not be PHI because that information, although developed by aggregating information from individual plan member records, does not identify any individual plan members and there is no reasonable basis to believe that it could be used to identify an individual.

The relationship with health information is fundamental.  Identifying information alone, such as personal names, residential addresses, or phone numbers, would not necessarily be designated as PHI.  For instance, if such information was reported as part of a publicly accessible data source, such as a phone book, then this information would not be PHI because it is not related to heath data (see above).  If such information was listed with health condition, health care provision or payment data, such as an indication that the individual was treated at a certain clinic, then this information would be PHI.

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Covered Entities, Business Associates, and PHI

In general, the protections of the Privacy Rule apply to information held by covered entities and their business associates.  HIPAA defines a covered entity as 1) a health care provider that conducts certain standard administrative and financial transactions in electronic form; 2) a health care clearinghouse; or 3) a health plan. 3   A business associate is a person or entity (other than a member of the covered entity’s workforce) that performs certain functions or activities on behalf of, or provides certain services to, a covered entity that involve the use or disclosure of protected health information. A covered entity may use a business associate to de-identify PHI on its behalf only to the extent such activity is authorized by their business associate agreement.

See the OCR website https://www.hhs.gov/ocr/privacy/ for detailed information about the Privacy Rule and how it protects the privacy of health information.

De-identification and its Rationale

The increasing adoption of health information technologies in the United States accelerates their potential to facilitate beneficial studies that combine large, complex data sets from multiple sources.  The process of de-identification, by which identifiers are removed from the health information, mitigates privacy risks to individuals and thereby supports the secondary use of data for comparative effectiveness studies, policy assessment, life sciences research, and other endeavors.

The Privacy Rule was designed to protect individually identifiable health information through permitting only certain uses and disclosures of PHI provided by the Rule, or as authorized by the individual subject of the information.  However, in recognition of the potential utility of health information even when it is not individually identifiable, §164.502(d) of the Privacy Rule permits a covered entity or its business associate to create information that is not individually identifiable by following the de-identification standard and implementation specifications in §164.514(a)-(b).  These provisions allow the entity to use and disclose information that neither identifies nor provides a reasonable basis to identify an individual. 4 As discussed below, the Privacy Rule provides two de-identification methods: 1) a formal determination by a qualified expert; or 2) the removal of specified individual identifiers as well as absence of actual knowledge by the covered entity that the remaining information could be used alone or in combination with other information to identify the individual.

Both methods, even when properly applied, yield de-identified data that retains some risk of identification.  Although the risk is very small, it is not zero, and there is a possibility that de-identified data could be linked back to the identity of the patient to which it corresponds.

Regardless of the method by which de-identification is achieved, the Privacy Rule does not restrict the use or disclosure of de-identified health information, as it is no longer considered protected health information.

The De-identification Standard

Section 164.514(a) of the HIPAA Privacy Rule provides the standard for de-identification of protected health information.  Under this standard, health information is not individually identifiable if it does not identify an individual and if the covered entity has no reasonable basis to believe it can be used to identify an individual.

§ 164.514 Other requirements relating to uses and disclosures of protected health information. (a) Standard: de-identification of protected health information. Health information that does not identify an individual and with respect to which there is no reasonable basis to believe that the information can be used to identify an individual is not individually identifiable health information.

Sections 164.514(b) and(c) of the Privacy Rule contain the implementation specifications that a covered entity must follow to meet the de-identification standard. As summarized in Figure 1, the Privacy Rule provides two methods by which health information can be designated as de-identified.

Figure 1. Two methods to achieve de-identification in accordance with the HIPAA Privacy Rule.

The first is the “Expert Determination” method:

(b) Implementation specifications: requirements for de-identification of protected health information. A covered entity may determine that health information is not individually identifiable health information only if: (1) A person with appropriate knowledge of and experience with generally accepted statistical and scientific principles and methods for rendering information not individually identifiable: (i) Applying such principles and methods, determines that the risk is very small that the information could be used, alone or in combination with other reasonably available information, by an anticipated recipient to identify an individual who is a subject of the information; and (ii) Documents the methods and results of the analysis that justify such determination; or

The second is the “Safe Harbor” method:

(2)(i) The following identifiers of the individual or of relatives, employers, or household members of the individual, are removed:

(B) All geographic subdivisions smaller than a state, including street address, city, county, precinct, ZIP code, and their equivalent geocodes, except for the initial three digits of the ZIP code if, according to the current publicly available data from the Bureau of the Census: (1) The geographic unit formed by combining all ZIP codes with the same three initial digits contains more than 20,000 people; and (2) The initial three digits of a ZIP code for all such geographic units containing 20,000 or fewer people is changed to 000

(C) All elements of dates (except year) for dates that are directly related to an individual, including birth date, admission date, discharge date, death date, and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older

(D) Telephone numbers

(L) Vehicle identifiers and serial numbers, including license plate numbers

(E) Fax numbers

(M) Device identifiers and serial numbers

(F) Email addresses

(N) Web Universal Resource Locators (URLs)

(G) Social security numbers

(O) Internet Protocol (IP) addresses

(H) Medical record numbers

(P) Biometric identifiers, including finger and voice prints

(I) Health plan beneficiary numbers

(Q) Full-face photographs and any comparable images

(J) Account numbers

(R) Any other unique identifying number, characteristic, or code, except as permitted by paragraph (c) of this section [Paragraph (c) is presented below in the section “Re-identification”]; and

(K) Certificate/license numbers

(ii) The covered entity does not have actual knowledge that the information could be used alone or in combination with other information to identify an individual who is a subject of the information.

Satisfying either method would demonstrate that a covered entity has met the standard in §164.514(a) above.  De-identified health information created following these methods is no longer protected by the Privacy Rule because it does not fall within the definition of PHI.  Of course, de-identification leads to information loss which may limit the usefulness of the resulting health information in certain circumstances. As described in the forthcoming sections, covered entities may wish to select de-identification strategies that minimize such loss.

Re-identification

The implementation specifications further provide direction with respect to re-identification , specifically the assignment of a unique code to the set of de-identified health information to permit re-identification by the covered entity.

If a covered entity or business associate successfully undertook an effort to identify the subject of de-identified information it maintained, the health information now related to a specific individual would again be protected by the Privacy Rule, as it would meet the definition of PHI.  Disclosure of a code or other means of record identification designed to enable coded or otherwise de-identified information to be re-identified is also considered a disclosure of PHI.

(c) Implementation specifications: re-identification. A covered entity may assign a code or other means of record identification to allow information de-identified under this section to be re-identified by the covered entity, provided that: (1) Derivation. The code or other means of record identification is not derived from or related to information about the individual and is not otherwise capable of being translated so as to identify the individual; and (2) Security. The covered entity does not use or disclose the code or other means of record identification for any other purpose, and does not disclose the mechanism for re-identification.

Preparation for De-identification

The importance of documentation for which values in health data correspond to PHI, as well as the systems that manage PHI, for the de-identification process cannot be overstated.  Esoteric notation, such as acronyms whose meaning are known to only a select few employees of a covered entity, and incomplete description may lead those overseeing a de-identification procedure to unnecessarily redact information or to fail to redact when necessary.  When sufficient documentation is provided, it is straightforward to redact the appropriate fields.  See section 3.10 for a more complete discussion.

In the following two sections, we address questions regarding the Expert Determination method (Section 2) and the Safe Harbor method (Section 3).

In §164.514(b), the Expert Determination method for de-identification is defined as follows:

 (1) A person with appropriate knowledge of and experience with generally accepted statistical and scientific principles and methods for rendering information not individually identifiable: (i) Applying such principles and methods, determines that the risk is very small that the information could be used, alone or in combination with other reasonably available information, by an anticipated recipient to identify an individual who is a subject of the information; and (ii) Documents the methods and results of the analysis that justify such determination

Have expert determinations been applied outside of the health field?

Yes. The notion of expert certification is not unique to the health care field.  Professional scientists and statisticians in various fields routinely determine and accordingly mitigate risk prior to sharing data. The field of statistical disclosure limitation, for instance, has been developed within government statistical agencies, such as the Bureau of the Census, and applied to protect numerous types of data. 5

Who is an “expert?”

There is no specific professional degree or certification program for designating who is an expert at rendering health information de-identified.  Relevant expertise may be gained through various routes of education and experience. Experts may be found in the statistical, mathematical, or other scientific domains.  From an enforcement perspective, OCR would review the relevant professional experience and academic or other training of the expert used by the covered entity, as well as actual experience of the expert using health information de-identification methodologies.

What is an acceptable level of identification risk for an expert determination?

There is no explicit numerical level of identification risk that is deemed to universally meet the “very small” level indicated by the method.  The ability of a recipient of information to identify an individual (i.e., subject of the information) is dependent on many factors, which an expert will need to take into account while assessing the risk from a data set.  This is because the risk of identification that has been determined for one particular data set in the context of a specific environment may not be appropriate for the same data set in a different environment or a different data set in the same environment.  As a result, an expert will define an acceptable “very small” risk based on the ability of an anticipated recipient to identify an individual.  This issue is addressed in further depth in Section 2.6.

How long is an expert determination valid for a given data set?

The Privacy Rule does not explicitly require that an expiration date be attached to the determination that a data set, or the method that generated such a data set, is de-identified information.  However, experts have recognized that technology, social conditions, and the availability of information changes over time.  Consequently, certain de-identification practitioners use the approach of time-limited certifications.  In this sense, the expert will assess the expected change of computational capability, as well as access to various data sources, and then determine an appropriate timeframe within which the health information will be considered reasonably protected from identification of an individual.

Information that had previously been de-identified may still be adequately de-identified when the certification limit has been reached.  When the certification timeframe reaches its conclusion, it does not imply that the data which has already been disseminated is no longer sufficiently protected in accordance with the de-identification standard.  Covered entities will need to have an expert examine whether future releases of the data to the same recipient (e.g., monthly reporting) should be subject to additional or different de-identification processes consistent with current conditions to reach the very low risk requirement.

Can an expert derive multiple solutions from the same data set for a recipient?

Yes.  Experts may design multiple solutions, each of which is tailored to the covered entity’s expectations regarding information reasonably available to the anticipated recipient of the data set.  In such cases, the expert must take care to ensure that the data sets cannot be combined to compromise the protections set in place through the mitigation strategy. (Of course, the expert must also reduce the risk that the data sets could be combined with prior versions of the de-identified dataset or with other publically available datasets to identify an individual.) For instance, an expert may derive one data set that contains detailed geocodes and generalized aged values (e.g., 5-year age ranges) and another data set that contains generalized geocodes (e.g., only the first two digits) and fine-grained age (e.g., days from birth).  The expert may certify a covered entity to share both data sets after determining that the two data sets could not be merged to individually identify a patient.  This certification may be based on a technical proof regarding the inability to merge such data sets.  Alternatively, the expert also could require additional safeguards through a data use agreement.

How do experts assess the risk of identification of information?

No single universal solution addresses all privacy and identifiability issues. Rather, a combination of technical and policy procedures are often applied to the de-identification task. OCR does not require a particular process for an expert to use to reach a determination that the risk of identification is very small.  However, the Rule does require that the methods and results of the analysis that justify the determination be documented and made available to OCR upon request. The following information is meant to provide covered entities with a general understanding of the de-identification process applied by an expert.  It does not provide sufficient detail in statistical or scientific methods to serve as a substitute for working with an expert in de-identification.

A general workflow for expert determination is depicted in Figure 2. Stakeholder input suggests that the determination of identification risk can be a process that consists of a series of steps.  First, the expert will evaluate the extent to which the health information can (or cannot) be identified by the anticipated recipients.  Second, the expert often will provide guidance to the covered entity or business associate on which statistical or scientific methods can be applied to the health information to mitigate the anticipated risk.  The expert will then execute such methods as deemed acceptable by the covered entity or business associate data managers, i.e., the officials responsible for the design and operations of the covered entity’s information systems.  Finally, the expert will evaluate the identifiability of the resulting health information to confirm that the risk is no more than very small when disclosed to the anticipated recipients.  Stakeholder input suggests that a process may require several iterations until the expert and data managers agree upon an acceptable solution. Regardless of the process or methods employed, the information must meet the very small risk specification requirement.

Figure 2.  Process for expert determination of de-Identification.

Data managers and administrators working with an expert to consider the risk of identification of a particular set of health information can look to the principles summarized in Table 1 for assistance. 6   These principles build on those defined by the Federal Committee on Statistical Methodology (which was referenced in the original publication of the Privacy Rule). 7 The table describes principles for considering the identification risk of health information. The principles should serve as a starting point for reasoning and are not meant to serve as a definitive list. In the process, experts are advised to consider how data sources that are available to a recipient of health information (e.g., computer systems that contain information about patients) could be utilized for identification of an individual. 8

Table 1. Principles used by experts in the determination of the identifiability of health information.

When evaluating identification risk, an expert often considers the degree to which a data set can be “linked” to a data source that reveals the identity of the corresponding individuals.  Linkage is a process that requires the satisfaction of certain conditions.  The first condition is that the de-identified data are unique or “distinguishing.”  It should be recognized, however, that the ability to distinguish data is, by itself, insufficient to compromise the corresponding patient’s privacy.  This is because of a second condition, which is the need for a naming data source, such as a publicly available voter registration database (see Section 2.6).  Without such a data source, there is no way to definitively link the de-identified health information to the corresponding patient. Finally, for the third condition, we need a mechanism to relate the de-identified and identified data sources. Inability to design such a relational mechanism would hamper a third party’s ability to achieve success to no better than random assignment of de-identified data and named individuals. The lack of a readily available naming data source does not imply that data are sufficiently protected from future identification, but it does indicate that it is harder to re-identify an individual, or group of individuals, given the data sources at hand. 

Example Scenario Imagine that a covered entity is considering sharing the information in the table to the left in Figure 3. This table is devoid of explicit identifiers, such as personal names and Social Security Numbers.  The information in this table is distinguishing, such that each row is unique on the combination of demographics (i.e., Age , ZIP Code , and Gender ).  Beyond this data, there exists a voter registration data source, which contains personal names, as well as demographics (i.e., Birthdate , ZIP Code , and Gender ), which are also distinguishing.  Linkage between the records in the tables is possible through the demographics.  Notice, however, that the first record in the covered entity’s table is not linked because the patient is not yet old enough to vote.

Figure 3.  Linking two data sources to identity diagnoses.

Thus, an important aspect of identification risk assessment is the route by which health information can be linked to naming sources or sensitive knowledge can be inferred. A higher risk “feature” is one that is found in many places and is publicly available. These are features that could be exploited by anyone who receives the information.  For instance, patient demographics could be classified as high-risk features.  In contrast, lower risk features are those that do not appear in public records or are less readily available.  For instance, clinical features, such as blood pressure, or temporal dependencies between events within a hospital (e.g., minutes between dispensation of pharmaceuticals) may uniquely characterize a patient in a hospital population, but the data sources to which such information could be linked to identify a patient are accessible to a much smaller set of people. 

Example Scenario An expert is asked to assess the identifiability of a patient’s demographics.  First, the expert will determine if the demographics are independently replicable .  Features such as birth date and gender are strongly independently replicable—the individual will always have the same birth date -- whereas ZIP code of residence is less so because an individual may relocate.  Second, the expert will determine which data sources that contain the individual’s identification also contain the demographics in question.  In this case, the expert may determine that public records, such as birth, death, and marriage registries, are the most likely data sources to be leveraged for identification.  Third, the expert will determine if the specific information to be disclosed is distinguishable .  At this point, the expert may determine that certain combinations of values (e.g., Asian males born in January of 1915 and living in a particular 5-digit ZIP code) are unique, whereas others (e.g., white females born in March of 1972 and living in a different 5-digit ZIP code) are never unique.  Finally, the expert will determine if the data sources that could be used in the identification process are readily accessible , which may differ by region.  For instance, voter registration registries are free in the state of North Carolina, but cost over $15,000 in the state of Wisconsin.  Thus, data shared in the former state may be deemed more risky than data shared in the latter. 12

What are the approaches by which an expert assesses the risk that health information can be identified?

The de-identification standard does not mandate a particular method for assessing risk.

A qualified expert may apply generally accepted statistical or scientific principles to compute the likelihood that a record in a data set is expected to be unique, or linkable to only one person, within the population to which it is being compared. Figure 4 provides a visualization of this concept. 13 This figure illustrates a situation in which the records in a data set are not a proper subset of the population for whom identified information is known.  This could occur, for instance, if the data set includes patients over one year-old but the population to which it is compared includes data on people over 18 years old (e.g., registered voters).

The computation of population uniques can be achieved in numerous ways, such as through the approaches outlined in published literature. 14 , 15   For instance, if an expert is attempting to assess if the combination of a patient’s race, age, and geographic region of residence is unique, the expert may use population statistics published by the U.S. Census Bureau to assist in this estimation.  In instances when population statistics are unavailable or unknown, the expert may calculate and rely on the statistics derived from the data set.  This is because a record can only be linked between the data set and the population to which it is being compared if it is unique in both.  Thus, by relying on the statistics derived from the data set, the expert will make a conservative estimate regarding the uniqueness of records. 

Example Scenario Imagine a covered entity has a data set in which there is one 25 year old male from a certain geographic region in the United States.  In truth, there are five 25 year old males in the geographic region in question (i.e., the population).  Unfortunately, there is no readily available data source to inform an expert about the number of 25 year old males in this geographic region.

By inspecting the data set, it is clear to the expert that there is at least one 25 year old male in the population, but the expert does not know if there are more.  So, without any additional knowledge, the expert assumes there are no more, such that the record in the data set is unique.  Based on this observation, the expert recommends removing this record from the data set.  In doing so, the expert has made a conservative decision with respect to the uniqueness of the record.

In the previous example, the expert provided a solution (i.e., removing a record from a dataset) to achieve de-identification, but this is one of many possible solutions that an expert could offer.  In practice, an expert may provide the covered entity with multiple alternative strategies, based on scientific or statistical principles, to mitigate risk.

Figure 4. Relationship between uniques in the data set and the broader population, as well as the degree to which linkage can be achieved.

The expert may consider different measures of “risk,” depending on the concern of the organization looking to disclose information.  The expert will attempt to determine which record in the data set is the most vulnerable to identification.  However, in certain instances, the expert may not know which particular record to be disclosed will be most vulnerable for identification purposes.  In this case, the expert may attempt to compute risk from several different perspectives. 

What are the approaches by which an expert mitigates the risk of identification of an individual in health information?

The Privacy Rule does not require a particular approach to mitigate, or reduce to very small, identification risk.  The following provides a survey of potential approaches.  An expert may find all or only one appropriate for a particular project, or may use another method entirely.

If an expert determines that the risk of identification is greater than very small, the expert may modify the information to mitigate the identification risk to that level, as required by the de-identification standard. In general, the expert will adjust certain features or values in the data to ensure that unique, identifiable elements no longer, or are not expected to, exist.  Some of the methods described below have been reviewed by the Federal Committee on Statistical Methodology 16 , which was referenced in the original preamble guidance to the Privacy Rule de-identification standard and recently revised.

Several broad classes of methods can be applied to protect data.  An overarching common goal of such approaches is to balance disclosure risk against data utility. 17   If one approach results in very small identity disclosure risk but also a set of data with little utility, another approach can be considered.  However, data utility does not determine when the de-identification standard of the Privacy Rule has been met.

Table 2 illustrates the application of such methods. In this example, we refer to columns as “features” about patients (e.g., Age and Gender) and rows as “records” of patients (e.g., the first and second rows correspond to records on two different patients).

Table 2. An example of protected health information.

A first class of identification risk mitigation methods corresponds to suppression techniques. These methods remove or eliminate certain features about the data prior to dissemination.  Suppression of an entire feature may be performed if a substantial quantity of records is considered as too risky (e.g., removal of the ZIP Code feature).  Suppression may also be performed on individual records, deleting records entirely if they are deemed too risky to share.  This can occur when a record is clearly very distinguishing (e.g., the only individual within a county that makes over $500,000 per year).   Alternatively, suppression of specific values within a record may be performed, such as when a particular value is deemed too risky (e.g., “President of the local university”, or ages or ZIP codes that may be unique).  Table 3 illustrates this last type of suppression by showing how specific values of features in Table 2 might be suppressed (i.e., black shaded cells).

Table 3. A version of Table 2 with suppressed patient values.

A second class of methods that can be applied for risk mitigation are based on generalization (sometimes referred to as abbreviation) of the information.  These methods transform data into more abstract representations.  For instance, a five-digit ZIP Code may be generalized to a four-digit ZIP Code, which in turn may be generalized to a three-digit ZIP Code, and onward so as to disclose data with lesser degrees of granularity.  Similarly, the age of a patient may be generalized from one- to five-year age groups. Table 4 illustrates how generalization (i.e., gray shaded cells) might be applied to the information in Table 2.

Table 4. A version of Table 2 with generalized patient values.

A third class of methods that can be applied for risk mitigation corresponds to perturbation .  In this case, specific values are replaced with equally specific, but different, values.  For instance, a patient’s age may be reported as a random value within a 5-year window of the actual age.  Table 5 illustrates how perturbation (i.e., gray shaded cells) might be applied to Table 2.  Notice that every age is within +/- 2 years of the original age.  Similarly, the final digit in each ZIP Code is within +/- 3 of the original ZIP Code.

Table 5. A version of Table 2 with randomized patient values.

In practice, perturbation is performed to maintain statistical properties about the original data, such as mean or variance.

The application of a method from one class does not necessarily preclude the application of a method from another class.  For instance, it is common to apply generalization and suppression to the same data set.

Using such methods, the expert will prove that the likelihood an undesirable event (e.g., future identification of an individual) will occur is very small.  For instance, one example of a data protection model that has been applied to health information is the k -anonymity principle. 18 , 19   In this model, “ k ” refers to the number of people to which each disclosed record must correspond.  In practice, this correspondence is assessed using the features that could be reasonably applied by a recipient to identify a patient.  Table 6 illustrates an application of generalization and suppression methods to achieve 2-anonymity with respect to the Age, Gender, and ZIP Code columns in Table 2.  The first two rows (i.e., shaded light gray) and last two rows (i.e., shaded dark gray) correspond to patient records with the same combination of generalized and suppressed values for Age, Gender, and ZIP Code.  Notice that Gender has been suppressed completely (i.e., black shaded cell).

Table 6, as well as a value of k equal to 2, is meant to serve as a simple example for illustrative purposes only.  Various state and federal agencies define policies regarding small cell counts (i.e., the number of people corresponding to the same combination of features) when sharing tabular, or summary, data. 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27   However, OCR does not designate a universal value for k that covered entities should apply to protect health information in accordance with the de-identification standard.  The value for k should be set at a level that is appropriate to mitigate risk of identification by the anticipated recipient of the data set. 28

Table 6. A version of Table 2 that is 2-anonymized.

As can be seen, there are many different disclosure risk reduction techniques that can be applied to health information. However, it should be noted that there is no particular method that is universally the best option for every covered entity and health information set.  Each method has benefits and drawbacks with respect to expected applications of the health information, which will be distinct for each covered entity and each intended recipient.  The determination of which method is most appropriate for the information will be assessed by the expert on a case-by-case basis and will be guided by input of the covered entity.

Finally, as noted in the preamble to the Privacy Rule, the expert may also consider the technique of limiting distribution of records through a data use agreement or restricted access agreement in which the recipient agrees to limits on who can use or receive the data, or agrees not to attempt identification of the subjects.  Of course, the specific details of such an agreement are left to the discretion of the expert and covered entity.

Can an Expert determine a code derived from PHI is de-identified?

There has been confusion about what constitutes a code and how it relates to PHI.  For clarification, our guidance is similar to that provided by the National Institutes of Standards and Technology (NIST) 29 , which states:

“ De-identified information can be re-identified (rendered distinguishable) by using a code, algorithm, or pseudonym that is assigned to individual records.  The code, algorithm, or pseudonym should not be derived from other related information* about the individual, and the means of re-identification should only be known by authorized parties and not disclosed to anyone without the authority to re-identify records.  A common de-identification technique for obscuring PII [Personally Identifiable Information] is to use a one-way cryptographic function, also known as a hash function, on the PII.

*This is not intended to exclude the application of cryptographic hash functions to the information.”

In line with this guidance from NIST, a covered entity may disclose codes derived from PHI as part of a de-identified data set if an expert determines that the data meets the de-identification requirements at §164.514(b)(1).  The re-identification provision in §164.514(c) does not preclude the transformation of PHI into values derived by cryptographic hash functions using the expert determination method, provided the keys associated with such functions are not disclosed, including to the recipients of the de-identified information.

Must a covered entity use a data use agreement when sharing de-identified data to satisfy the Expert Determination Method?

No. The Privacy Rule does not limit how a covered entity may disclose information that has been de-identified.  However, a covered entity may require the recipient of de-identified information to enter into a data use agreement to access files with known disclosure risk, such as is required for release of a limited data set under the Privacy Rule.  This agreement may contain a number of clauses designed to protect the data, such as prohibiting re-identification. 30 Of course, the use of a data use agreement does not substitute for any of the specific requirements of the Expert Determination Method. Further information about data use agreements can be found on the OCR website. 31   Covered entities may make their own assessments whether such additional oversight is appropriate.

In §164.514(b), the Safe Harbor method for de-identification is defined as follows:

(R) Any other unique identifying number, characteristic, or code, except as permitted by paragraph (c) of this section; and

When can ZIP codes be included in de-identified information?

Covered entities may include the first three digits of the ZIP code if, according to the current publicly available data from the Bureau of the Census: (1) The geographic unit formed by combining all ZIP codes with the same three initial digits contains more than 20,000 people; or (2) the initial three digits of a ZIP code for all such geographic units containing 20,000 or fewer people is changed to 000. This means that the initial three digits of ZIP codes may be included in de-identified information except when the ZIP codes contain the initial three digits listed in the Table below.  In those cases, the first three digits must be listed as 000.

OCR published a final rule on August 14, 2002, that modified certain standards in the Privacy Rule.  The preamble to this final rule identified the initial three digits of ZIP codes, or ZIP code tabulation areas (ZCTAs), that must change to 000 for release. 67 FR 53182, 53233-53234 (Aug. 14, 2002)).

Utilizing 2000 Census data, the following three-digit ZCTAs have a population of 20,000 or fewer persons. To produce a de-identified data set utilizing the safe harbor method, all records with three-digit ZIP codes corresponding to these three-digit ZCTAs must have the ZIP code changed to 000. Covered entities should not, however, rely upon this listing or the one found in the August 14, 2002 regulation if more current data has been published .

The 17 restricted ZIP codes are:

The Department notes that these three-digit ZIP codes are based on the five-digit ZIP Code Tabulation Areas created by the Census Bureau for the 2000 Census. This new methodology also is briefly described below, as it will likely be of interest to all users of data tabulated by ZIP code. The Census Bureau will not be producing data files containing U.S. Postal Service ZIP codes either as part of the Census 2000 product series or as a post Census 2000 product. However, due to the public’s interest in having statistics tabulated by ZIP code, the Census Bureau has created a new statistical area called the Zip Code Tabulation Area (ZCTA) for Census 2000. The ZCTAs were designed to overcome the operational difficulties of creating a well-defined ZIP code area by using Census blocks (and the addresses found in them) as the basis for the ZCTAs. In the past, there has been no correlation between ZIP codes and Census Bureau geography. Zip codes can cross State, place, county, census tract, block group, and census block boundaries. The geographic designations the Census Bureau uses to tabulate data are relatively stable over time. For instance, census tracts are only defined every ten years. In contrast, ZIP codes can change more frequently. Because of the ill-defined nature of ZIP code boundaries, the Census Bureau has no file (crosswalk) showing the relationship between US Census Bureau geography and U.S. Postal Service ZIP codes.

ZCTAs are generalized area representations of U.S. Postal Service (USPS) ZIP code service areas. Simply put, each one is built by aggregating the Census 2000 blocks, whose addresses use a given ZIP code, into a ZCTA which gets that ZIP code assigned as its ZCTA code. They represent the majority USPS five-digit ZIP code found in a given area. For those areas where it is difficult to determine the prevailing five-digit ZIP code, the higher-level three-digit ZIP code is used for the ZCTA code. For further information, go to: https://www.census.gov/programs-surveys/geography/guidance/geo-areas/zctas.html

The Bureau of the Census provides information regarding population density in the United States.  Covered entities are expected to rely on the most current publicly available Bureau of Census data regarding ZIP codes. This information can be downloaded from, or queried at, the American Fact Finder website (http://factfinder.census.gov).  As of the publication of this guidance, the information can be extracted from the detailed tables of the “Census 2000 Summary File 1 (SF 1) 100-Percent Data” files under the “Decennial Census” section of the website. The information is derived from the Decennial Census and was last updated in 2000.  It is expected that the Census Bureau will make data available from the 2010 Decennial Census in the near future.  This guidance will be updated when the Census makes new information available.

May parts or derivatives of any of the listed identifiers be disclosed consistent with the Safe Harbor Method?

No.  For example, a data set that contained patient initials, or the last four digits of a Social Security number, would not meet the requirement of the Safe Harbor method for de-identification.

What are examples of dates that are not permitted according to the Safe Harbor Method?

Elements of dates that are not permitted for disclosure include the day, month, and any other information that is more specific than the year of an event.  For instance, the date “January 1, 2009” could not be reported at this level of detail. However, it could be reported in a de-identified data set as “2009”.

Many records contain dates of service or other events that imply age.  Ages that are explicitly stated, or implied, as over 89 years old must be recoded as 90 or above.  For example, if the patient’s year of birth is 1910 and the year of healthcare service is reported as 2010, then in the de-identified data set the year of birth should be reported as “on or before 1920.”  Otherwise, a recipient of the data set would learn that the age of the patient is approximately 100.

Can dates associated with test measures for a patient be reported in accordance with Safe Harbor?

No. Dates associated with test measures, such as those derived from a laboratory report, are directly related to a specific individual and relate to the provision of health care. Such dates are protected health information.  As a result, no element of a date (except as described in 3.3. above) may be reported to adhere to Safe Harbor. 

What constitutes “any other unique identifying number, characteristic, or code” with respect to the Safe Harbor method of the Privacy Rule?

This category corresponds to any unique features that are not explicitly enumerated in the Safe Harbor list (A-Q), but could be used to identify a particular individual.  Thus, a covered entity must ensure that a data set stripped of the explicitly enumerated identifiers also does not contain any of these unique features.  The following are examples of such features:

Identifying Number There are many potential identifying numbers.  For example, the preamble to the Privacy Rule at 65 FR 82462, 82712 (Dec. 28, 2000) noted that “Clinical trial record numbers are included in the general category of ‘any other unique identifying number, characteristic, or code.’

Identifying Code A code corresponds to a value that is derived from a non-secure encoding mechanism.  For instance, a code derived from a secure hash function without a secret key (e.g., “salt”) would be considered an identifying element.  This is because the resulting value would be susceptible to compromise by the recipient of such data. As another example, an increasing quantity of electronic medical record and electronic prescribing systems assign and embed barcodes into patient records and their medications.  These barcodes are often designed to be unique for each patient, or event in a patient’s record, and thus can be easily applied for tracking purposes.  See the discussion of re-identification.

Identifying Characteristic A characteristic may be anything that distinguishes an individual and allows for identification.  For example, a unique identifying characteristic could be the occupation of a patient, if it was listed in a record as “current President of State University.”

Many questions have been received regarding what constitutes “any other unique identifying number, characteristic or code” in the Safe Harbor approach, §164.514(b)(2)(i)(R), above.  Generally, a code or other means of record identification that is derived from PHI would have to be removed from data de-identified following the safe harbor method.  To clarify what must be removed under (R), the implementation specifications at §164.514(c) provide an exception with respect to “re-identification” by the covered entity.  The objective of the paragraph is to permit covered entities to assign certain types of codes or other record identification to the de-identified information so that it may be re-identified by the covered entity at some later date. Such codes or other means of record identification assigned by the covered entity are not considered direct identifiers that must be removed under (R) if the covered entity follows the directions provided in §164.514(c).

What is “actual knowledge” that the remaining information could be used either alone or in combination with other information to identify an individual who is a subject of the information?

In the context of the Safe Harbor method, actual knowledge means clear and direct knowledge that the remaining information could be used, either alone or in combination with other information, to identify an individual who is a subject of the information.  This means that a covered entity has actual knowledge if it concludes that the remaining information could be used to identify the individual.  The covered entity, in other words, is aware that the information is not actually de-identified information.

The following examples illustrate when a covered entity would fail to meet the “actual knowledge” provision.

Example 1: Revealing Occupation Imagine a covered entity was aware that the occupation of a patient was listed in a record as “former president of the State University.”  This information in combination with almost any additional data – like age or state of residence – would clearly lead to an identification of the patient.  In this example, a covered entity would not satisfy the de-identification standard by simply removing the enumerated identifiers in §164.514(b)(2)(i) because the risk of identification is of a nature and degree that a covered entity must have concluded that the information could identify the patient.  Therefore, the data would not have satisfied the de-identification standard’s Safe Harbor method unless the covered entity made a sufficient good faith effort to remove the ‘‘occupation’’ field from the patient record.

Example 2: Clear Familial Relation Imagine a covered entity was aware that the anticipated recipient, a researcher who is an employee of the covered entity, had a family member in the data (e.g., spouse, parent, child, or sibling). In addition, the covered entity was aware that the data would provide sufficient context for the employee to recognize the relative.  For instance, the details of a complicated series of procedures, such as a primary surgery followed by a set of follow-up surgeries and examinations, for a person of a certain age and gender, might permit the recipient to comprehend that the data pertains to his or her relative’s case.  In this situation, the risk of identification is of a nature and degree that the covered entity must have concluded that the recipient could clearly and directly identify the individual in the data.  Therefore, the data would not have satisfied the de-identification standard’s Safe Harbor method.

Example 3: Publicized Clinical Event Rare clinical events may facilitate identification in a clear and direct manner.  For instance, imagine the information in a patient record revealed that a patient gave birth to an unusually large number of children at the same time.  During the year of this event, it is highly possible that this occurred for only one individual in the hospital (and perhaps the country).  As a result, the event was reported in the popular media, and the covered entity was aware of this media exposure.  In this case, the risk of identification is of a nature and degree that the covered entity must have concluded that the individual subject of the information could be identified by a recipient of the data.  Therefore, the data would not have satisfied the de-identification standard’s Safe Harbor method.

Example 4: Knowledge of a Recipient’s Ability Imagine a covered entity was told that the anticipated recipient of the data has a table or algorithm that can be used to identify the information, or a readily available mechanism to determine a patient’s identity.  In this situation, the covered entity has actual knowledge because it was informed outright that the recipient can identify a patient, unless it subsequently received information confirming that the recipient does not in fact have a means to identify a patient.  Therefore, the data would not have satisfied the de-identification standard’s Safe Harbor method.

If a covered entity knows of specific studies about methods to re-identify health information or use de-identified health information alone or in combination with other information to identify an individual, does this necessarily mean a covered entity has actual knowledge under the Safe Harbor method?

No.  Much has been written about the capabilities of researchers with certain analytic and quantitative capacities to combine information in particular ways to identify health information. 32 , 33 , 34 , 35   A covered entity may be aware of studies about methods to identify remaining information or using de-identified information alone or in combination with other information to identify an individual.  However, a covered entity’s mere knowledge of these studies and methods, by itself, does not mean it has “actual knowledge” that these methods would be used with the data it is disclosing.  OCR does not expect a covered entity to presume such capacities of all potential recipients of de-identified data.  This would not be consistent with the intent of the Safe Harbor method, which was to provide covered entities with a simple method to determine if the information is adequately de-identified.

Must a covered entity suppress all personal names, such as physician names, from health information for it to be designated as de-identified?

No. Only names of the individuals associated with the corresponding health information (i.e., the subjects of the records) and of their relatives, employers, and household members must be suppressed.  There is no explicit requirement to remove the names of providers or workforce members of the covered entity or business associate.  At the same time, there is also no requirement to retain such information in a de-identified data set.

Beyond the removal of names related to the patient, the covered entity would need to consider whether additional personal names contained in the data should be suppressed to meet the actual knowledge specification.  Additionally, other laws or confidentiality concerns may support the suppression of this information.

Must a covered entity use a data use agreement when sharing de-identified data to satisfy the Safe Harbor Method?

No. The Privacy Rule does not limit how a covered entity may disclose information that has been de-identified.  However, nothing prevents a covered entity from asking a recipient of de-identified information to enter into a data use agreement, such as is required for release of a limited data set under the Privacy Rule.  This agreement may prohibit re-identification. Of course, the use of a data use agreement does not substitute for any of the specific requirements of the Safe Harbor method. Further information about data use agreements can be found on the OCR website. 36   Covered entities may make their own assessments whether such additional oversight is appropriate.

Must a covered entity remove protected health information from free text fields to satisfy the Safe Harbor Method?

PHI may exist in different types of data in a multitude of forms and formats in a covered entity.  This data may reside in highly structured database tables, such as billing records. Yet, it may also be stored in a wide range of documents with less structure and written in natural language, such as discharge summaries, progress notes, and laboratory test interpretations.  These documents may vary with respect to the consistency and the format employed by the covered entity.

The de-identification standard makes no distinction between data entered into standardized fields and information entered as free text (i.e., structured and unstructured text) -- an identifier listed in the Safe Harbor standard must be removed regardless of its location in a record if it is recognizable as an identifier.

Whether additional information must be removed falls under the actual knowledge provision; the extent to which the covered entity has actual knowledge that residual information could be used to individually identify a patient. Clinical narratives in which a physician documents the history and/or lifestyle of a patient are information rich and may provide context that readily allows for patient identification.

Medical records are comprised of a wide range of structured and unstructured (also known as “free text”) documents.  In structured documents, it is relatively clear which fields contain the identifiers that must be removed following the Safe Harbor method.  For instance, it is simple to discern when a feature is a name or a Social Security Number, provided that the fields are appropriately labeled.  However, many researchers have observed that identifiers in medical information are not always clearly labeled. 37 . 38 As such, in some electronic health record systems it may be difficult to discern what a particular term or phrase corresponds to (e.g., is 5/97 a date or a ratio?).  It also is important to document when fields are derived from the Safe Harbor listed identifiers.  For instance, if a field corresponds to the first initials of names, then this derivation should be noted.  De-identification is more efficient and effective when data managers explicitly document when a feature or value pertains to identifiers.  Health Level 7 (HL7) and the International Standards Organization (ISO) publish best practices in documentation and standards that covered entities may consult in this process.

Example Scenario 1 The free text field of a patient’s medical record notes that the patient is the Executive Vice President of the state university.  The covered entity must remove this information.

Example Scenario 2 The intake notes for a new patient include the stand-alone notation, “Newark, NJ.”  It is not clear whether this relates to the patient’s address, the location of the patient’s previous health care provider, the location of the patient’s recent auto collision, or some other point.  The phrase may be retained in the data.

Glossary of terms used in Guidance Regarding Methods for De-identification of Protected Health Information in Accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.  Note: some of these terms are paraphrased from the regulatory text; please see the HIPAA Rules for actual definitions.

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About the Vaccine Education Center

The Vaccine Education Center (VEC) was launched in October 2000 to provide accurate, comprehensive and up-to-date information about vaccines and the diseases they prevent.

Through our websites, videos, informational tear sheets, e-newsletters, webinars and speaker programs, we  seek to dispel some of the common misconceptions and misinformation surrounding vaccines. The goal of our effort is to communicate the facts about each vaccine as well as how vaccines are made, how and why vaccines work, who recommends them, whether they are safe, whether they are still necessary, and when they should be given. We have also developed educational materials for elementary, middle, high school and college students.

The VEC is funded by Children's Hospital of Philadelphia and through philanthropic donations and does not receive support from vaccine manufacturers.

The VEC is a member of the World Health Organization's (WHO) Vaccine Safety Net because our website meets the criteria for credibility and content as defined by the Global Advisory Committee on Vaccine Safety. Learn more about the WHO’s Vaccine Safety Net.

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How a TV series showed what happens to your body when you're stressed

by Jamie Hugo Macdonald, The Conversation

Your heart starts racing, your mouth goes dry and sweat beads on your forehead. We've all been there, caught in a moment of stress. When you encounter a situation that threatens your safety, your brain must make a critical decision—how to react to the danger at hand.

This is a phenomenon my colleagues and I explore in the program Michael Mosley: Wonders of the Human Body on Channel 5, the late doctor and presenter's final TV series. He died in June this year.

A team of us from Bangor University took Michael out of his normal comfort zone to complete an activity with a very high potential risk. We then monitored his body to measure his stress response . He was no stranger to putting his body to the test to help viewers at home understand their own bodies.

Response to stress starts in the hypothalamus, the brain's command center. Once the hypothalamus decides on a course of action, it activates the sympathetic nervous system. It's a bit like the body's accelerator pedal, revving up your internal engines to prepare for action.

The signal from your brain travels to the adrenal glands , located just above your kidneys. These glands release adrenaline, a hormone many of us are familiar with. Adrenaline is responsible for many of the physical changes you experience during stress, such as increased heart rate and rapid breathing.

As adrenaline floods your system, your body gears up for fight or flight. Blood flow increases, delivering more oxygen and energy to your muscles and brain. This prepares you to either confront the threat or make a quick escape.

If the threat passes and the situation changes, your body needs to slow down and return to a state of calm. This is where the parasympathetic nervous system comes into play. Acting like a brake pedal, it slows your breathing, heart rate, sweating, metabolism and blood flow , helping us relax and recover.

The fight-or-flight response happens within milliseconds. But when you need to stay on high alert for an extended period, your body relies on a different system to keep us in overdrive. This system is known as the HPA axis, which involves the hypothalamus (H) and pituitary (P) in the brain, along with the adrenal (A) glands above the kidneys. Together, the HPA axis eventually produces cortisol, commonly referred to as the stress hormone.

To help viewers visualize what was happening inside his body, we monitored Michael's heart rate using a chest strap and a smartwatch. This is a reliable indicator of the immediate fight-or-flight response, driven by the sympathetic nervous system and the release of adrenaline.

We also measured his cortisol levels , a marker of the body's longer-lasting stress response, through saliva samples, reflecting the activity of the HPA axis. And to gain deeper insights into Michael's experience, a sports psychologist from our team interviewed and supported him before, during and after the stressful situation.

But knowing what we know about the body's response, how can we use that to help us manage stressful situations? Here's the advice we gave Michael.

1. Know your body

When your heart starts racing, your breath quickens and you begin to sweat, it's all part of your body's fight-or-flight response. While these sensations can feel unsettling, they're actually your body's natural way of preparing you for action.

These responses are crucial. They prime your muscles for physical activity and sharpen your brain for optimal performance. By recognizing these changes as normal and beneficial, you can reduce the anxiety that often accompanies them.

A useful strategy is to write down the physical reactions you experience during stress. Before facing a potentially stressful situation, review this list. Remind yourself that these responses are your body's way of helping you perform at your best.

2. Practice makes perfect

The fight-or-flight response varies from person to person and also depends on the circumstances. While one person may experience intense stress in a given situation, another may hardly react at all.

This difference often comes down to experience, self-confidence and the coping mechanisms we use. The good news is that you can train your body and mind to handle stress more effectively with practice.

For example, if you're preparing for an exam, try taking a mock test in a similar environment beforehand. If you have a presentation at work, rehearse it in front of friends or family first.

You can also benefit from psychological skills training , such as visualizing success, or using relaxation techniques before stressful events.

3. Be kind to yourself

Although the fight or flight response is generally considered helpful and healthy, the response can be harmful if prolonged over time. Yet many of us will experience such protracted periods of stress in our lives, be it at work, school or in a personal situation. These can result in elevated cortisol levels. Over time, this can increase the risk of cardiovascular disease and mental health issues like anxiety.

To keep your stress response in check, it's useful to use strategies that help prevent it from spiraling out of control. These can include using mindfulness techniques, taking part in physical activities and eating a healthy diet .

4. Seek support

Research shows that having support from peers, family and mentors can reduce the body's physiological responses to stress. Whether you're seeking advice for a specific upcoming challenge or simply building a strong support network, the presence of others can help lower your adrenaline and cortisol levels during stressful situations. Surrounding yourself with supportive people is a powerful way to manage and mitigate stress.

The potential of understanding and managing the fight or flight response is huge. As we show in the program, it could enable athletes to perform under pressure, students to better prepare for exams and employees to handle workplace stress more effectively.

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Best Supplements for Hair Growth and Thickness

Supplements for hair growth, similar supplements, frequently asked questions.

Zinc, omega-3 fatty acids, and other supplements may offer benefits for hair growth and thickness, but research on supplement use for hair growth has yielded mixed results. Supplements of specific vitamins and minerals may be used to correct nutrient deficiencies associated with hair loss. However, it's overall nutrition that can be important for hair growth.

Keep in mind that hair loss also can occur with too much supplement use, as well as underlying health conditions, medications you take (including chemotherapy), stress, and other factors. Talk with your healthcare provider about hair loss if you experience other symptoms that may require diagnosis of a specific cause.

In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. When  choosing a supplement , look for third-party tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.

DragonImages / Getty Images

Diet is key to healthy hair, with some studies noting that a plant-based diet (such as the Mediterranean diet) can boost hair growth. Supplements, however, often are used to provide micronutrients that may improve hair growth. Some of these vitamins and minerals include:

• Zinc : This mineral supports hair follicles and the hair growth cycle. Low zinc levels have been associated with hair loss , though study results are mixed on how supplements can help. There may be benefits in specific cases, such as females diagnosed with polycystic ovary syndrome (PCOS) who took zinc supplements even with baseline normal levels.  However, more research is needed.
• Protein : Hair primarily consists of protein . Not eating enough protein (the recommended amount is 0.8 grams per kilogram of body weight) may contribute to hair loss. Some people may need more. Much research on protein includes other nutrients as well, so it’s hard to draw a clear link between individual amino acids and hair loss.  
• Iron : Some types of hair loss are associated with iron deficiency. Hair cells are among the most active in the body and require adequate iron levels to function properly. More evidence is needed on how iron supplements can help, but vitamin C to improve the body's use of iron also may be needed (even though there's no evidence that vitamin C itself helps with hair growth).
• Omega-3 fatty acid : A deficiency of omega-3 fatty acids is associated with hair and eyebrow loss. It's unclear if the omega-3 fatty acids, or antioxidants in general, can help with hair loss.
• Vitamin A : Most people can get enough vitamin A from their diet. There's some evidence that supplement use may provide too much vitamin A to keep you (and your hair) healthy.
• Biotin : Deficiencies in biotin (vitamin B7) as well as B12, riboflavin (B2), and folate may play a role in hair loss. Biotin is the only one produced in the body and while deficiencies are rare, the B-vitamin supplements may improve hair loss. More study is needed on these effects.
• Selenium : Selenium supplements have been shown to help with hair health during chemotherapy. But toxicity can occur and most people already get enough selenium from their diets.

The average daily amount of zinc necessary to meet nutrient requirements for most healthy adults (recommended dietary allowance, or RDA) includes the following: 

• 11 mg for males
• 8 mg for females
• 11 mg during pregnancy
• 12 mg during lactation

Zinc can be obtained through food. It is naturally found in meat, fish, and seafood and is added to many breakfast cereals. Foods containing the most zinc include:

• Oysters : 32 mg per 3 ounces
• Beef : 3.8 mg per 3 ounces
• Breakfast cereals and oats : 2.3 mg per cup
• Pumpkin seeds : 2.2 mg per ounce  

You absorb only between 5% and 50% of the zinc in food. This amount can vary depending on the food source of zinc and the meal composition. 

Plant-based foods are lower in zinc than their animal counterparts. Additionally, certain substances found in plants (phytates) influence zinc absorption. So, absorbing zinc with a plant-based diet can be more challenging.

Zinc deficiency is less prevalent in the United States, as most people meet requirements through food or supplements. Insufficient zinc levels are more common in low- and middle-income countries. 

It is possible for a zinc supplement to do more harm than good, especially if you take too much. Always consult a healthcare provider before starting a new supplement.

In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. When choosing a supplement , look for third-party tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.

Precautions

Avoid zinc if you’re allergic to it or its components (parts). Seek immediate medical attention if you have a severe allergic reaction (itching, hives, shortness of breath).

People with Wilson’s disease (hepatolenticular degeneration,   a condition of excess copper) should consult a healthcare provider before starting zinc supplements. 

• The Food and Nutrition Board (FNB) at the Institute of Medicine (IOM) set the tolerable upper intake limit for zinc at 40 mg daily for every adult, including those who are pregnant or lactating

The tolerable upper limit (UL) reflects the maximum daily amount that someone can take without risk of adverse health effects for most individuals.

The FNB does not recommend taking doses of 50 mg of zinc or more for a prolonged period. Excessive zinc can affect copper absorption and reduce immune function.  

Side Effects

Too much zinc can cause adverse effects. While it is difficult to exceed recommendations through diet alone, toxicity is possible with zinc supplements. 

Side effects include the following:

• Loss of appetite

Long-term side effects like reduced immune function are also possible. 

Excessive zinc supplementation can also impact the absorption of other vital micronutrients like copper and iron . 

Interactions

Zinc may interact with certain medications, and medications can affect zinc levels. These medications include the following:

• Antibiotics : Antibiotics treat or prevent bacterial infections. Some antibiotics may interact with zinc supplements in the digestive tract, impacting the absorption of both medications.
• Cuprimine (penicillamine) : Penicillamine removes high levels of heavy metal from the body. It can treat rheumatoid arthritis and Wilson’s disease, a condition in which copper levels in the body are too high. Zinc supplements may lower the absorption and effect of penicillamine. Taking zinc and penicillamine at least one hour apart may reduce this interaction. 
• Diuretics : Diuretics prevent the accumulation of and help remove excess fluid from the body. Specific types of diuretics can increase the removal of zinc via urine, contributing to lower nutrient levels. It is essential to carefully read a supplement's ingredients list and nutrition facts panel to know which ingredients and how much of each ingredient is included. Review the supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.

Omega-3 Fatty Acids

Omega-3 fatty acid deficiency is associated with hair and eyebrow loss. One randomized controlled trial among women with hair loss found a supplement containing 460 mg of fish oil (a source of omega-3 fatty acids ) reduced hair loss and improved hair thickness. But the supplement also contained antioxidants, which fish oil is weak in, and the added antioxidants may have contributed to the beneficial results.

There is no set recommended dietary level for omega-3 fatty acids. However, it is encouraged for adults to consume the following amounts of omega-3 fatty acids daily to ensure nutritional adequacy:

• 1.6 g for males
• 1.1 g for females
• 1.4 g for people who are pregnant
• 1.3 g for people who are lactating

Foods rich in omega-3 fatty acids include the following:

• Fatty fish (salmon, mackerel, sardines, herring)
• Flaxseed oil

If you’re worried about hair loss, talk to a healthcare provider to help identify the underlying cause.

A healthy diet with enough nutrients and protein provides the best support for hair growth. Sometimes, a nutrient deficiency may contribute to hair loss. If you have low levels of zinc or iron, taking a supplement may help restore nutrient levels and promote hair growth. But if your levels of these minerals are already within normal range, then a supplement likely will not support hair growth or prevent hair loss. 

Taking zinc when not needed can do more harm than good, contributing to unwanted side effects and affecting the absorption of other minerals essential for health.

It depends. Supplements correcting a nutrient deficiency may reduce hair loss. However, the data do not support supplements targeted for hair growth in individuals already getting enough of these nutrients.

There is no best supplement for hair growth. Instead, overall nutrition from a balanced diet is fundamental for hair growth. Contact your healthcare provider to discuss whether hair loss may result from an underlying issue or nutrient deficiency.

Despite its mainstream popularity, there is limited evidence to support the use of biotin for hair regrowth. In healthy individuals, biotin does not promote hair growth. However, biotin supplements may encourage hair growth among people with low biotin levels.

Gokce N, Basgoz N, Kenanoglu S, Akalin H, Ozkul Y, Ergoren MC, et al . An overview of the genetic aspects of hair loss and its connection with nutrition . J Prev Med Hyg . 2022 Oct 17;63(2 Suppl 3):E228-E238. doi:10.15167/2421-4248/jpmh2022.63.2S3.2765

Pham CT, Romero K, Almohanna HM, Griggs J, Ahmed A, Tosti A. The Role of Diet as an Adjuvant Treatment in Scarring and Nonscarring Alopecia . Skin Appendage Disord . 2020 Mar;6(2):88-96. doi:10.1159/000504786

Almohanna HM, Ahmed AA, Tsatalis JP, et al. The role of vitamins and minerals in hair loss: A review . Dermatol Ther (Heidelb) . 2019;9(1):51-70. doi:10.1007/s13555-018-0278-6

Jamilian M, Foroozanfard F, Bahmani F, et al. Effects of zinc supplementation on endocrine outcomes in women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial . Biol Trace Elem Res . 2016;170(2):271-8. doi: 10.1007/s12011-015-0480-7

Guo E, Katta R. Diet and hair loss: effects of nutrient deficiency and supplement use . Dermatol Pract Concept . 2017;7(1):1-10. doi: 10.5826/dpc.0701a01

Lonnie M, Hooker E, Brunstrom JM, et al.  Protein for life: Review of optimal protein intake, sustainable dietary sources and the effect on appetite in ageing adults .  Nutrients . 2018;10(3):360. doi:10.3390/nu10030360

Le Floc’h C, Cheniti A, Connetable S, et al. Effect of a nutritional supplement on hair loss in women . J Cosmet Dermatol . 2015;14(1):76-82.doi: 10.1111/jocd.12127

National Institutes of Health Office of Dietary Supplements. Zinc .

National Institutes of Health Office of Dietary Supplements. Omega-3 fatty acids .

Patel D, Swink S, Castelo-Soccio L. A review of the use of biotin for hair loss . Skin Appendage Disord . 2017;3(3):166-169.doi:10.1159/000462981

Adelman M, Bedford L, Potts G. Clinical efficacy of popular oral hair growth supplement ingredients . Int J Dermatol . 2021;60(10):1199-1210. doi: 10.1111/ijd.15344

By Amy Brownstein, MS, RDN Amy Brownstein, MS, RDN, is a private practice dietitian and nutrition consultant based on the West Coast. She is passionate about translating nutrition science into digestible and actionable educational information and recommendations.

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Why volunteer?

Benefit 1: volunteering connects you to others, benefit 2: volunteering is good for your mind and body, benefit 3: volunteering can advance your career, benefit 4: volunteering brings fun and fulfillment to your life, how to find the right volunteer opportunity, getting the most out of volunteering, volunteering and its surprising benefits.

Volunteering can help you make friends, learn new skills, advance your career, and even feel happier and healthier. Learn how to find the right volunteer opportunity for you.

With busy lives, it can be hard to find time to volunteer. However, the benefits of volunteering can be enormous. Volunteering offers vital help to people in need, worthwhile causes, and the community, but the benefits can be even greater for you, the volunteer. The right match can help you to find friends, connect with the community, learn new skills, and even advance your career.

Giving to others can also help protect your mental and physical health. It can reduce stress, combat depression, keep you mentally stimulated, and provide a sense of purpose. While it’s true that the more you volunteer, the more benefits you’ll experience, volunteering doesn’t have to involve a long-term commitment or take a huge amount of time out of your busy day. Giving in even simple ways can help those in need and improve your health and happiness.

Benefits of volunteering: 4 ways to feel healthier and happier

• Volunteering connects you to others.
• Volunteering is good for your mind and body.
• Volunteering can advance your career.
• Volunteering brings fun and fulfillment to your life.

One of the more well-known benefits of volunteering is the impact on the community. Volunteering allows you to connect to your community and make it a better place. Even helping out with the smallest tasks can make a real difference to the lives of people, animals, and organizations in need. And volunteering is a two-way street: It can benefit you and your family as much as the cause you choose to help. Dedicating your time as a volunteer helps you make new friends, expand your network, and boost your social skills.

Make new friends and contacts

One of the best ways to make new friends and strengthen existing relationships is to commit to a shared activity together. Volunteering is a great way to meet new people, especially if you are new to an area. It strengthens your ties to the community and broadens your support network, exposing you to people with common interests, neighborhood resources, and fun and fulfilling activities.

Increase your social and relationship skills

While some people are naturally outgoing, others are shy and have a hard time meeting new people. Volunteering gives you the opportunity to practice and develop your social skills, since you are meeting regularly with a group of people with common interests. Once you have momentum, it’s easier to branch out and make more friends and contacts.

Volunteering as a family

Children watch everything you do. By giving back to the community, you’ll show them firsthand how volunteering makes a difference and how good it feels to help other people and animals and enact change. It’s also a valuable way for you to get to know organizations in the community and find resources and activities for your children and family.

Volunteering provides many benefits to both mental and physical health.

Volunteering helps counteract the effects of stress, anger, and anxiety. The social contact aspect of helping and working with others can have a profound effect on your overall psychological well-being. Nothing relieves stress better than a meaningful connection to another person. Working with pets and other animals has also been shown to improve mood and reduce stress and anxiety.

Volunteering combats depression. Volunteering keeps you in regular contact with others and helps you develop a solid support system, which in turn protects you against depression.

Volunteering makes you happy . By measuring hormones and brain activity, researchers have discovered that being helpful to others delivers immense pleasure. Human beings are hard-wired to give to others. The more we give, the happier we feel.

[Read: Cultivating Happiness]

Volunteering increases self-confidence. You are doing good for others and the community, which provides a natural sense of accomplishment. Your role as a volunteer can also give you a sense of pride and identity. And the better you feel about yourself, the more likely you are to have a positive view of your life and future goals.

Volunteering provides a sense of purpose. Older adults, especially those who have retired or lost a spouse, can find new meaning and direction in their lives by helping others. Whatever your age or life situation, volunteering can help take your mind off your own worries, keep you mentally stimulated, and add more zest to your life.

Volunteering helps you stay physically healthy. Studies have found that those who volunteer have a lower mortality rate than those who do not. Older volunteers tend to walk more, find it easier to cope with everyday tasks, are less likely to develop high blood pressure, and have better thinking skills. Volunteering can also lessen symptoms of chronic pain and reduce the risk of heart disease.

Speak to a Licensed Therapist

BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.

I have limited mobility—can I still volunteer?

People with disabilities or chronic health conditions can still benefit greatly from volunteering. In fact, research has shown that adults with disabilities or health conditions ranging from hearing and vision loss to heart disease, diabetes or digestive disorders all show improvement after volunteering.

Whether due to a disability, a lack of transportation, or time constraints, many people choose to volunteer their time via phone or computer. In today’s digital age, many organizations need help with writing, graphic design, email, and other web-based tasks. Some organizations may require you to attend an initial training session or periodical meetings while others can be conducted completely remotely. In any volunteer situation, make sure that you are getting enough social contact, and that the organization is available to support you should you have questions.

If you’re considering a new career, volunteering can help you get experience in your area of interest and meet people in the field. Even if you’re not planning on changing careers, volunteering gives you the opportunity to practice important skills used in the workplace, such as teamwork, communication, problem solving, project planning, task management, and organization. You might feel more comfortable stretching your wings at work once you’ve honed these skills in a volunteer position first.

Teaching you valuable job skills

Just because volunteer work is unpaid does not mean the skills you learn are basic. Many volunteering opportunities provide extensive training. For example, you could become an experienced crisis counselor while volunteering for a women’s shelter or a knowledgeable art historian while donating your time as a museum docent.

[Read: Finding the Right Career]

Volunteering can also help you build upon skills you already have and use them to benefit the greater community. For instance, if you hold a successful sales position, you can raise awareness for your favorite cause as a volunteer advocate, while further developing and improving your public speaking, communication, and marketing skills.

Gaining career experience

Volunteering offers you the chance to try out a new career without making a long-term commitment. It is also a great way to gain experience in a new field. In some fields, you can volunteer directly at an organization that does the kind of work you’re interested in. For example, if you’re interested in nursing, you could volunteer at a hospital or a nursing home.

Your volunteer work might also expose you to professional organizations or internships that could benefit your career.

When it comes to volunteering, passion and positivity are the only requirements

While learning new skills can be beneficial to many, it’s not a requirement for a fulfilling volunteer experience. Bear in mind that the most valuable assets you can bring to any volunteer effort are compassion, an open mind, a willingness to pitch in wherever needed, and a positive attitude.

Volunteering is a fun and easy way to explore your interests and passions. Doing volunteer work you find meaningful and interesting can be a relaxing, energizing escape from your day-to-day routine of work, school, or family commitments. Volunteering also provides you with renewed creativity, motivation, and vision that can carry over into your personal and professional life.

[Read: Building Better Mental Health]

Many people volunteer in order to make time for hobbies outside of work as well. For instance, if you have a desk job and long to spend time outdoors, you might consider volunteering to help plant a community garden, walk dogs for an animal shelter, or help out at a children’s camp.

There are numerous volunteer opportunities available. The key is to find a position that you would enjoy and are capable of doing. It’s also important to make sure that your commitment matches the organization’s needs. Ask yourself the following:

• Would you like to work with adults, children, animals, or remotely from home?
• Do you prefer to work alone or as part of a team?
• Are you better behind the scenes or do you prefer to take a more visible role?
• How much time are you willing to commit?
• What skills can you bring to a volunteer job?
• What causes are important to you?

Consider your interests

You will have a richer and more enjoyable volunteering experience if you first take some time to identify your goals and interests. Think about why you want to volunteer. What would you enjoy doing? The opportunities that match both your goals and your interests are most likely to be fun and fulfilling.

What are your volunteering goals?

To find a volunteer position that’s right for you, look for something that matches your personality, skills, and interests. Ask yourself if there is something specific you want to do or achieve as a volunteer.

For example, you might want to:

• Improve your neighborhood.
• Meet new people with different outlooks or experiences.
• Try something new.
• Do something rewarding with your spare time.
• See new places or experience a different way of living.
• Try a new type of work that you might want to pursue as a full-time job.
• Expand on your interests and hobbies.

Consider several volunteer possibilities

Don’t limit yourself to just one organization or one specific type of job. Sometimes an opportunity looks great on paper, but the reality is quite different. Try to visit different organizations and get a feel for what they are like and if you click with other staff and volunteers.

Where to find volunteer opportunities

• Community theaters, museums, and monuments.
• Libraries or senior centers.
• Service organizations such as Lions Clubs or Rotary Clubs.
• Local animal shelters, rescue organizations, or wildlife centers.
• Youth organizations, sports teams, and after-school programs.
• Historical restorations, national parks, and conservation organizations.
• Places of worship such as churches or synagogues.
• Online directories and other resources (see below).

How much time should you volunteer?

Volunteering doesn’t have to take over your life to be beneficial. In fact, research shows that just two to three hours per week, or about 100 hours a year, can confer the most benefits—to both you and your chosen cause. The important thing is to volunteer only the amount of time that feels comfortable to you. Volunteering should feel like a fun and rewarding hobby, not another chore on your to-do list.

You’re donating your valuable time, so it’s important that you enjoy and benefit from your volunteering. To make sure that your volunteer position is a good fit:

Ask questions. You want to make sure that the experience is right for your skills, your goals, and the time you want to spend. Sample questions for your volunteer coordinator might address your time commitment, if there’s any training involved, who you will be working with, and what to do if you have questions during your experience.

Make sure you know what’s expected. You should be comfortable with the organization and understand the time commitment. Consider starting small so that you don’t over commit yourself at first. Give yourself some flexibility to change your focus if needed.

Don’t be afraid to make a change. Don’t force yourself into a bad fit or feel compelled to stick with a volunteer role you dislike. Talk to the organization about changing your focus or look for a different organization that’s a better fit.

If volunteering overseas, choose carefully. Some volunteer programs abroad can cause more harm than good if they take much-needed paying jobs away from local workers. Look for volunteer opportunities with reputable organizations.

Enjoy yourself. The best volunteer experiences benefit both the volunteer and the organization. If you’re not enjoying yourself, ask yourself why. Is it the tasks you’re performing? The people you’re working with? Or are you uncomfortable simply because the situation is new and unfamiliar? Pinpointing what’s bothering you can help you decide how to proceed.

VolunteerMatch  – Find opportunities that match your volunteer interests, from location to type of work. (VolunteerMatch)

Idealist  – Find volunteer opportunities in your local area or internationally. (Idealist)

National and Community Service  – Federal organization offering volunteer positions across the U.S. (National Service)

Volunteer  – Directory of environmental volunteer opportunities. (Volunteer.gov)

U.S. Peace Corps  – Offers volunteer opportunities overseas and includes a  50 Plus  division. (Peace Corps)

American Red Cross  – Volunteer in any of the Red Cross’s key service areas. (Red Cross)

More Information

• Simple Changes, Big Rewards - A Practical, Easy Guide for Healthy, Happy Living. (Harvard Medical School Special Health Report)
• The Health Benefits of Volunteering: Recent Research (PDF) - Research on the benefits of volunteering, especially for seniors. (Corporation for National and Community Service)
• The many ways volunteering is good for your heart - Includes resources for finding volunteer positions. (Harvard Health Publications)
• 10 Tips on Volunteering Wisely - Tips to make the most of your volunteering experience. (Network for Good)
• Carr, D. C., Kail, B. L., & Rowe, J. W. (2018). The Relation of Volunteering and Subsequent Changes in Physical Disability in Older Adults. The Journals of Gerontology: Series B , 73(3), 511–521. Link
• Kim, E. S., Whillans, A. V., Lee, M. T., Chen, Y., & VanderWeele, T. J. (2020). Volunteering and Subsequent Health and Well-Being in Older Adults: An Outcome-Wide Longitudinal Approach. American Journal of Preventive Medicine , 59(2), 176–186. Link
• Lawton, R. N., Gramatki, I., Watt, W., & Fujiwara, D. (2021). Does Volunteering Make Us Happier, or Are Happier People More Likely to Volunteer? Addressing the Problem of Reverse Causality When Estimating the Wellbeing Impacts of Volunteering. Journal of Happiness Studie , 22(2), 599–624. Link
• Okun, M. A., Yeung, E. W., & Brown, S. (2013). Volunteering by older adults and risk of mortality: A meta-analysis. Psychology and Aging , 28(2), 564–577. Link
• Salt, E., Crofford, L. J., & Segerstrom, S. (2017). The Mediating and Moderating Effect of Volunteering on Pain and Depression, Life Purpose, Well-Being, and Physical Activity. Pain Management Nursing , 18(4), 243–249. Link

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• Safe outdoor activities during the COVID-19 pandemic

The COVID-19 pandemic doesn't have to halt all of your outdoor fun. Here are several fun outdoor activities you can still enjoy.

Since the start of the coronavirus disease 2019 (COVID-19) pandemic, the activities of many people have been affected.

With COVID-19 vaccines, testing and treatment, events and travel are back to typical levels in many places. But as waves of COVID-19 cases — called outbreaks — happen, it's important to stay flexible with your plans.

Even if it takes extra planning, seeking out fun activities can help you cope with life's challenges. That's especially true if you do activities with people in your community and boost your social network.

When it comes to being social and active during the COVID-19 pandemic, outdoor activities can be a good way to have fun safely.

Why choose outdoor activities?

It's harder to catch the virus that causes COVID-19 when you are in a space with good airflow and where you can spread out.

The COVID-19 virus is mainly spread from person to person. The virus spreads when a person with COVID-19 breathes, coughs, sneezes, sings or talks.

When you're outside, fresh air is always moving, so your risk of breathing in the virus that causes COVID-19 is lower.

Low-risk ways to move more

When COVID-19 is spreading in your area, low-risk activities can keep you active in a safe way. In general, any activity that allows you to keep your distance from others is a lower risk activity.

Wearing a mask can give you added protection against catching the COVID-19 virus.

In warm or cold weather, there are many ways to be active outdoors. Walking, running and hiking are common options either in your neighborhood or at a park.

Cold-weather activities, such as skiing or sledding, can be an option for one person or a group. Finding a fun activity during the cold months can help you enjoy the season and winter activities more.

Low- to moderate-risk outdoor activities

Some outdoor activities have a low to moderate risk of exposure to the virus that causes COVID-19. Basically, the less an activity brings you into contact with groups of people, the lower the risk of exposure to the virus.

Outdoor patio dining at uncrowded restaurants where patio tables are spaced apart is typically safer than indoor dining.

Gathering with a small group of friends and meeting outdoors may be a good option.

At the beach or swimming pool, it's the close contact with others, not water itself, that can make activities at these locations risky. Water itself doesn't spread the virus that causes COVID-19 from person to person.

High-risk outdoor activities

Being in large gatherings or crowds of people where it's difficult to stay a safe distance apart makes some outdoor activities higher risk for exposure to the COVID-19 virus. Festivals and parades are examples.

Think safety and enjoyment

As the COVID-19 pandemic continues, it's important to take care of yourself and those around you.

• Stay up to date with COVID-19 vaccines to help prevent serious COVID-19 illness.
• Make your activities as safe as possible.
• Test for COVID-19 if you have symptoms.
• Cancel plans if someone may be sick.

When you are out, clean your hands often. Avoid touching your face. If you live in an area where the virus that causes COVID-19 is spreading, wear a well-fitted mask.

With the right information, you can make thoughtful choices about ways to bring a sense of normalcy and joy to your life during the ups and downs of the COVID-19 pandemic.

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• Create joy and satisfaction. Mental Health America. https://www.mhanational.org/create-joy-and-satisfaction. Accessed June 7, 2024.
• Social connection. U.S. Department of Health and Human Services. https://www.hhs.gov/surgeongeneral/priorities/connection/index.html. Accessed June 7, 2024.
• Taking steps for cleaner air for respiratory virus prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/respiratory-viruses/prevention/air-quality.html. Accessed June 7, 2024.
• Goldman L, et al., eds. COVID-19: Epidemiology, clinical manifestations, diagnosis, community prevention, and prognosis. In: Goldman-Cecil Medicine. 27th ed. Elsevier; 2024. https://www.clinicalkey.com. Accessed June 7, 2024.
• Nyenhuis SM, et al. Exercise and fitness in the age of social distancing during the COVID-19 pandemic. The Journal of Allergy and Clinical Immunology: In Practice. doi:10.1016/j.jaip.2020.04.039.
• Masks and respiratory viruses prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/respiratory-viruses/prevention/masks.html. Accessed June 7, 2024.
• How to stay active in cold weather. American Heart Association. https://www.heart.org/en/healthy-living/fitness/getting-active/how-to-stay-active-in-cold-weather. Accessed June 7, 2024.
• Exercising in hot and cold environments. American College of Sports Medicine. https://www.acsm.org/read-research/resource-library/resource_detail?id=2b5a55f7-e357-4909-b68f-727a604e3913. Accessed June 7, 2024.
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• How COVID-19 spreads. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html. Accessed June 7, 2024.
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• Hygiene and respiratory viruses Prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/respiratory-viruses/prevention/hygiene.html. Accessed June 7, 2024.

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