GIS and

Judy 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 Hippocrates 5th-6th BCE

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

• Spatial distribution of disease (beginning of Medical Geography) Plague 1300s and 1600s

Source: New York Academy of Medicine Library Dr. Valentine Seaman New York 1798

• Plotted incidence of yellow fever • Location-related • Seasonal Yellow Fever New York 1798

Source: National Library of Medicine mid 1800s

Cholera outbreak in London Present day John Snow John Snow

• Distribution of deaths • Cluster near the Broad Street pump • Father of ? 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

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| 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= Map Types

Source: ESRI 2009 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!