Applications of GIS Technology in Professional Health

1. Applications of GIS Technology in Professional Health Christian Connections for International Health Annual Conference, May 27 – 29, 2006 Scott A. Todd

2. What is GIS (Geographic Information System) • Geographic Maps • Information Database • System Hardware, Software, Data, People, Plans/Programs GIS combines the intuitive visual clarity of a map together with the information structuring, searching and analyzing power of a database.

3. What is not GIS:GPS - The Global Positioning System A GPS receiver is a tool used for data collection, determining your position on the earth, or wayfinding GPS coordinates can be a type of data input for a Geographic Information System

4. Data – The Main Ingredient How GIS Works. . . Features, Attributes & Operations • Vector – points, lines, polygons (areas) • Raster – images (aerial photos), grids • Tabular – databases, spreadsheets

5. Features (Vector data) • Points – Village, Facility, Household, Patient • Lines – Roads, Rivers, Utility Line • Polygons –Parcel, Census Tract, Service Area

6. Attributes (Tabular Data) • Events/Objects – Village name, Facility type, Household size, Patient condition • Route/Network – Road capacity, River name, Sewer main size, Boundary length • Area/Region – Parcel size (Acres), Demographics, Service Area (number of patients)

7. Operations - Geoprocessing • Data Integration – Collection, Conversion, Rectification, Correlation/Confirmation • Management – Data update/maintenance, Joining w/ other databases, Merge data sets • Analysis – Selection/Extraction, Proximity, Distribution, Relationships, Overlay, Change/Trends • Reporting – Printed Maps, Tabular Reports

8. So What . . . • A Geographic Information System is not just a fancy tool for making attractive, detailed maps. • GIS provides a dynamic visual representation of the information contained in a database, along with the power to query and manage the database. • GIS tools support the creation and integration of various kinds of data sets to analyze and better understand existing patterns, distributions and relationships between features. • GIS analysis can generate new data to support clearer insight and communication for needs assessment, decision making for strategic planning and data management for implementation, monitoring and evaluation of programs and initiatives.

10. Who Uses GIS • Libraries and Museums • Location Services • Logistics • Marine, Coast and Oceans • Marketing • Media • Mining and Earth Sciences • Natural Resources • Petroleum • Real Estate • Retail Business • Telecommunications • Transportation • Universities • Water and Wastewater • Weather • Archaeology • Agriculture • Banking • Defense and Intelligence • Education • Electric and Gas • Engineering • Fire/EMS/Disaster/Homeland Security • Forestry • Government (Federal, State, County, Local) • Health and Human Services • Insurance • Landscape Architecture • Law Enforcement and Criminal Justice Source: Environmental Systems Research Institute – Geography Matters, White Paper, 2002

11. Health Geography It is useful to divide the geography of health into two interrelated areas: • The geography of disease, which covers the exploration, description and modelling of the spatio-temporal (space-time) incidence of disease and related environmental phenomena, the detection and analysis of disease clusters and patterns, causality analysis and the generation of new disease hypotheses; • The geography of healthcare systems, which deals with the planning, management and delivery of suitable health services (ensuring among other things adequate patient access) after determining healthcare needs of the target community and service catchment zones. Source: Boulos, Kamel MN - Geographic Informatics in Health, School for Health, University of BathBath BA2 7AY, UK

12. GIS Health Software Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

13. WHO: HealthMapper • About HealthMapper: • Original version 1993 by World Health Organization • Supports range of infectious diseases in over 60 countries • Public Health Needs Capable of Addressing: • Analysis of disease outbreaks, chronic diseases, injuries • Limited Management of distribution of health resources • Software is Free • Data Format Support: • Import and modify shapefiles • Import and Link: Excel, Access, dBase, .CSV, .REC (EpiInfo) • System Requirements:Windows (98/NT/2000/Me/XP) Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

14. WHO: HealthMapper • Advantages: • Free: can be downloaded from WHO website • Very useful in supporting health surveillance, disease prevention and control • Disadvantages: • Limited complex statistical capabilities • Data not provided with software • Publicly funded programs • Limited Technical support Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

15. EpiInfo / EpiMap • About EpiInfo / EpiMap: • Created by the Centers for Disease Control (CDC), in 1985 • Latest Version: Epi Info™ Version 3.3.2, released Feb 2005 • Over 1,000,000 downloads in 180 countries • Public Health Needs Capable of Addressing: • Meets most needs in epidemiological studies, such as disease outbreaks or other public health analysis • Software is Free • Data Format Support: • Import and modify shapefiles • Compatible with ESRI ArcView, MS Access, Excel, dBase, CSV, XML • System Requirements:(Windows 95/NT/98/2000/Me/XP) Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

16. CDC: EpiInfo/EpiMap • Advantages of EpiInfo: • Meets most needs in epidemiological studies • Free, can be downloaded from CDC WebPages • With a little computer experience can do simple useful analysis • Disadvantages of EpiInfo: • Lacks statistical spatial data analysis • EpiInfo and EpiMap are two stand-alone programs • Data not provided with software • Publicly funded programs • Limited Technical support - reference to available manual Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

17. SIGEpi About SIGEpi: • Developed by Pan American Health Organization (PAHO), latest version 1.4 • Supports Multi-languages (Spanish and Portuguese) Public Health Needs Capable of Addressing: • Provides complex analysis methods for health data • Management of distribution of health resources Data Format Support: • Reads and processes files in Shapefile and ArcInfo coverage formats from ESRI; other formats include Vector Product Format (VPF); CAD and EpiMap • SIGEpi has RDBMS that use MS Access and interchange in other formats (Dbase, Excel, Btrieve, EpiInfo) System Requirements:Windows (98/NT/2000/Me/XP) Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

18. SIGEpi • Price: • Health and Academic Institutions ($100) • Non-Profit Agencies ($500) • Personal and Private Agencies ($1,000) • Advantages: • Offers a broad GIS platform with functions for statistical spatial data analysis integrated into the program • Creates geographical layers based on geographic data from GPS receivers • SIGEpi was built based on ESRI’s MapObjects • Disadvantages: • It has limitations in editing geographic databases • Maintenance & Technical support via Discussion forum or emails or reporting errors or recommendations Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

19. ESRI: ArcGIS • About ESRI ArcGIS: • Company started in 1969, founded by Jack and Laura Dangermond, privately held company • ArcView® 1.0 released in 1992 • Public Health Needs Capable of Addressing: • Analysis of disease outbreaks, chronic diseases, injuries • Management of distribution of health resources • Data Format Support: • Direct read and import capabilities of more than 70 different formats, including rasters (images) and ODBC • Import, edit, and export of shape files • Price:Single user license $1500 • Annual Maintenance:$500 to $3,000 • System Requirements:Windows (98/NT/2000/Me/XP) Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

20. ESRI: ArcGIS • Technical Assistance: • Free for initial year of purchase • Advantages: • Industry leader in Public health sector • Many extensions built on ArcGIS • Base data provided with software • Software is scalable • Custom Scripting Capabilities - in VB, C++, .NET • Disadvantages: • Expensive application and maintenance package • Not specifically oriented toward Health Applications • Need to have hands-on experience or extensive training Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

21. Data Formats • Each offers Free Online Training Manuals • Each product offers Data format support for: • Shapefiles (.SHP) • Excel • .CSV • MS Access • dBase • .REC • Each product can read data from a GPS Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

22. Comparison Matrix Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

23. The Future of GIS in Health • HealthQuery: An online healthcare services/access application. • Collaborative project of Good Hope Medical Foundation, California Department of Health Services — Centre for Health Statistics, the National Health Foundation (NHF), ESRI, Oracle and Sun Microsystems • This figure shows a search for the nearest hospitals within a 5-mile radius around 92373 (Zip code, CA, US). • HealthQuery found 4 locations. Source: Boulos, Kamel MN - Geographic Informatics in Health, School for Health, University of BathBath BA2 7AY, UK

24. GIS Demonstration

25. Sources: Contact: • Alsahhar, Belew, Getachew, McElroy - GIS in Public Health University of Dallas, Oct 2005 • Boulos, Kamel MN - Geographic Informatics in Health School for Health, University of Bath, Bath BA2 7AY, UK • Scott A Todd scott@gmi.org 610-617-0195 • Global Mapping International 15435 Glen Eagle Drive, Suite 100 Colorado Springs, CO 80921 USA info@gmi.org