Privacy and Security in Health Big Data: A NIST-Guided Systematic Review of Technologies, Challenges, and Future Directions

The rapid expansion of health big data, encompassing genomic profiles and wearable device telemetry, has significantly escalated personal privacy risks. This systematic literature review (SLR) synthesizes 86 peer-reviewed studies (2014–2025) through the dual lens of the NIST Cybersecurity and Privacy Frameworks to evaluate emerging risks, mitigation technologies, and regulatory landscapes. Our analysis identifies unauthorized access as the predominant threat, while blockchain-based solutions comprise 22.1% of proposed interventions. However, a comparative evaluation reveals critical performance trade-offs: differential privacy mechanisms incur a 15–35% utility loss, whereas blockchain implementations impose a 40–50% computational overhead. Furthermore, an assessment of major regulatory frameworks (GDPR, HIPAA, PIPL, and emerging regional laws in Sub-Saharan Africa) elucidates significant cross-jurisdictional conflicts. To address these challenges, we propose the Bio-inspired Adaptive Healthcare Privacy (BAHP) framework, validated through retrospective case study analysis, offering a dynamic approach to securing sensitive health ecosystems.