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Geographic Information Systems (GIS): Shaping Global Health May 30, 2008 GIS and Infectious Diseases Symposium RIVM Bilthoven, Netherlands Chris Kinabrew, MPH, MSW Public Health Specialist (ESRI) Chris Kinabrew, MPH, MSW • Public Health Specialist with ESRI since Fall 2005 • Graduate of Tulane School of Public Health / Social Work • Graduate of CDC’s Public Health Leadership Institute • Previously Associate Director of a Network of Public Health Nonprofit Research and Practice Institutes in the United States (NNPHI) • Member of American Public Health Association and many other trade/professional organizations • Frequent speaker on GIS and Health 2 Agenda • Overview of GIS – What is it? – Who uses it in public health and healthcare – Basis for GIS in public health • GIS User Community in Health • GIS Applications for Infectious Disease Research, Control and Prevention • GIS Resources Before we get started…a video Using GIS for Assessment and Communication: Estimating the Number of People Displaced by Hurricane Katrina What is GIS? A system for capturing, storing, editing, integrating, managing, displaying, querying, analyzing & distributing geographic data. Answers! Maps Charts Health Data Data layers linked by Geography Road Networks Facilities/Buildings Administrative Units Understand & visualize spatial relationships Reports GIS is Composed of . . . . . Software GIS Staffing Training Data Hardware Applications How does it work: Geocoding an address A street address… for RIVM (administrative data) address matching to a street file Antonie van Leeuwenhoeklaan 9 3721 MA Bilthoven Converts to this… (geographical data) 52.117 degrees latitude 5.192 degrees longitude Geocoding Land Features… The Dam in Amsterdam… (landmark) GPS receiver reading from ground Converts to this… (geographical data) 52.222 degrees latitude 4.534 degrees longitude (A system of geopositioning satellites.) Geocoding weather patterns Hurricane… (weather data) remote sensing technology (instruments and satellite photos) Converts to this… a geographical “shape” GIS allows us to… ask questions about our data Identifying Specific Features Identifying Features Based on Conditions Florida Counties Where more Than 25% of the Population live Below the Poverty Level GIS also facilitates… more complex spatial analysis Map rates of disease Visualize patterns over time Run Models Based on Conditions ESRI User Community in Public Health – Global to Local • UN Agencies & Affiliates …WHO, FAO • European CDC • 86 Ministries of Health • 85% of European Union Member Nations • 50 State Health Departments in US • 500+ Local Health Departments in US • Hundreds of Hospitals • Numerous Health NGOs • Schools of Public Health & Medicine Why do health organizations use GIS? • Enhances knowledge of community health needs and health status – “What is the demographic composition of this community or neighborhood?” – Is this a health professional shortage area? – Are there healthy food stores within walking distance? – Are there health disparities – outcomes, access, etc? • Enhances evidence-based decision making – Where should we prioritize this intervention given limited resources? – Does the population meet the criteria for this program? • Improves quality of data collection and analysis – Is this a representative sample? – Where is our shipment of supplies? Why do health organizations use GIS? • Improves ability to alert, analyze and respond to public health emergencies when geography is relevant – How many vulnerable people live in area X? – How many and what types of assets are available in neighborhood X • Improves workflows and processes that are geo-centric – Where should we pre-position stockpiles? – How can we optimize home health routing • Brings a relevancy to data analysis and information presentation – empowers people to take action – allows rapid evaluations of alternatives How are organizations using GIS in health? Essential Uses Emerging Uses • Disease Surveillance & Tracking • Situational Awareness • Web-based Resource Locators and Atlases • Disaster Response • Field Data Collection • Managing Workforce Logistics • Policy Analysis & Planning (e.g., gap analysis, disparity analysis) • Consumer Empowerment • Environmental Health Monitoring • Vital, Immunization and Disease Registries • Population Health Research • Travel Directions • Disease Management • Back Office Geo-enabling • Health “business” Analysis • I & R Services • Biomedical Applications US National Public Health Performance Standards Specific references and measures for GIS in Essential Service #1 and #2 “Utilization of appropriate methods and technology, such as geographic information systems (GIS), to interpret and communicate data to diverse audiences.” “Tools such as geographic information systems (GIS) are used to combine geography, data, and computer mapping to support the exploration of spatial relationships, patterns, and trends in health data. Use of geocoded data (matching of street address to a corresponding latitude and longitude) is promoted, while maintaining appropriate safeguards for confidentiality. Increased public access to GIS information provides new insights to develop strategies that are appropriate for specific geographic areas and to align health status indicators with health resources.” 2.1.3.1 Does the LPHS use information technology for surveillance activities (e.g., geographic information systems, word processing, spreadsheets, database analysis, and graphics presentation software)? Updated local public health system assessment instrument available at http://www.cdc.gov/od/ocphp/nphpsp/documents/local/Local.BookletA.pd Building GIS Capacity in Local Health Departments “Many GIS-based projects have been successful in supporting public and environmental health practice, including those investigating toxic exposure, vector-borne disease, health information access, and the built environment” Miranda et al., Building Geographic Information System Capacity in Local Health Departments: Lessons from a North Carolina Project, American Journal of Public Health. 2005; Vol 95, No. 12 Video demonstrating ArcGIS: Buffering, Geoprocessing and Spatial Statistics: Pandemic Flu: Prepare or Panic (6:45) GIS and Infectious DiseasesResearch and Applications Pandemic Influenza and GIS GIS facilitates: • Containment • Modeling the Spread • Syndromic Surveillance • Resource Allocation – people, – vaccines / antivirals – ventilators • Situational Awareness • Decision Making during Exercises (e.g., Mass Vaccination) • Identifying Vulnerable Populations Seasonal Influenza and GIS GIS facilitates: • Status maps • Analysis of spreading patterns • Vaccine allocation • Mapping vaccination rates • Planning Vaccination Clinics and Outreach HIV and GIS (and other STIs) GIS Facilitates: • Showing location of services in relation to need (Service Availability Mapping) • access to and gaps in providing: -HIV counselling and testing (VCT) -treatment (ART) and -mother-to-child transmission (PMTCT) services • Accurate surveillance reports through geocoding • More refined knowledge of localized sexually transmitted infection activity • Improved assessment of disease intervention staffing needs • Greater understanding and rationale for targeted prevention efforts Tuberculosis and GIS GIS facilitates: • Identifying areas of TB transmission and incidence • Analyzing access to care and treatment • Network analysis to more efficiently route case workers to home visits (to save time) • PDA/GPS devices used to locate clinic attendees' homes • Performance management – monitoring and evaluation • Kriging …to predict the prevalence of Bovine Tuberculosis… “an excellent tool to predict BTB distribution with major potential savings.” Legionnaire’s and GIS (non-infectious) GIS facilitates: • Outbreak analysis • Tracking movement of patients • In this example, traced to an air scrubber as source • The high velocity, large drift and high humidity may have contributed to the wide spread • GIS very helpful for exposure analysis Vector-Borne Diseases and GIS GIS utilized in the prevention and control of Malaria, Lyme Disease, and many other vector-borne diseases. Sipe and Dale examined literature in 2003 and found major uses of GIS include: • Map incidence and prevalence • Map of relationships between malaria incidence/prevalence and other potentially related variables • Remote Sensing (data collection) • Model malaria risk From ESRI user experience, also see many applications including: • Field Data Collection • Web-based display of data for mosquitoes, sentinels, human cases Animal Disease and GIS • Continued concerns about swine flu, foot and mouth disease, BSE (mad cow), MRSA in pigs and cattle…. GIS facilitates: – Routine field data collection • Outbreak control – quicker access to information about other nearby farms to initiate containment / culling (see http://www.vet.upenn.edu/schoolresources/communications/publications/bellwethe r/61/preventing_pandemic.html • Tracking food from farm to table • Kriging to predict the prevalence of Bovine Tuberculosis… “an excellent tool to predict BTB distribution with major potential savings.” • Increasing connections to human disease surveillance systems, with geography as common identifier Mobile GIS Rapid Needs Assessment • In North Carolina, GIS technology introduced a new methodology for randomization in the selection of households and also simplified the mapping process • Hurricane Response • Legionnaire’s Investigation More recently, Food Recall scenario – According to Steve Ramsey (Preparedness Manager, Guilford County (NC) Department of Public Health), “Utilizing desktop and mobile GIS applications to route our staff to retail establishments, collect data electronically at the point of inspection, and plan for future operational periods, we were able to conduct the most efficient response to a food recall effort in NC.” GIS and Hospitals • Asset tracking and “Geo-fencing” • Bed management • Business intelligence (financials, performance) • ED surveillance / Situational Awareness • Strategic Planning • Site Location Analysis • Outbreak detection and monitoring / Clinical Surveillance Resources for GIS and Public Health ESRI Health User Group • ESRI Health GIS User Community –Listserve for 900+ health professionals worldwide –Recent inquiries include Tuberculosis, Obesity, and several methodology questions –ESRI Health Team has also started networking activities for sub-segments such as state & local health GIS coordinators –Sign up at www.esri.com/hug Health GIS Newsletters and other GIS publications • ESRI Publications – HealthyGIS (quarterly newsletter to 40,000) – ArcUser (240,000) – ArcNews (500,000) Resources: Books from ESRI Press Journals and books from other publishers • International Journal of Health Geographics • Health & Place • Additional book titles (other publishers): • GIS and Public Health (Cromley) • Geographic Information Systems and Health Applications (Khan et al) Health GIS Conferences Proceedings available at http://gis.esri.com/library/userconf/health07/index.html and http://gis.esri.com/library/userconf/proc07/track.html#Heal th%20and%20Human%20Services The Urban and Regional Information Systems Association recently offered its first GIS and Public Health conference www.urisa.org/conferences/health For information about ESRI 2008 Health GIS Conference, please visit www.esri.com/hug Videos demonstrating ArcGIS: Buffering, Geoprocessing and Spatial Statistics: Social Distancing (4:50) Bedankt en tot ziens! Chris Kinabrew, MPH, MSW Meer informatie? [email protected]