Health User Conference Proceedings 2005

Presentations

ESRI Health GIS Conference Proceedings 2005

ESRI's 2005 ESRI International Health GIS Conference Proceedings is a collection of the various presentations and papers delivered October 23–26, 2005, in Chicago, Illinois.

Our users contributed a fundamental part to the conference by submitting and presenting their presentations on a diverse collection of GIS applications. The proceedings promote GIS application by stimulating users to share their experiences and knowledge.

Proceedings

California’s Experience with Implementing GIS to Support Equitable Health Care Accessibility Michael Byrne, Office of Statewide Health Planning and Development

The California Office of Statewide Health Planning and Development (OSHPD) is a state department charged with plan¬ning equitable health care accessibility for California. Recently, OSHPD had approved a feasibility study report for implementing an enterprise GIS. This paper will describe OSHPD’s process for implementing enterprise GIS and articulate the business process GIS will support. It will further demonstrate the suite of applica¬tions OSHPD will push to internal and external clients. Finally, we will describe our future goals and direction for enterprise GIS activities.

County Health Department Improves Septic System Management Using GIS Bob Brems, Zanesville/Muskingum County Health Department

Septic systems are utilized extensively in rural areas of Muskingum County, Ohio, to manage wastewater from house¬holds that do not have the option of connecting to a municipal system. Muskingum County has more than 10,500 existing sys¬tems, and more than 300 new systems are installed each year. To better manage alterations to existing systems and construc¬tion of new ones, a GIS was implemented. Utilizing an existing Microsoft Access dataset of septic system information and spa¬tial data generated by the Muskingum County GIS department, all septic system locations were geocoded using ArcGIS 9. Now, utilizing parcel information, soil composition, and land contours, sanitarians are able to perform preliminary septic system reviews in minutes and eliminate the need to review printed parcel maps located in another building and usually at least one site visit. The resulting map was made accessible to all sanitarians on the computer network using ArcGIS Publisher.

Creating GIS-Based Cancer Density Maps for Trabzon Province of Turkey Ebru Colak, KTU GISLab, Karadeniz Technical University

In Turkey, the prevalence of cancer cases increased, and cancer was ranked as the second highest cause of death. Therefore, forming a cancer control program and putting strategic action plans into practice became important matters for the health industry. The correlation of variations in different societies and environmental factors should be examined spatially with reliable data. To do this, cancer occurrence density maps have to be created. In this study, a database was built with the use of GIS to examine the distribution of cancer cases, and maps relating to cancer events in allocation units were created. Cancer cases data registered in 2004 by the Cancer Struggle Department of Health Directorate of Trabzon Province of Turkey was used. Using ArcGIS, the distribution of cancer cases was presented on cancer maps including allocation units and incidence values, which were calculated for each town-based region. According to the world standards, cancer rates were determined and examined by the spatial analysis power of GIS.

DecisionTree^® and Childhood Lead Poisoning Bradley Breuer, Avencia Incorporated

This paper discusses the feasibility and utility of web-based software tools for the geographic assessment of lead poisoning risk in residential neighborhoods. It discusses how the DecisionTree^® technology can be leveraged to better advance lead abatement and lead poisoning prevention priorities. With declining public health funds for lead abatement and lead poisoning prevention, it is increasingly important to allocate these scarce resources for maximum effect by prioritizing public health expenditures toward particular neighborhoods, blocks and individual homes. Lead poisoning is a phenomenon displaying a great deal of geographic concentration and our research has suggested several risk factors that can be both mapped at a high resolution and combined into a risk assessment model that will assist public health officials with prioritization of resources, tracking of abatement efforts, and measurement of outcomes.

The technologies discussed represent a major innovation in controlling and eradicating the lead epidemic in America. We believe that developing software which executes sophisticated spatial models over the internet and produces output for non-technical end-users holds enormous potential for tracking, cataloguing, measuring, and predicting the lead epidemic in American cities. Furthermore, we believe these tools will have wide applicability to other environmental health concerns and will enable the development of a framework for geographically sensitive public health analysis.

Estimating Asthma Prevalence Rates in the United States Yvonne Palm, Grinnell College

Objective: The purpose of this research is to develop models to predict asthma prevalence rates in the United States and identify areas in need of intervention by the Environmental Protection Agency.

Abstract: This project incorporates geospatial demographics with National Health Interview Survey (NHIS) responses to pro¬duce models that estimate asthma prevalence rates at the cen¬sus tract and county levels. Three of the resulting models based on small area analysis and logistic regression are compared. These models’ predictions are then compared to selected sample county data from the Centers for Disease Control’s Behavioral Risk Factor Surveillance System (BRFSS) in an attempt to supply better localized estimates of the asthma epidemic. Finally, the differences between the model predictions and the BRFSS data are compared to environmental pollutants of concern across the country to identify areas where intervention may be successful.

Generating Synthetic Populations Using Public Use Microdata Bill Wheaton, RTI International

Agent-based models, including those developed to model infec¬tious diseases, require realistic populations of individual agents (people) to function. Since there is no existing database of indi¬viduals suitable for use in these models, a number of researchers have developed methods for generating synthetic populations in which the individual agents created reflect the characteristics of the population for a given study area as a whole. This paper will present an overview of the various methods proposed by scientists working on synthetic population research and will then describe the particular method RTI uses to create a national synthetic population for the United States for the MIDAS project. RTI’s method uses nationwide block group boundaries and Public Use Microdata (PUMS) data. The process results in spatially referenced synthetic populations where housing density matches census data at the block group level and household structure, demographic, and occupation data match SF3 counts at the county level.

Geographic Clustering of Obesity, Diabetes, and Hypertension in Nashville, Tennessee Dr. David G. Schlundt, Vanderbilt University

Introduction: Obesity, diabetes, and hypertension threaten the health of communities.

Purpose: To describe and map the spatial clustering of obesity, diabetes, and hypertension in Nashville, Tennessee.

Method: Data from two random community phone surveys was geocoded and combined into a single dataset. Data was aggregated by census tract, and those tracts with 10 or more interviews (129 of 144, 7,606 cases) were included.

Results: Obesity, hypertension, and diabetes prevalence in the 129 census tracts showed clear geographic clustering when mapped using GIS software. Linear regression analysis shows that spatial distribution of risk factors clusters with diabetes, hypertension, and obesity prevalence. Geographic clusters were similar for the health access, health behaviors, neighborhood safety, demographics, socioeconomic status, and neighborhood contextual measures obtained from census data.

Conclusion: Analysis of geographic clustering can be used to identify high-risk neighborhoods and may be useful in planning and targeting public health interventions.

Geographic Masking and Interpretation: Health Providers’ Proximity to Patients Jennifer Ferrell, University of Louisville

The focus of this paper is to investigate patients in Jefferson County, Kentucky, who suffer from cardiopulmonary conditions and examine the relationship of correlations between median income and geographic locations. The growing interest in health care statistics has raised numerous issues of patients’ privacy. In accordance with HIPAA, the data for this study has to be masked for confidentiality. This study examines the identifica¬tion of procedures that preserve the confidentiality of individual records and the geographic properties of the data. By using geographic masking techniques, it is possible to gain geographic insight while protecting patients’ confidentiality. The application of random perturbation, in which each point is displaced by a randomly determined amount and in a randomly determined direction, best fits this study. The masking was performed using the statistical software package, SAS, along with the SAS Bridge for ESRI that was developed jointly by SAS Institute, Inc., and ESRI.

GIS Analysis for Structural Changes in Public Health System Dr. Michael Vit, Czech Ministry of Health

Two years ago legislation was implemented in the Czech public health system that separated public health state administration, state health supervision (SHS), and the expert service provided by hygiene service (HS). The former system was a mixture of these activities.

The main goal of the structural change was the standardization of SHS. The input data was obtained from routinely collected annual reports of the Czech Ministry of Health from the year 2001 (efficiency of laboratory activities, regional HS economic activities, number of supervised subjects, etc.) and the population data from Census 2001.

GIS was chosen to be a proper tool for the analysis of hygiene service requirements in relation to the geographical distribution.

The results of the GIS analysis were successfully used to support negotiations in the legislation process in both chambers of the Czech Parliament.

GIS for Integrated Pest Management Christina Hailey, Harris County Public Health and Environmental Services

At its formation in 1965, Harris County Mosquito Control, located in Houston, Texas, (HCMC) was primarily involved in the prevention and control of mosquito-borne diseases, in particular SLE. With the introduction of West Nile virus (WNV) into the United States in 1999 and its eventual spread to Harris County in 2002, WNV quickly became another important disease concern.

To address these issues, HCMC incorporated integrated pest management (IPM). Key components of IPM include mosquito/bird surveillance, geographic information systems (GIS) technology, insecticide resistance management, innovative applied research, and educational outreach. These components directly enhanced resource management for disease prevention and control activities.

HCMC has incorporated GIS applications such as ArcGIS and ArcPad. An ArcIMS application is being created for increased mapping capability in the field and increased public participation.

Health Effects Near USEPA Toxic Release Inventory (TRI) Sites Allan C. Harris, Harris-Brown & Associates

This study uses remote sensing and GIS technology with visualiza¬tion algorithms for an innovative Land-Use/Land-Cover (LU/LC) computer model of the 2004-2005 U.S. EPA Environmental Justice Action Plans. The LU/LC computer model compares/analyzes environmental health effects near toxic release sites with geographic, demographic, and socioeconomic data from the U.S. Census 2000 and Community Sourcebook•America data from ESRI. This presentation extends former President Clinton’s February 1994 Executive Order 12898 on Environmental Justice, the revised U.S. Environmental Protection Agency Environmental Justice Action Plans, the American Society for Testing and Materials (ASTM) Phase I Environmental Site Assessment require¬ments, and the United States Geological Survey (USGS) LU/LC classification system created to be used with satellite data.

Health GIS in CORE Group Nepal Kabindra Joshi, CARE International In Nepal

This paper is about the implementation of GIS as one of the monitoring and documentation making tools. CORE imple¬mented GIS as a spatial decision-making tool in late 2003. With limited resources we are also able to manage health GIS by providing training, technical help, and support to various partner organizations. With GPS and GIS, various analyses of health service adequacy and accessibility mapping were performed. Linking the tabular database with spatial data and classifying according to needs have attracted health professionals, and information is well conveyed through such visual means. Hence, CORE partners are strongly motivated to apply it. Various organizations have encouraged the CORE group to expand this technology in health as well as other sectors. The paper will give a scenario on how health GIS has been effective in the districts where CORE has implemented it.

The Integration of Urban Form and Public Health Neal Rosenblatt, MS, Kentucky Department of Health and Family Services: The Built Environment

Using Feedback in Designing an Environmental Health Information Mapping System Dr Colette Hochstein, National Library of Medicine

TOXMAP (http://toxmap.nlm.nih.gov) uses maps of the United States to help users visually explore data from the U.S. Environmental Protection Agency’s (EPA) Toxics Release Inventory (TRI). This session will discuss how feedback was used to improve TOXMAP by enhancing its usability and by keeping its presentation of environmental health data readable and understandable. Maps are a powerful way of visualizing data, but presenting geospatial data to users can be complex. To guide us in approaching this challenge, we collected feedback from potential users via a series of focus group sessions, both Web- and non-Web-based, and professionally and nonprofes¬sionally moderated. This session will discuss the advantages and disadvantages of these approaches including associated use of “mock-ups,” Web-based exercises, and follow-up processes. Focus groups have been a critical tool in assessing the strengths and weaknesses of this resource. Feedback received on future datasets is now guiding key next steps for TOXMAP.

Using GIS to Impact Federal Health Policy Decision Making Michael Shambaugh-Miller, University of Nebraska Medical Center

Over the last decade, the role of geography and GIS has expanded inside and outside the halls of the federal government as decision makers have come to realize the power of location based information. Researchers in health policy and health services research have begun to use the power of GIS to their advantage when pressing for relevant rural health policies. One of the leading agencies funding this research has been the Federal Office of Rural Health Policy through its Centers for Rural Health Research. This presentation will cover a few of the leading projects in which the centers have used GIS to help change or mold current federal health policy, including the 2004 Medicare Prescription Drug Program, with regard to rural America.