How Usable are Current GIS Maps?: Communicating Emergency Preparedness to Urban Populations

Transcription

1 How Usable are Current GIS Maps?: Communicating Emergency Preparedness to Urban Populations Christina Zarcadoolas PhD, Jennefer Boyer MPH, Arthi Krishnaswami MA, Andrea Rothenberg, MS, LCSW Mount Sinai School of Medicine New York City

2 Growing GIS Presenting population, risk, epidemiologic and myriad other data to scientists, policy makers and planners. Analyzing and presenting health and emergency information at the global, federal and state levels (ATSDR, 1998; CDC, 2000, 2006; WHO, 2006; NLM, 2006; FEMA, 2005; CA Nutrition, 2006) % of all government databases, including public health, contain geo-referenced information (Cheves & Wang, 2004).

3 GIS for Lay Publics Becoming a common way of communicating information to lay publics (FEMA, 2005; NYOEM, 2006; Florida 2006). CDC s GATHER tool (Geographic Analysis Tool for Health & Environmental Research) - provides the public health community and general public access to spatial data that is pertinent to the analysis and exploration of public health issues.

4 FEMA high hope for GIS GIS is a very useful tool for many aspects of emergency management, including: emergency response, planning, exercises, mitigation, homeland security and national preparedness. The current trend in GIS is on web-based mapping. This capability can allow users to view an already created map or create maps, based on their own specifications, on their personal computers. Webbased mapping is expected to widely expand the use of GIS in the workplace, in schools, and in homes. (

5 Public Understanding and Use Despite the growing popularity of GIS as a tool in public health there is very little research done on the ability of the lay public s and low literate people s abilities to read and use GIS data as it is presently being displayed to them.

6 Approximately half of the adults in the US read at 8 th grade level and lower. Half of adults have Low Health Literacy. (NAALS, 1993 & NAL, 2003)

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10 Post Katrina national focus on flood emergencies The NY Office of Emergency Preparedness released the New York City Coastal Storm Plan (CSP) to the public as Ready New York: Hurricanes and New York City Aug-Sept ( uide.shtml). The brochure + web, mailed to all residents living in designated hurricane evacuation zones in NYC. Large, fold-out map indicating areas designated hurricane evacuation zones, degree of hazard of zone, and where the evacuation centers are located.

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14 Harlem Demographics 18% of East and Central Harlem residents are not proficient in English (NYC Dept Planning). Other languages - 82% speak Spanish (Healthy Harlem, 2006). Literacy Very Low - 46% of East Harlem residents and 33.5% of Central Harlem residents have not graduated high school. 38.2% live in poverty.

15 Harlem Environmental hazards, two sewage treatment plants, brownfields, six out of seven of Manhattan s diesel bus depots and home-based exposures percent children in central Harlem have asthma - double expected rate and one of highest ever documented for American neighborhood. 1996,Central Harlem had the highest crude death rate of 14.1 per 1,000 population compared to a citywide rate of 9.1 per 1,000. East Harlem tops the city in childhood asthma hospitalizations, with hospitalizations per 10,000 population for children aged 0-14 in the year 2000, compared to a citywide average of 64 per 10,000, and a national average of 33.6 childhood asthma hospitalizations per 10,000 people

16 Methods (Aug-Sept 2006) Street-readable sized version of the CSP Hurricane Evacuation Zone map. Cross-sectional - face-to-face interviews. Opportunistic/random sampling - various locations throughout East and Central Harlem Age 18 years or older. Total of 178 residents (134 English-speaking, 44 Spanish-speaking). Interviewers were trained ethnographers, supervised by a sociolinguist specializing in health literacy.

17 Questions Current knowledge, attitudes, and preparedness with emergency situations. 40% (n=72) had not graduated high school, a number very representative of the U.S. Census statistics that maintain 39% of East and Central Harlem adults have not graduated high school (New York City Department of City Planning, 2006).

18 Harlem Study Aug-Sept Surveyed 178 residents, aged 18+ (134 English-speaking, 44 Spanish-speaking). 83% of less-educated participants could not correctly identify which evacuation zone they lived in. High School or higher: 9.4 times more likely to be able to correctly identify their zone. 83% of less-educated said they did not know how to get to the evacuation center closest to their home. 46% of adults in E. Harlem have not completed High School. Thousands at risk.

19 Study Results 83% of less-educated participants (based on telling us where they lived) could not correctly identify which evacuation zone they lived in. (Those who had completed high school are 9.4 times more likely to be able to correctly identify their zone.) 83% of those with less education reported that they did not know how to get to the evacuation center closest to their home. HS or some/college - 48% said they did not know how to get to the closest evacuation center. Even before residents determined that the map was not clear and decipherable, 40% said they do not (somewhat/a little/not at all) trust emergency directions from city officials.

20 Findings Map is not readable and usable by a significant portion of the Harlem community. Vast majority of residents who had not completed HS could not correctly determine: if they lived in a hurricane evacuation zone which zone the correct location of the nearest Hurricane Evacuation Center 40% of those who had not graduated high school could not use the map to locate where they lived After adjusting for education, the other variables (age, sex, language, and length of time living in NYC) were not found to be significant.

21 Ability to Answer Questions Correctly while Looking at GIS Map (based on education level) Question Level of Education Incorrect n (%) Correct n (%) OR (CI)* Can you point to where you live? Low Ed 29 (40.3) 43 (59.7) 5.65 (2.58, 12.35) High Ed 11 (10.7) 92 (89.3) 1.0 Judging from these maps, do you live in a hurricane Low Ed 51 (73.9) 18 (26.1) 6.58 (3.32, 12.99) evacuation zone? High Ed 31 (30.1) 72 (69.9) 1.0 What zone do you live in? Low Ed 57 (82.6) 12 (17.4) 9.35 (4.44, 19.61) High Ed 34 (33.7) 67 (66.3) 1.0 Which hurricane evacuation center is closest to your Low Ed 46 (65.7) 24 (34.3) 5.32 (2.75, 10.31) home? High Ed 27 (26.5) 75 (73.5) 1.0 Do you know how to get there? Low Ed 57 (82.6) 12 (17.4) 5.15 (2.46, 10.75) High Ed 47 (48.0) 51 (52.0) 1.0 Low Ed = Less than High School; High Ed = At least High School graduate / GED *OR = Odds Ratio; CI = 95% Confidence Interval

22 Discussion

23 What makes GIS maps hard to read and use? Fundamental Literacy Vocabulary, phrases Numbers Science, civic and cultural literacies Visual topography The grammar of maps color, legends, physical orientation Connecting language and visuals

24 Elements of Complexity Color Typography Architecture/Layout Language Health and Environmental Literacy Load

25 What questions do you want your map to answer (functions) Is it reporting information (data) or is it asking people to analyze the data? Report/record What is it you re telling me? What is this before me? What do you want me to understand? What do you want me to do about/with it?

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27 Titles of Maps make an art form of understatement Scientific Literacy highly deleted, compact, brief, nonnarrative language. Lead Exposure Risk Asthma Hospitalization Rates by Zip Code

28 Readers comprehend better when they can anticipate/frame Advance Organizer Get ready to read about Phrase + Advance Organizer

29 Clarify the declarative and propositional statements in a map When asthma is serious, children go to the hospital. This map shows where children are going to the hospital most because of asthma. This map uses zip codes to chunk communities. This map shows that many more children from Northern Manhattan are going to the hospital every year. This map shows where the polluters are bus depots, transfer stations, sewage treatment plants. Most of the polluters are in Northern Manhattan

30 Connecting the dots for readers: synthesizing More children in Northern Manhattan have asthma than anywhere else in NYC. Northern Manhattan has more than its fair share of polluters. Pollution is causing high rates of children s asthma in Northern Manhattan. What can be done?

31 Needed Research What is the linguistic and design structure of complexity in GIS information for vulnerable populations (low literate/low SES/ethnic minorities)? What does usability testing of GIS maps with low literate adults tell us about how GIS presentations can be adapted for greater readability and usability among the target audience? What are optimal templates for designing GIS maps to advance the use of these maps among low literate populations? What are best practice guidelines in writing, designing and using GIS map information with general and low literate publics?

32 Using GIS s potential and surmounting its flaws Good planning Appropriation of resources Careful goal setting by communicators/educators Incorporating Health Literacy principles Health/Environmental Literacy Incorporate Information Design principles

33 Indigenous knowledge use of local knowledge

34 Creating information that is matched to the health literacy needs of your population Identify the complexity/opportunity via an elaborated model of health literacy Collaborate with target audience collaborative GIS mapping Revise and simplify (appropriately) Contextualize Reinforce Evaluate and be ready to revise again

35 Conduct Health Literacy Load Analysis What does the material/message assume/require of the patient? Fundamental literacy Science literacy Civic literacy Cultural literacy

36 There is no civil ( and safe) society if we do not communicate and do so effectively. There is no capacity for social justice without communication.