GIS and Public Health 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 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= 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!.