i Geographic Information Systems and Public Health: Eliminating Perinatal Disparity Andrew Curtis Louisiana State University, USA Michael Leitner Louisiana State University, USA IRM Press Publisher of innovative scholarly and professional information technology titles in the cyberage Hershey • London • Melbourne • Singapore ii Acquisitions Editor: Michelle Potter Development Editor: Kristin Roth Senior Managing Editor: Amanda Appicello Managing Editor: Jennifer Neidig Copy Editor: Killian Piraro Typesetter: Amanda Kirlin Cover Design: Lisa Tosheff Printed at: Yurchak Printing Inc. Published in the United States of America by IRM Press (an imprint of Idea Group Inc.) 701 E. Chocolate Avenue, Suite 200 Hershey PA 17033-1240 Tel: 717-533-8845 Fax: 717-533-8661 E-mail: [email protected] Web site: http://www.irm-press.com and in the United Kingdom by IRM Press (an imprint of Idea Group Inc.) 3 Henrietta Street Covent Garden London WC2E 8LU Tel: 44 20 7240 0856 Fax: 44 20 7379 0609 Web site: http://www.eurospanonline.com Copyright © 2006 by Idea Group Inc. All rights reserved. No part of this book may be reproduced, stored or distributed in any form or by any means, electronic or mechanical, including photocopying, without written permission from the publisher. Product or company names used in this book are for identification purposes only. Inclusion of the names of the products or companies does not indicate a claim of ownership by IGI of the trademark or registered trademark. Library of Congress Cataloging-in-Publication Data Geographic information systems and public health : eliminating perinatal disparity / Andrew Curtis and Michael Leitner, editors. p. ; cm. Includes bibliographical references and index. Summary: "This book provides an overview of why geography is important in the investigation of health, the importance of the main components of a GIS, how important neighborhood context is when using a GIS, and the general differences found between urban and rural health environments"--Provided by publisher. ISBN 1-59140-756-7 (hardcover) -- ISBN 1-59140-609-9 (softcover) 1. Geographic information systems. 2. Public health--Data processing. [DNLM: 1. Geographic Information Systems. 2. Infant Mortality. 3. Community Health Planning. 4. Pregnancy, High-Risk. WS 16 G345 2006] I. Curtis, Andrew, 1967- II. Leitner, Michael, 1965- RA566.G462 2006 362.1'0285--dc22 2005023873 eISBN 1-59140-610-2 British Cataloguing in Publication Data A Cataloguing in Publication record for this book is available from the British Library. All work contributed to this book is new, previously-unpublished material. The views expressed in this book are those of the authors, but not necessarily of the publisher. iii This book is dedicated to everyone who has been involved with the Baton Rouge Healthy Start program. iv Geographic Information Systems and Public Health: Eliminating Perinatal Disparity Table of Contents Preface .................................................................................................. ix Acknowledgments ............................................................................... xxi Chapter I Explaining the Geography of Infant Health ......................................... 1 Geographic Variations in Infant Health ........................................ 2 Smoking is Bad ..................................................................... 9 What Does It Mean to Be Poor? ......................................... 10 Stress ................................................................................... 11 The Geography of Health ............................................................ 12 References .................................................................................... 18 Chapter II An Introduction to GIS (All Things Data) .......................................... 21 Data Input .................................................................................... 24 Health Data ........................................................................ 24 Confidentiality Issues .......................................................... 27 Address Matching/Geocoding ............................................. 28 Other Useful Data 1: Socioeconomic Data ........................ 31 Other Useful Data 2: Boundary and Background Data ..... 32 Data Manipulation ....................................................................... 37 Aggregating into Spatial Units ........................................... 37 Data Reduction ................................................................... 41 v Creating New Data ............................................................. 42 Calculating Deprivation Indexes ........................................ 42 Improving Health Outcome Information ............................ 44 Perinatal Periods of Risk (PPOR) ...................................... 45 References .................................................................................... 47 Chapter III An Introduction to GIS (All Things Spatial) ....................................... 52 Visualizing the Data ..................................................................... 52 Choropleth Map .................................................................. 57 Common Dot Map .............................................................. 60 Isarithmic (Isoline) Map ...................................................... 61 Proportional (Graduated) Point Symbol Map .................... 61 Spatial Analysis ............................................................................ 62 CrimeStat® .......................................................................... 64 GeoDa™ .............................................................................. 65 Geographically Weighted Regression (GWR) ..................... 65 SaTScan™ ............................................................................ 66 GIS as a Management Information System ........................ 68 What is a Neighborhood? ................................................... 69 Including Geography in the Analysis ........................................... 70 Holistic Neighborhood Investigations ................................ 72 Spatially Synthesizing Previous Research ........................... 73 References .................................................................................... 73 Chapter IV The Geography of Health Risks ......................................................... 79 Infant Deaths, Low Birth Weight, and Short Gestation Deliveries ............................................................................ 83 Medical Risks ............................................................................... 85 Behavioral Risks .......................................................................... 87 So What Can We Do With GIS? ......................................... 91 Cohort or Social Risks ................................................................. 95 Social Risks: Disparities in African American Neighborhoods ............................................................... 96 Spatial Cohort .................................................................... 98 Neighborhood Risks ............................................................ 99 Suffer the Children ........................................................... 100 Environmental Risks .................................................................. 103 GIS Analyses of Environmental Risks .............................. 107 vi GIS, Cancer, and Low Birth Weight Research in Louisiana ...... 110 Cancer and Birth Outcome Co-Investigation Template ... 111 Summarizing It All: The Relationship Between Risk and Stress ..................................................................................... 113 So What Can Be Done? .................................................... 114 References .................................................................................. 119 Chapter V GIS and Spatial Analysis: Keeping It Simple .................................. 146 Exploratory Analysis vs. Hypothesis Testing ............................. 146 Spatial Design ............................................................................ 148 Spatial Sampling ........................................................................ 149 Aggregation Effects ................................................................... 153 Three Simple Techniques: Overlay, Density, and a Difference of Proportions Test ............................................................... 154 Overlay as Analysis ........................................................... 154 A Cautionary Tale ............................................................ 157 Density Analysis ................................................................ 157 Difference of Proportions Test ......................................... 160 Results for Year One (Table 1) .......................................... 165 Results for Year Two (Table 2) ......................................... 165 Results for Year Three (Table 3) ....................................... 167 Under-18 Pregnancies (Table 4) ...................................... 169 References .................................................................................. 172 Chapter VI Advanced Spatial Analysis ................................................................ 174 Spatial Autocorrelation ............................................................. 174 Global Spatial Autocorrelation .......................................