GIS and Public HealthJudy Seidel, MEDes, PhD

Alberta Health Services

CIPHI, Calgary, October 03, 2011

Overview of Presentation

What is GIS

History of Maps in Health

GIS Components and Benefits

Applications Around the World

What is GIS?

Geographic Information Systems & Science

What is GIS?

a computer-based system for input, storage, manipulation, and output of geographic information

a class of software

combines software with hardware, data, a user, etc., to solve a problem, support a decision, help to plan

(GoodChild 1997)

Why is GIS Important to PH?

GIS provides a digital lens to explore the connections between people, their health and well-being, and the changing physical and social environments.

(Cromely & McLafferty, 2002)

Geography and Public Health

Populations at risk

Health outcomes

Risk factors

Associations between risk factors & health outcome

Health interventions

History of Maps

Hippocrates5th-6th BCE

• Effect of location on one’s health (On Airs, Waters and Places)

• Spatial distribution of disease (beginning of Medical Geography)

Plague 1300sand 1600s

Source: New York Academy of Medicine Library

Dr. Valentine SeamanNew York 1798

• Plotted incidence of yellow fever

• Location-related

• Seasonal

Yellow Fever New York 1798

Source: National Library of Medicine

John Snow mid 1800s

Cholera outbreak in London

Present day

John Snow

John Snow

• Distribution of deaths

• Cluster near the Broad Street pump

• Father of Epidemiology?

Father of Medical Geography?

Clusters of Cholera in London

Source: http://en.wikipedia.org/wiki/John_Snow

GIS is More than Mapping

patterns (disease, exposure, environmental conditions)

relationships (people, places, interactions, environments)

trends (over time and space)

GIS Functions

Spatial database management

Visualization and mapping

Spatial Analysis

Internet and web-based GIS

Public health informatics

Mobile device – capture & retrieve field data

Real-time GIS

Digital Spatial Layers

Source: http://www.thepiazza.org.uk/bb/viewtopic.php?f=21&t=

Source: ESRI 2009

Map Types

GIS Applications in AHS

Standardize geographic areas

Population demographics

Accessibility to health services

New facility planning

Human resources planning

Health service utilization

Chronic disease site planning

Defining Rural-Urban Continuum

Source: Alberta Health Services, 2011

Age & Income Distribution in Alberta

Source: Alberta Health Services, 2011

New Hospital Catchment Areas

Source: Alberta Health Services, 2011

1 Hour Access to Hospital Services

Source: Alberta Health Services, 2011

Human Resource Planning

Source: Alberta Health Services, 2011

Public Health Applications

Chronic disease prevention

Community health assessment & planning

Injury Prevention

Communicable disease prevention & control

Environmental health

Emergency and preparedness response

Chronic Disease Prevention

Health promotion (alcohol and tobacco use)Location of product sales, SES and public schools

Cancer clusters (location, exposures, SES, housing)

Diseases (age, sex and race adjusted)

Classic Cancer Mortality Map

Source: Globocan, 2002

Heart Disease

Source: ESRI 2009

Community Health Assessment & Planning

Access to health services (distance decay, SES, availability)

Community health assessments (SES, housing, language, work type, ethnicity, health issues and outcomes)

Public health observatories (e.g., UK, Saskatoon)

Bhutan Access to Health Services

Source: Bhutan Living Standard Survey, 2007

Injury Prevention

Intentional injury

Unintentional injury

Child Pedestrian Accidents

Source: http://data.gov.uk 2011

Death Rates by All Injuries

Source: Centre for Disease Control, 2011

Communicable Disease

Vaccine preventable diseases (targeting immunization programs, identifying and predicting pockets of need)

Vector-borne and parasitic diseases (track spread of vector & disease outbreaks)

Sexually transmitted diseases (hot spot analysis)

Tuberculosis (spread and hot spots)

Communicable disease surveillance system (putting it all together)

Environmental Health

Nonionizing radiation (potential exposure for future follow up)

Air emissions (target communities for health screening)

Drinking water pollution (target communities at risk of septic contamination, nitrates and VOCs)

Environmental toxins (potential exposure, hazardous sites)

Environmental equity – communities at disproportional risk

Food safety

Environmental Health

Animal health and relationship to human health

Public Health Tracking Network (CDC – integrated health and environmental data for monitoring, responding to and reducing the burden)

http://ephtracking.cdc.gov/showHome.action

Water Monitoring

Source: GESAP 2009

Cranberry Bogs and Tree Spray

Brody JG, et al 2002

BSE Outbreaks

Source: OIE, 2003

What can GIS Do?

It can inform and education (professionals & public)

It can support decision making (evidence-based)

It can assist in planning (safety, effectiveness, efficiency, quality)

It can help modify or change practices

It can identify spatial relationship that might otherwise be overlooked.

The application of GIS to Public Health and Environmental Health is limited

by only your IMAGINATION!