The story of surveillance is a story of colonization, expansion, and what happens when human beings police and control each other. Tracing the exact linear timeline of how policing and surveillance have impacted communities is an impossible task. The focus of this story is on the roots of surveillance, particularly how they developed in Europe and then on Turtle Island (North America), and how that wider surveillance culture both fostered and was fueled by surveillance within the public health and medical systems. These systems developed alongside the institution of chattel slavery, the colonization of Indigenous lands & people, and the suppression of mass rebellions, and therefore emerged as a combination of social control and institutional data collection and tracking.

It matters that the technological surveillance we are familiar with in 2026 didn’t just appear out of nowhere. These systems can be traced back to medieval Europe: to churches where surveilling patrons’ confessions was a regular practice by priests, and to mass data collection for tracking mortality rates during the Black Plague. These methods of objectifying, tracking, and reducing human life to numbers were then imported and refined through the institutionalization of chattel slavery in the Americas. All of this created the practice of surveillance that defines our everyday lives in the 21st century.

Surveillance in Europe’s churches

Painting of a priest listening to a shrouded figured in a confessional booth.

Surveillance is not a recently imagined or crafted method of tracking people. It did not only follow the escalation of the industrialization era, nor was it invented alongside the tech revolution that built contemporary forms of surveillance. Instead, it is a cultural practice that has roots in Europe before the colonization of the Americas (see our Story of the Colonizer Wound for more).

Following the Fourth Lateran Council in 1215, when the Roman Catholic Church deemed that annual confession was mandatory, the papacy increasingly used surveillance to assess and track individuals in medieval Europe. Patrons were instructed to confess their sins, both what they had actually done as well as everything they thought about doing. This was a cultural shift whereby the Church had access not only to the public actions of its congregants, but also to their followers’ private lives. The church then used these confessions as a baseline assessment of their patrons’ behaviors, looking for any actions or views that fell outside the mandates of the church. This information was used to publicly and privately shame congregants, to identify pagans, Jews, and infidels (people not following Catholic law) and, eventually, to fuel the political and military aims of the Church.

After the Lateran Council, the Catholic Church focused on completing the forced conversions of the European tribes through the witch trials and the Northern Crusades, as well as attacking and attempting to control The Holy Land through the Crusades on the lands from Turkey to Egypt. This eventually paved the way for the Doctrine of Discovery, the mandate used to justify the colonization of the Americas and Africa. The church deepened its control of its members using religion and the fear of God, forcing those who were wavering in their faith to engage in the Church’s military endeavors and rewarding these soldiers by giving them parcels of newly-seized land, thus extending deeper into the private lives of the community. In understanding how surveillance operates today, it’s important to remember these newly-emerged strategies of attempting to control people’s private lives for the purposes of empire.

Early glimpses of surveillance in public health

The term “surveillance” comes from the French “sur” (over) “veiller” (to watch). The term was popularized during the French Revolution, as both revolutionary movements and states began concerning themselves with watching over the "masses" in the context of widespread uprisings across Europe and the Americas. Early surveillance practices, such as aerial observation with balloons, were widely developed and honed in military contexts throughout Europe, as well as other parts of the world. This was a period of widespread social revolution, particularly as workers fought against the imperial wealth of royalty, the aristocracy, and the State. New ways of attempting to control and end the waves of social revolution emerged constantly. This story will focus on the role of public health surveillance in normalizing a wider surveillance culture, one part of what emerged from this broader expansion of social control.

Within public health practice, the word surveillance was first used to describe methods of monitoring contacts between people with communicable diseases such as smallpox, so that public health entities such as hospitals or local wards could track and detect early symptoms and enforce isolation for affected individuals. This is often how new surveillance strategies emerge, by riding on the backs of responses to social needs, such as the need to track and protect people from epidemics. As social reforms were put into place, particularly reforms focused on increasing equity of care, some of the mechanisms of social control also gained traction.

The word surveillance was used for the first time in a public health context by Alexander D. Langmuir in the 72nd Shattuck Lecture to the Massachusetts Medical Society in 1962. Langmuir was the chief epidemiologist at the Communicable Disease Center, now known as the Centers for Disease Control and Prevention (CDC). Langmuir used the term surveillance to refer to the importance of analysis and dissemination of data.

However, while Langmuir might have been the first person to use the word in this context, he didn’t get there on his own. Hippocrates, the fourth century BCE Greek physician, was the first person recorded to state that diseases occur naturally and not through the influence of gods or other superstitions. He is also generally credited with first recommending methods for recording, analyzing, and informing the public about the appropriate course of action when it came to diseases occurring naturally. The tracking of healthcare data over time is at the heart of the lineage of Western medicine and, again, while intended to support physicians in assessing patterns over time, it also opened the door for that information to be used as a form of control.

Establishing large scale public health surveillance in Europe

Langmuir’s concept of public health surveillance can also be traced back to the emergence of early European public health strategies. During the heightened period of the bubonic plague in the early 1300s, when authorities in the Venetian Republic became aware that the plague was fatal, they ordered ships to be boarded in the port and issued the first ever quarantine. Although there were no sophisticated systems of institutional tracking for mortality rates or symptoms during the Black Plague, this is understood to be the first large-scale public health effort. During this period, public health efforts were rapidly emerging in the attempt to combat and contain the spread of infectious diseases. One of the first organized attempts to collect data for the purpose of surveilling a population was in London in the 17th century, when parish clerks began making regular weekly reports on the plague, including the number of burials and their causes of death.

The 18th century saw these practices spread, including a growing recognition of the integral role for states to play in the provision of population health. In 1766, Johann Peter Frank, a German medical doctor, advocated for a comprehensive form of public health surveillance as part of his system of “medical police” in Germany. Frank described the State’s duty to “protect” the health of its citizens. This concept of the State being responsible for its citizens’ health continued to expand. During the 19th century, states began to oversee the collection and interpretation of health-related data for the purpose of identifying appropriate next steps. Sir Edwin Chadwick, the Secretary of the Poor Law Commission in England, was the first health administrator on record to demonstrate that poverty and disease were closely related through surveillance methods. Chadwick advocated for an increase in the kind of health data collected. He recommended a general census every ten years, the standardization of descriptions for diseases and causes of death, and the collection of health data by age, sex, occupation, socioeconomic level, and locality. While this was still asserted as a form of reform, it expanded methods of data collection that began with the Church and had now passed to the State, reinforcing the idea that it is the State’s right to access its citizens’ private information for the purpose of caring for and protecting them.

Over the next few decades, health councils were established across Europe and began numeric analysis of mortality statistics for health planning. This included disease-specific death counts to track disease patterns as well as local-scale practices, and each of these records included personal information about the person who had been ill.

Chattel slavery

At the same time as public health surveillance practices were emerging, the same governmental institutions in Europe and the private corporations they sponsored were developing new surveillance practices to expand their operations in order to become more profitable. The same data-tracking practices used to maintain public health records were then replicated to build a successful “business” model: chattel slavery.

Plantation and slave owners and traders used the same methods of data collection to disassociate enslaved human beings from their personhood and to track them as data, all for the optimization and efficiency of their “business.” Slave owners tracked “empirical” rows and columns of enslaved people's names, duties, locations, and behavior that made it easier for them to identify human beings as categories of labor, thereby denying their humanity. Documented records, narratives, and ledgers such as the “Negro Account” made it possible for slave owners and traders to detail enslaved peoples’ identities, sales, valuation, and personal experiences for profit. Similarly, a “Livestock Account” in British Guyana plantations was used by account keepers for calculating increase, decrease, purchase, sale, death, appreciation, and depreciation.

Chattel slavery translated human life into numbers and aggregated collected data in order to control relationships, track weapons, and restrict information, movement, and behavior. The system of chattel slavery used methods that had originated to track disease and used them to control human lives, cementing the marriage between systems of policing, control, and surveillance. The systemic control, pathology, and surveillance of Black and Indigenous bodies through the transatlantic slave trade and the extermination of Indigenous people in the Americas laid the foundation for the next few centuries of large-scale policing and criminalization.

Institutionalizing & resisting watchfulness, pathology, and criminalization

From the middle of the 17th century to the American Revolution, the British colonies on Turtle Island were culturally dominated by a puritanical ethic that highly emphasized a strict collective moral code of neighborly “watchfulness.” This Christian-based moral code normalized stigma, shame, and the policing of each other. While the Catholic Church had used priests and representatives of the Church for its surveillance, the Protestant Reformation moved “God’s work” from the infrastructure of the Church to the hands of everyday people. This included the labor of morality policing. Public health data collection continued to evolve during this period and was heavily influenced by these notions of morality and watchfulness.

This same practice of neighbors enforcing moral purity was used in the development of mandates like the Lantern Laws. Lantern Laws forced Black, Indigenous, and people of mixed ancestry to use a lantern when traveling without a white person or their "owner" accompanying them. This made these bodies of color visible so that their movements could be tracked by the police and by private citizens. Individual white people were deputized to stop, interrogate, and violently harass anyone who wasn’t white and who was traveling without a lit candle after dark. These were the early roots of modern police methods such as “stop and frisk” and strategies like “neighborhood watch.”

It matters that the rising surveillance of non-white people by white supremacy was taking place at the same time as public health was expanding its data collection approach. While not directly linked, this correlation showed an increasing cultural shift towards viewing human lives as data to be collected and then used to define broader political strategies.

Following the National Quarantine Act in 1878, the predecessor to the U.S. Public Health Service (USPHS), the Marine Health Service (see our Story of Marine Health for more), began tracking morbidity rates for illnesses such as smallpox, cholera, yellow fever, and the plague. Similar to systems in Western Europe, this process focused on tracking people in order to reduce the spread of these contagious diseases. The Marine Hospital Service was also authorized by Congress to collect morbidity reports from U.S. consuls overseas in order to determine how to prevent diseases from entering the United States and spreading.

Take a moment to notice what was happening. The State was building an increasingly broad data set of complex information about people based on their demographics, their geographies, and their health experiences. At the same time, industrialization was rapidly shifting social conditions, including the expansion of urban density and migration for employment. The industrial revolution also brought an explosion of economic inequality, as wealth grew for the few at the expense of a rapidly expanding class of workers.

In the late 1800s, a French Criminologist named Alphonse Bertillon wrote that "every measurement slowly reveals the workings of the criminal." He was referring to data that had been collected on the physical shape of the bodies of French citizens, in particular, data that he believed showed the differences between bodies that were “criminal” and those bodies that were as “innocent.” Bertillon took this data and began to build a “biological” system for behavior, essentially stating that someone’s activities could be predicted based on physical characteristics. Charles Darwin had just written The Origin of the Species about 30 years previously, and conversations about evolution were shaping everything. Bertillon created a system that mixed his perception of evolution with his theories about data that measured the length and breadth of the head and the length of the middle finger, left foot, and forearm in order to identify the physiological characteristics of a “criminal.” Using measurements and photography (the precursor to the "mugshot"), Bertillon kept extensive records of incarcerated and/or arrested people in order to build his case.

The Bertillon System was the first "scientific" tracking system to be used by the police to “predict” and stop criminal behavior. It was first used in the U.S. to track Black women sex workers, called “alley workers,” in Minneapolis, Minnesota. The Minneapolis police force used photography and data collection to attempt to build a case, steeped in misogynoir, that Black women are essentially more sexual and more dangerous. However, the Black women being surveilled thwarted the system by all using the same alias name, "Mamie," preventing the police from tracking individual specific women.

The use of health data and tracking of physical characteristics to control specific populations continued to expand across the United States. In the early 1900s, Thomas Salmon, a failed doctor, began building out a psychiatry department on Ellis Island under the Public Health and Marine Hospital Service with the intention of determining which immigrants would be deemed "beneficial" to the State and which would be deemed "dangerous." This was the first recorded time in American history that psychiatric evaluations became part of the structure that identifies immigrants as being either "worthy" or "unworthy" of entry into the United States. This was only the start of health surveillance data becoming increasingly used to control movement and migration throughout the 20th century.

Health record surveillance as a weapon

In the 20th century, health surveillance continued to rapidly expand. In 1918, the Chamberlain-Kahn Act empowered the government to detain women suspected of carrying sexually transmitted infections, who were required to submit to a medical exam. If an infection was found, the woman could then be sentenced to a hospital or penal institution until cured. Also known as the "American Plan," the act was designed to prevent the spread of sexually transmitted infections among soldiers. While theoretically gender-neutral, it was almost exclusively applied to women, who were detained for "suspicious" activities as broad as walking alone or changing jobs.

What also expanded was the use of this kind of surveillance to police what was considered “American”, which was code for European/white and Christian. Since its formation, the U.S. government has targeted and criminalized the traditional cultural and medicinal practices of Indigenous communities on Turtle Island. In the 1900s, healing practices and methods from other parts of the world were increasingly surveilled and criminalized as well. In 1920, Paramahansa Yogananda founded the Self-Realization Fellowship in Boston, where he began to teach meditation and to develop Kriya yoga. Concurrently, he was put on a government watch list and kept under surveillance by the Federal Bureau of Investigation (FBI) and the British authorities, who were concerned about his political activities and the growing independence movement in India.

Many different cultural shifts wove together: the encroachment of the State into private behavior, the use of data to manipulate cultural ideas of what is “dangerous” or “innocent,” and the attempt to protect a particular kind of white Christian power in the face of rising immigration waves. Data collection and surveillance was also used to expand U.S. interests globally. Public health surveillance methods that were created to track infectious diseases for the sake of communal safety were increasingly mobilized as a tool of control, watchfulness, and pathologization. This showed up everywhere, including with a proliferation of methods to track “racial purity,” to prohibit interracial unions, to force sterilization, to institutionalize people with disabilities, to deport immigrants, and more.

However, this level of surveillance for the purposes of control wasn’t met with silence nor apathy from the populations impacted directly. There were always large, decentralized resistance and solidarity movements across the country – from plantation rebellions to workers strikes in the beginning of the 20th century. These forms of resistance were also then targeted by increasingly sophisticated government surveillance. Many recorded and unrecorded forms of resistance began to emerge as the pathologization and control of marginalized people continued to increase. In response, states doubled down on control of targeted communities. This meeting of attempted control and resistance defined the 20th century, from Black South African organizers under apartheid who were required to carry identity documents to enable surveillance of their movements, to the first mandatory sex verifications for women’s sports, to the ending of the Bracero program and an increase in surveillance of undocumented people.

Technological sophistication and resistance movements in the mid-20th century

The introduction and expansion of technological tools for surveillance in the middle of the 20th century marked a shift towards what we recognize as contemporary surveillance methods today. Tools of surveillance became more commonly used to establish control over people held in institutions. For example, the development of Closed Circuit Television (also known as CCTV) revolutionized surveillance technology. In 1955, the Nebraska Psychiatric Institute and Norfolk State Hospital began using CCTV for the first time to organize therapy groups. Mental health institutions rapidly began using closed-circuit television to remotely monitor and treat patients. This was the first time digital monitoring was used in healthcare for both medical treatment and education purposes.

At the same time, the mid-20th century saw increased resistance from social movements, which had been building for a long time through the efforts of Civil Rights movement leaders, anti-war activists, feminist and gay liberation movements, labor rights organizers, and more. Particularly in the 1960s and 1970s, concerns about widespread uprisings across the country motivated an increase in state surveillance and the development of new technologies. Civil Rights movement leaders were closely monitored and questioned, as Black leaders throughout the country started desegregating white institutions. In 1958, a Black pastor and Civil Rights activist, Clennon W. King Jr., was arrested and held for a “mental health” examination after attempting to enroll in the University of Mississippi, on the grounds that any Black man "who tried to enter Ole Miss must be crazy.” Similarly, Martin Luther King Jr. was confined to a mental hospital for twelve days before a panel of doctors established the activist's sanity and he was finally released. The next few decades saw an escalation in policing, disruption, and counter-intelligence of political organizing, which set the stage for mass incarceration of significant percentages of impoverished Black and Brown communities, sex workers, LGBTQ+ people, and substance users.

In 1971, a cab driver, a day-care provider, and two professors broke into a Federal Bureau of Investigation (FBI) office and stole classified materials that provided evidence that for over 20 years, the FBI's Counterintelligence Program (also known as COINTELPRO) had been surveilling, infiltrating, discrediting, and disrupting political organizing in the United States. Programs like COINTELPRO illustrated the rising weaponization of surveillance as a means to disrupt and assassinate prime organizers.

Surveillance has had many different uses throughout its history: from tools meant for tracking and containing the spread of infectious diseases to tools of policing and maintaining control and so-called “order.” By the end of the 20th century, surveillance had become completely unrecognizable from its roots in monitoring the health and safety of populations. With time, public health surveillance also became a weapon of extortion, as governments have withheld and released individuals’ health privacy information at will. In 1981, during the the HIV/AIDS epidemic, public health officials in New York City publicly reported the names and personal information of patients with a positive status, which they believed was justified to enable "contact tracing." This was met with widespread resistance from AIDS activists fighting for confidentiality, who considered it an ethical violation to use private health privacy information to target queer, black, and Latinx patients with positive status. Many of these activists demanded a role in shaping what forms public health surveillance of HIV would take and how it might benefit the most affected communities.

The rise of the internet and digital surveillance in the 21st century

At the turn of the millennia, the rise of the internet brought widespread, unprecedented access to online medical information for the masses. In 1999, "eHealth" began to be used as a broadly-defined term, referring to any form of healthcare that relies heavily on the Internet. It includes the use of electronic health records, electronic prescriptions, telemedicine, online access to medical research and medical information, and more. This period marked a significant shift in how healthcare was experienced by the public, and continues to have a grave impact on underfunded hospitals, especially in rural areas, that don't have the financial resources to expand their telemedicine systems. The rise of eHealth and telehealth has also raised concerns about health surveillance and the digitization of health records over subsequent decades.

Concurrently with this new norm of widespread availability of health information and surveillance online, government-funded surveillance in the name of domestic safety rose following the September 11 attacks. After the World Trade Center's twin towers in New York City were destroyed and the Pentagon and U.S. Capitol were targeted in attacks that killed approximately 3,000 people, the United States government passed successive and aggressive legislation to “protect” its citizens. At the same time, Islamophobia in the county increased, including increased violence and heightened surveillance against Arab and Muslim communities. The U.S. government has also increasingly targeted social justice organizations that are anti-policing and pro-Palestine for increased surveillance, labelling their activities as "acts of terrorism."

The legacy of legislation passed in reaction to the September attacks has included many new surveillance practices, such as the Real ID Act and many other citizenship and identity tracking technologies embedded within basic identity cards, including drivers' licenses. Many critics of these policies have raised concern about infringements on rights to privacy and freedom of movement. The State continues to claim that these surveillance practices are necessary for collective safety, in order to gain access to everything from genetic data to racial make-up of individuals in order to “predict” or pinpoint “criminal activities.”

The 21st century has also seen a rise in private entities collaborating with government institutions, raising real safety and privacy concerns about the collection of genetic material for medical purposes. In 2013, when researchers at the Whitehead Institute conducted "vulnerability research" to assess the likelihood of privacy breaches in genetic databases, they were spurred by concerns over how this information might be sold or traded. Their findings motivated the National Human Genome Research Institute to remove certain demographic information from the publicly-accessible portion of their genetic data repository.

In 2020, the COVID-19 global pandemic emerged in the midst of this cross-collaboration between governments, medical research and healthcare institutions, corporations, NGOs, and otherwise categorized entities. This marked a prominent moment where public health surveillance was used for tracking the virus and isolating individuals who were impacted. Despite the many positive uses of this data, many concerns have also been raised, particularly by Communities of Color, about the links between healthcare and digital surveillance during the pandemic. This included concerns about new practices such as telecommunication companies texting health messaging directly to their customers. Unsurprisingly, this escalation of community surveillance linked to tools for tracking health information showed up again in late 2020 when PredPol, a predictive policing corporation that attempts to identify crime "before it happens," proposed that police become the de facto public health officials to track COVID-19 in Communities of Color in Los Angeles.

This proposal wasn’t met with silence or complacency, as the Stop Los Angeles Police Department Spying Coalition and Free Radicals denounced it as a means of exploiting COVID-19 as an opportunity for profit that would result in the targeting and policing of the poorest, Black, Indigenous, and People of Color neighborhoods in LA under the false guise of "national security." They pointed out that this proposal harkened back to methods of surveillance rooted in white supremacy and colonization in the mid-18th century, such as the "Lantern Laws.”

Communities continue to firmly resist the usage of data mining and the disregard of community stories in the production of data science. In 2021, IndigiData, a workshop created and led by Indigenous scientists, organized an annual one-week offering "to introduce data science skills to undergraduates and graduates' and expand the definition of data from Indigenous oral histories, to genetic sequences of soil microbiomes, to traditional worldviews. The Indigi-data workshop centers on Indigenous data sovereignty, the idea that nations have the right to govern the collection, ownership and application of their own data. The movement pushes back on a long history of how researchers have taken Native data without permission, often stigmatizing the communities who participated or disregarding their customs surrounding the dead” (Imbler, 2021). IndigiData’s work disrupts biocommercialism, the extractive and for-profit use of data without any relationship to the Indigenous communities it is harming through the normalization of data surveillance.

In 2026, issues of digital surveillance and data extraction continue to affect communities historically most impacted by criminalization and disproportionate access to care. These communities are often sacrificed in the service of the continued sophistication of surveillance tools. Today we see continued collaborations between government entities and private companies – like the Pentagon and AI companies like Anthropic – which permit coercion and rewrite the bounds of what is possible for citizen “protection.” We are also seeing the dramatic expansion of ICE’s budget for surveillance tools to track, surveil, harass everyone from asylum seekers to U.S. citizens, and private companies getting access to medical information meant for keeping populations safe. We have come very far from the roots of early public health surveillance and what practitioners and caretakers imagined and visioned for us. Rather than keeping populations safe, we are living in an era of keeping populations controlled and unsafe.

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