From Administrative Infrastructure to Biomedical Resource: Danish Population Registries, the “Scandinavian Laboratory,” and the “Epidemiologist's Dream”

Abstract

ArgumentSince the 1970s, Danish population registries were increasingly used for research purposes, in particular in the health sciences. Linked with a large number of disease registries, these data infrastructures became laboratories for the development of both information technology and epidemiological studies. Denmark's system of population registries had been centralized in 1924 and was further automated in the 1960s, with individual identification numbers (CPRnumbers) introduced in 1968. The ubiquitous presence of CPR-numbers in administrative routines and everyday lives created a continually growing data archive of the entire population. The resulting national-level database made possible unprecedented record linkage, a feature epidemiologists and biomedical scientists used as a resource for population health research. The specific assemblages that emerged with their practices of data mining were constitutive of registry-based epidemiology as a style of thought and of a distinct relationship between science, citizens, and the state that emerged as "Scandinavian."188 Susanne Bauer will be printed, together with the new resident's name, the 10-digit CPR-number and the address on the "yellow CPR-card." While it takes some days until the plastic card is sent out, the number itself spreads quickly -a host of people and institutions already wait for it, as their routines and software demand it, e.g. in contracts for employment and housing, the pension fund, electricity or telephone companies, the local library or a sponsored language course. Introduced in 1968, the CPR-number has played a central role in the organization of Danish society. It functions as identifier and shortcut between institutions and for contracts, as an underlying infrastructure of public services from taxation to healthcare. For the healthcare systems, connections between the central population registry and health matters range from the choice of one general practitioner in the registration office through patient registries, automated invitations to screenings to the numerous disease registries.Denmark was neither the only country nor the first one to implement such a central identification number and in many ways the CPR-number corresponds to social security numbers in other countries. What is different is the extent of its usage, its significance in everyday life and the degree of linkage enabled by this ID-number. CPR-numbers and their usage produce a continually growing archive of information that records and stores information on interactions between citizens and the state as well as many corporate bodies providing services to citizens, such as privatized telephone companies. Significantly, a welfaristic concept of the role of public services that brought about data keeping and the traceability of each individual resident also coshaped the approaches taken in empirical social sciences and public health research in Denmark.For the case of health research, this paper examines how the system of population registries was instrumental in dev...

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