Spatial Analysis, GIS, and Remote Sensing Applications in the Health Sciences Editors Donald P.Albert Wilbert M.Gesler Barbara Levergood Ann Arbor Press Chelsea, Michigan This edition published in the Taylor & Francis e-Library, 2005. “To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.” Library of Congress Cataloging-in-Publication Data Spatial analysis, GIS and remote sensing: applications in the health sciences/ edited by Donald P.Albert, Wilbert M.Gesler, Barbara Levergood. p. cm. Includes bibliographical references and index. ISBN 1-57504-101-4 (Print Edition) 1. Medical geography. 2. Medical geography–Research–Methodology. I. Albert, Donald Patrick. II. Gesler, Wilbert M., 1941— . III. Levergood, Barbara. RA792 .S677 2000 614.4′2—dc21 99—089917 ISBN 0-203-30524-8 Master e-book ISBN ISBN 0-203-34374-3 (Adobe eReader Format) ISBN 1-57504-101-4 (Print Edition) © 2000 by Sleeping Bear Press Ann Arbor Press is an imprint of Sleeping Bear Press This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with permission, and sources are indicated. A wide vari ety of references are listed. Reasonable efforts have been made to publish reliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materials or for the consequences of their use. Neither this book nor any part may be reproduced or transmitted in any form by any means, electronic or mechanical, including photocopying, microfilming, and record ing, or by any information storage or retrieval system, without prior permission in writing from the publisher. The consent of Sleeping Bear Press does not extend to copying for general distribution, for promotion, for creating new works, or for resale. Specific permission must be ob tained in writing from Sleeping Bear Press for such copying. Direct all inquiries to Sleeping Bear Press, 310 North Main Street, P.O. Box 20, Chelsea, MI 48118. Trademark Notice: Product or corporate names may be trademarks or registered trade marks, and are used only for identification and explanation, without intent to in fringe. To Julie, Elizabeth, and Kenny Acknowledgments The editors would like to express their appreciation to Lesa Strikland with Medical Media, VA Medical Center (Durham, North Carolina), Department of Veterans Affairs for her assistance in scanning figures and maps. About the Authors Donald P.Albert, Ph.D., is an Assistant Professor in the Department of Geography and Geology at Sam Houston State University in Huntsville, Texas. His interests include applications of geographic information systems within the context of medical geography, health services research, and law enforcement. Kelly A.Crews-Meyer, Ph.D., is a recent graduate of the University of North Carolina at Chapel Hill and an Assistant Professor of Geography at the University of Texas at Austin. Her current work in population-environment interactions draws upon previous research experience in state government, consulting, and university settings in landuse/landcover change, geographic accessibility, and decision-making as applied to environmental policy and valuation. Her educational background includes a B.S. in Marine Science and a M.A. in Government and International Studies, both from the University of South Carolina, as well as a Masters Certificate in Public Policy Analysis from the University of North Carolina at Chapel Hill. Charles M.Croner, Ph.D., is a geographer and survey statistician with the Office of Research and Methodology, National Center for Health Statistics, Centers for Disease Prevention and Control (CDC). His research interests are in the use of GIS for disease prevention and health promotion planning, small area analysis, and human visualization and cognition. He is Editor of the widely circulated bimonthly report “Public Health GIS News and Information” (free by request at [email protected]). Rita Fellers, Ph.D. Student, Department of Geography, University of North Carolina at Chapel Hill. Rita Fellers is a medical geographer with a particular interest in potentially environmentally related diseases such as cancer, and in statistical techniques that improve the quality of information that ecologic studies can produce. Wilbert Gesler, Ph.D., Dr. Wilbert Gesler is a Full Professor of Geography at the University of North Carolina in Chapel Hill. His major research interests are in the Geography of Health, including studies of accessibility to health care in rural areas, socio-spatial knowledge networks involved in prevention of chronic diseases, and places which have achieved a reputation for healing. vi Ron D.Horner, Ph.D., Director, Epidemiologic Research and Information Center at Durham, North Carolina. His research interests are in racial/ethnic and rural/ urban variations in the patterns of care for cerebrovascular disease. Barbara Levergood, Ph.D., Electronic Document Librarian, University of North Carolina at Chapel Hill. Her interests include providing public access to Federal information products in electronic media, statistical data, and geographic information systems. Joseph Messina, Ph.D. Student, Department of Geography, University of North Carolina at Chapel Hill. He served in the U.S. Army using battlefield GIS to support indirect fire control missions. He worked as a GIS Applications Specialist for the SPOT Image Corporation. While with SPOT, he assisted in the development of the GeoTIFF format, developed new products and remote sensing algorithms, and served as contributing technical editor for SPOTLight magazine. He holds degrees in Biology and Geography from George Mason University. Peggy Wittie, a medical geographer and GIS specialist, is a doctoral candidate at the University of North Carolina at Chapel Hill and GIS Coordinator for North Carolina Superfund. Her research integrates GIS techniques to study health care access, environmental health and environmental justice issues. Preface This book is an expression of the myriad ways in which the range of geospatial methods and technologies can be applied to the analysis of issues related to human and environmental health. Since the study and management of the many diverse issues related to human health is one of the most important aspects of human endeavor it is not surprising that it has been a fruitful area for application of geo- spatial analysis tools. Contributions to this book run the gamut of these diverse applications areas from more classical medical geography to the study of infectious disease to environmental health. The tools used in these studies are also diverse– ranging from GIS as a core and unifying technology to geo-spatial statistics and the computer processing of remotely-sensed imagery. This book should prove useful for practitioners and researchers in the health care and allied fields as well as geographers, epidemiologists, demographers, and other academic researchers. Today one sees a continual increase in the power and ease of use of GIS, better integration and easier availability of related technologies, such as remote sensing and global positioning systems and rapidly falling costs of platforms, peripherals, and programs. Thus, one now sees an increasingly large cadre of users of geo-spatial technology in all fields, including health related ones. The methods and examples provided in this work are a starting point for this growing group of users who will find the power of spatial analysis tools and the increasing availability of data sources to enable them to obtain answers and to arrive at solutions to a host of critical health care related issues. The tools and knowledge are readily available and the skills can be developed by any dedicated user; therefore, what direction users of GIS in health related fields choose to take this and related technologies is now primarily limited by their imaginations. Dr. Mark R.Leipnik, Ph.D. Director GIS Laboratory, Texas Research Institute for Environmental Studies, Assistant Professor, Department of Geography and Geology, Sam Houston State University Huntsville, Texas Contents 1. Introduction 1 D.P.Albert, W.M.Gesler, B.Levergood, R.A.Fellers, and J.P.Messina 2. How Spatial Analysis Can be Used in Medical Geography 10 W.M.Gesler and D.P.Albert 3. Geographic Information Systems: Medical Geography 38 D.P.Albert, W.M.Gesler, and P.S.Wittie 4. Geographic Information Systems in Health Services Research 55 D.P.Albert, W.M.Gesler, and R.D.Horner 5. GIS-Aided Environmental Research: Prospects and Pitfalls 77 R.A.Fellers 6. Infectious Disease and GIS 111 D.P.Albert 7. A Historical Perspective on the Development of Remotely Sensed Data as 128 Applied to Medical Geography J.P.Messina and K.A.Crews-Meyer 8. The Integration of Remote Sensing and Medical Geography: Process and 147 Application J.P.Messina and K.A.Crews-Meyer 9. Conclusions 177 D.P.Albert, W.M.Gesler, and B.Levergood Master GIS/RS Bibliographic Resource Guide 178 D.P.Albert, B.Levergood, and C.M.Croner Glossary 200 Subject Index 207 Geographical Index 218 Spatial Analysis, GIS, and Remote Sensing Applications in the Health Sciences Chapter One Introduction Medical geography is a very active subdiscipline of geography which has traditionally focused on the spatial aspects of disease ecology and health care delivery. Until fairly recently, as was the case with most other geographic fields of study, medical geographers collected and analyzed their data using methods such as making on-the- ground observations (e.g., of malarial mosquito habitats) and drawing maps (e.g., of hospital catchment areas) by hand. With the advent of geographic information systems (GIS) and remote sensing (RS) technologies, computers which could handle large amounts of data, and sophisticated spatial analytic software programs, medical geography has been transformed. It is now possible, for example, to make many measurements from far above the earth’s surface and produce dozens of maps of disease and health phenomena in a relatively short time.