Agenda. What can GIS do? Use of Geographical Information Systems (GIS) in Health Care. What is Geographical Information Systems (GIS)?

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For: Presenter: Use of Geographical Information Systems (GIS) in Health Care Center for Global Development Naoru Koizumi, PhD, Assistant Professor School of Public Policy, George Mason University Agenda GIS overview Examples of GIS applications in Health and Other Sectors Amit Patel, PhD Candidate A success application of GIS to a health project in India UN Population Fund (UNPF) funded project Not too much GIS applications so far in development projects Any potential collaborations? What is Geographical Information Systems (GIS)? GIS is a information system that captures, stores, manages, presents, and analyzes data that is linked to location. Capturing geographical data GPS (lon/lat), Remote sensing (satellite images) Storing and managing geographical data Databases (e.g.,.dbf /.mdb formatted) Presenting and analyzing geographical data Mapping software and its extensions First GIS: Canadian GIS by Roger Tomlinson (British) of the Department of Energy, Mines, and Resources. ArcView by ESRI is currently the leading GIS software What can GIS do? Can create a fancy map ( spatial data visualization ) by overlaying multiple features by mapping lon/lat (x/y) or addresses ( geocoding ) by showing a trend over time and create a movie ( Tracking Analyst extension) by showing 3D view with rotation ( 3D Analyst extension) Can be used to do advanced spatial statistical analysis (w. potential collaboration with academia) Can be used to develop policies involving spatial issues (infectious disease, location decisions, transportation, etc.)

United Kingdom Brazil Italy Japan China Overlaying Multiple Features Mapping Lon/Lat, Address Data Thematic Map: A map with multiple features Choropleth Map: A map with different features (e.g., pop density, pollution level, etc.) that are colored or patterned in proportion to their sizes. Use of US census file Legend Water Bldg Park Road Display X/Y Data Geocoding Embassies on Mass Ave. in DC) Downloading Tiger files from census/esri websites and create Address Locator Use of SAS and other GIS software Korea Tracking Analyst Creating a movie with trend data Point data for a time period Spread of diseases (e.g., flu, small pox, FMD) Spread of service users (e.g., peapods, pesticide) Polygon data for a time period Change in supply/demand per region, state, etc. (e.g., energy, tobacco sales) FMD, UK 3D Analyst Creating a 3D map based on elevation/height data Map in the ArcScene (or ArcGlobe) platform Extruding based on Building height Land elevation (flooding) Any numerical attribute (pollution) Surface creation Smoothing by spatial interpolation PCB, Pontypool, UK

in Business Healthcare Provider Quality: OMH, Philadelphia, PA Visualization is a great advantage from GIS to make reporting intuitive A picture is worth 1000 words...(ex. Republican vs. Democrat states) Overlays can sometimes reveal several hidden answers Philadelphia mental health outpatient services Hurricane Katrina Outpatient services for mental health ( ( patients in ( Philadelphia, PA ( ( ( ( Does the service ( ( ( ( ( quality correlate to the neighborhood ( ( ( ( ( ( graphics? ( ( ( - Income? Philadelphia, PA Healthcare Providers - Race composition? Hurricane Katrina (Cat 5) Aug-05 Did Media Exaggerate??? Did minority suffer more? We must... come to terms with the ugly truth that skin color, age and economics played a deadly role in who survived and who did not. (Howard Dean, chairman of the Democratic Party) To Me, It Just Seems like Black People are Marked. (Wil Haygood of The Wash Post) So poor, so black (Wolf Blitzer of CNN) 5,000 African Americans perishing. (Jesse Jackson)

Evolving Features in ArcGIS More Spatial Modeling and Analysis in ArcGIS Area data analysis, spatial regressions Space time analysis (STAR model) Simulations Integration to google map / remote sensing image analysis Data sharing and formatting ( Open GIS ) Spatial Statistical Analysis with GIS Point data analysis Clustering / hot-spot analysis K-function analysis Continuous (surface) data analysis Spatial interpolation Kriging Network analysis Correlating traffic volume and air quality, etc. Plume model Simulation with area or point data Forecasting / prediction based on space-time data STAR model Analysis of Point Data Analysis of Point Data Identifying Clustering: K-function Analysis ( ( ( ( (( ( ( ( ( ( ( ( (( ( (( (( ( ( ( ( ( (( ( ( ( ( ( ( ( ( ( ( ( ( ((( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( HOT SPOT FOR ( ( ( ( ( ( C (( (( ( ( ( ( ( ( ( ( ( LARYNX CANCER? ( ( ( ( Lung Larynx Lung and Larynx cancer in Lancashire, England Identifying Clustering: K-function Analysis Where do we see unusual clustering of Larynx cancer events? # C Smoothing (Spatial Analyst Tool => Spatial Interpolation using the p- values

Analysis of Point Data: Outpatient Service Use Intensity of Service Use and provider locations Concentration of African American Census Population Analysis of Network Data Hot Spot Analysis of Pneumonia Cases Traffic Volume in VA Block level analysis Analysis controlling for: Race, Age, HIV Potential hot spot in certain areas in Philadelphia Philadelphia Area Pneumonia Cases Analysis of Continuous Data G Venice Study by Gambolati and Volpi (1979): Kriging Industry Data: 40 borehole measurements of the water table level (relative to sea level) around Venice area in 1973. Hypothesis: There was a suspicion that overuse of groundwater by industry is causing water table to go down (and sinking Venice) Geostatistical Analyst: Ordinary Kriging Analysis of Network Data Shenandoah Air Pollution Project: Plume model Data Traffic Volume in VA Data Traffic volume data Sample air quality data Health data: respiratory, cardio vascular Policy Scenario Analysis Traffic restriction (tracks) Promoting green cars Idling

Simulation of Point Data Foot-and-Mouth Disease Outbreak in England 2001 Space-time K-fn analysis Kernel function analysis Control Mechanism Custom control ( prevention ) Vaccine Slaughtering Some regulation (traffic/import restriction, etc.) (STAR analysis is still evolving in academia) Simulation of Areal Data STAR Analysis of Tobacco Sales: Measuring the effectiveness of various tobacco policies using space-time regression Proximity to tobacco states. Policies at neighboring states Simulating the impact of various tobacco policies based on the STAR model results. Tobacco sales (# packs/person) per state 1983 2003 Other GIS Projects STD Spread Military base project (VDH, DoD) Gas station geocoding projects (Census Bureau, DOE, NGA) Antimicrobial resistance spread and agricultural use of antibiotics (USDA) Organ allocation project (NIH) Thank you Q& A / Discussion?